1. Types of Movement

2. Types of Movement
By: Dr. M. Abbas Jamil

3. Types:
Active Movement
Passive Movement

4. Active Movement
Movement performed within the unrestricted ROM controlled by the voluntary contraction of the muscle is called active movement.

5. Active movements are "actively" performed by the patient's voluntary muscles and have their own special value in that they combine tests of joint range, control, muscle power, and the patient's willingness to perform the movement. These movements are sometimes referred to as physiological movements. The end of active movement is sometimes referred to as the physiological barrier.

6. Classification of Active Movements:
Voluntary movement
Involuntary movement

7. Voluntary Movement Free exercises Assisted exercises
Assisted-resisted exercises
Resisted exercises

8. Involuntary Movement
Reflex Movement

9. Passive Movement:
Movement performed within the unrestricted ROM produced by an external force, during which there is little or no voluntary muscular contraction is called passive movement.
External force may be a gravity, machine or physical therapist.

10. These movements may also be referred to as anatomical movements.
The end of passive movement is sometimes referred to as the anatomical barrier.

11. Classification of Passive Movement
Relaxed Passive Movements
Passive Manual Mobilization Techniques

12. Assessment: Pain in Movement Rhythm of Movement Abnormality
Timing in Movement
Pattern of Movement

13. Pain in Movement:
Therapist should note which movements, if any, cause pain or other symptoms and the amount and quality of pain that results. For example, small, unguarded movements causing intense pain indicate an acute, irritable joint. If the condition is very irritable or acute, it may not be possible to elicit all the movements desired.

14. Rhythm of Movement
Recurrence of a sequence of events is called rhythm.
Each movement has its own natural rhythm. Natural rhythm varies with age.
Rhythm of children’s movements being relatively quick as compared with that of adults while that of elderly is slower. Rhythmical movement taken too slowly or too quickly result in faulty timing and loss of efficiency.

15. Example:
Inspiratory muscles and heart muscle contract rhythmically, their period of contraction alternating with period of relaxation.

16. Therapist should note the rhythm of movement along with any pain, limitation) or trick movements that occur.
Trick movements are modified movements that the patient consciously or unconsciously uses to accomplish what the examiner has asked the patient to do. For example, in the presence of deltoid paralysis, if the examiner asks the patient to abduct the arm, the patient can accomplish this movement by laterally rotating the shoulder and using the biceps muscle to abduct the arm.

17. Abnormality:
Active movement may be abnormal for several reasons and the examiner must try to differentiate the cause.
Pain is a common cause for abnormal movement as is muscle weakness, paralysis or spasm.

18. Timing in movement:
Sequence of muscular contraction which takes place in the production of movement.
To produce an effective movement, force of each contraction is timed so that it is at its maximum.

19. Pattern of Movement:
Site and direction of movement are described as its pattern of movement.
When testing active movements, the examiner should note where in the arc of movement the symptoms occur.
For example, pain occurs during abduction of the shoulder between 60 and 120 degrees if there is impingement under the acromion process or coracoacromial ligament.

20. By observing the patient's reaction to pain, the examiner can get some idea of how much the condition is affecting the patient and the patient's pain threshold.
By noting the pattern of movement, the quality and rhythm of the movement, the movements in other joints, and the observable restriction, the examiner can tell if the patient is "cheating" (using accessory muscles) to do the movement and what tissues are affected.