1. Exercise Science
Range of Motion

2. Bell Work
What is Range of Motion?

3. ROM DEFINED
The full movement potential of a joint, usually its range of flexion and extension.

4. Range of Motion (ROM) definition:
exercising joints through the available motion to maintain available range and flexibility of joint structures

5. Purpose of ROM maintain joint movement and integrity
prevent deterioration of joint structures, ankylosis and contractures
Ankylosis is abnormal stiffening and immobility of a joint due to fusion of the bones.

6. Indications for ROM patients on prolonged bed rest
prevention of contracture: a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints
stimulates circulation

7. Types of ROM active (AROM) performed by patient
patient moves the joints through available ROM
maintains muscle strength and joint mobility

8. Types of ROM active assistive (AAROM)
performed by patient with assistance from another person or mechanical device
patient uses stronger limb to move or support weaker limb
practitioner completes movement through full available ROM

9. Types of ROM passive (PROM)
performed for patient by healthcare worker or caregiver
moves all muscle groups within each plane over each joint
does not maintain muscle strength
maintains joint flexibility & integrity

10. Types of ROM stretching forcing movement beyond the available ROM
contraindicated for most healthcare personnel

11. Principles of ROM Check doctor’s orders
Know the patient diagnosis and rationale for ROM
Explain the procedure to the patient

12. Principles of ROM use good body mechanics expose limb being exercised
support body part proximal to joint
use slow smooth rhythmic motion

13. Key Factors for ROM start ROM exercises on the unaffected side
start each movement in neutral position
use a firm comfortable grip while maintaining support of the extremity
avoid forcing beyond range
avoid overexerting patient
avoid skin friction
exercise just below point of pain, NOT beyond

14. Key Factors for ROM
if rigidity occurs slightly decrease ROM until it subsides
stop if spastic contraction occurs
talk to patient to help them relax
expect heart rate and respirations to rise
exercise 2-3x’s daily, 5-10 movements(see physician’s or Physical Therapist orders)
document procedure & patient reaction

15. Basic Terminology - ROM
Flexion
to bend a joint
Extension
to straighten a joint
Abduction
move away from midline of body
Adduction
move toward midline of body

16. Flexion and Extension
Flexion and extension are movements that occur in the sagittal plane. They refer to increasing and decreasing the angle between two body parts:
Flexion refers to a movement that decreases the angle between two body parts. Flexion at the elbow is decreasing the angle between the ulna and the humerus. When the knee flexes, the ankle moves closer to the buttock, and the angle between the femur and tibia gets smaller.
Unit III

17. Extension
Extension refers to a movement that increases the angle between two body parts. Extension at the elbow is increasing the angle between the ulna and the humerus. Extension of the knee straightens the lower limb.
Unit III

18. Dorsiflexion vs. Plantarflexion
Dorsiflexion refers to flexion at the ankle, so that the foot points more superiorly.
Plantarflexion refers extension at the ankle, so that the foot points inferiorly.
Unit III

19. Joint Movement Terms FLEXION vs. EXTENSION hyperextend flexion flexion
dorsiflexion
plantar
flexion
neutral
Unit III

20. Abduction vs Adduction
Abduction is any motion of the limbs or other body parts that pulls away from the midline of the body. 
Adduction is the movement of a body part toward the body's midline. So, if a person has their arms straight out at the shoulders and brings them down to their sides, it is adduction
Unit III

21. Joint Movement Terms
ABDUCT vs. ADDUCT
Unit III

22. Basic Terminology - ROM
Horizontal Abduction
moving away from body in a transverse plane
Horizontal Adduction
moving toward body in a transverse plane

23. Basic Terminology - ROM
Rotation
internal (medial)
pivoting inward along an axis
external (lateral)
pivoting outward along an axis

24. Inversion and Eversion
Inversion and eversion are movements which occur at the ankle joint, referring to the rotation of the foot around its long axis.
Inversion involves the lateral rotation of the foot, such that the sole points medially.
Eversion involves the medial rotation of the foot, such that the sole points laterally.
Unit III

25. Lateral and Midline Rotation
Movement that brings the anterior surface of the limb toward the midline of the body is called medial (internal) rotation
Anterior surface moves away from the midline is lateral (external) rotation
Unit III

26. Joint Movement Terms INVERSION vs. EVERSION turn inward or medially
turn outward or laterally
Unit III

27. Rotation
Rotation of the neck or body is the twisting movement produced by the summation of the small rotational movements available between adjacent vertebrae
Unit III

28. Circumduction
is the movement of a body region in a circular manner, in which one end of the body region being moved stays relatively stationary while the other end describes a circle
Unit III

29. ROTATION vs. CIRCUMDUCTION
Joint Movement Terms
ROTATION vs. CIRCUMDUCTION
pivot
circle
Unit III

30. Basic Terminology - ROM
Supination
rotate forearm, palm up
Pronation
rotate forearm, palm down
Opposition
oppose thumb tip to base of little finger (may be done to each individual finger tip)

31. Example of Opposition Thumb opposition
oppose thumb tip base of little finger or to finger tip of each individual finger

32. PRONE AND SUPINE
Prone: Position of lying on the anterior part of the body. Patient lies on stomach with head turned to the side. Supine: Position of lying on the posterior part of the body. Patient lies flat on back. Additional supportive devices may be added for comfort.

33. PRONATION vs. SUPINATION
Joint Movement Terms
PRONATION vs. SUPINATION
place on
front
place on
back
Unit III

34. Elbow flextion

35. Knee Flexion

36. Toe Flexion

37. Knee Extension

38. Head or neck extension

39. Hip abduction

40. toward midline
Toe Adduction

41. turning part on its axis
Left
Head and Neck rotation
turning part on its axis
Right

42. Example of Rotation
Hip internal rotation
pivoting inward

43. toward body in transverse plane
Shoulder horizontal adduction
toward body in transverse plane

44. Example of Supination
Forearm supination
rotate forearm, palm up

45. rotate forearm, palm down
Forearm pronation
rotate forearm, palm down

46. sole of foot turned outward at the ankle
Ankle eversion
sole of foot turned outward at the ankle

47. Example of Inversion sole of foot turned inward at the ankle
Ankle inversion
sole of foot turned inward at the ankle

48. Example of Dorsiflexion
Ankle dorsiflexion
an upward or backward motion of the ankle toward the hips

49. Example of Plantar Flexion
Ankle plantar flexion
a toe down motion of the foot at the ankle