What are the basic types of exercise?
Active and passive
What are the two main types of range of motion?
Passive range of motion (PROM) and Active range of motion (AROM)
What are PROM exercises?
- Movement created by an external force to maintain unrestricted joint range
- Passive stretch used to increase joint ROM
What are AROM exercises?
Movement produced from active, voluntary contraction of muscles to increase strength and endurance
What are the 5 indications for PROM exercises?
- Unable to preform active exercise
- Counteract negative effects of immobilization
- Evaluate joint ROM and stability
- Provide sensory stimulation and awareness
- Reduce cardiopulmonary stress
What are the 6 benefits of PROM exercises?
- Maintain existing ROM
- Minimize muscle shortening or other complications due to immobilization
- Maintain circulation
- Maintain sensory awareness
- Promote cartilage nutrition and movement of synovial fluid
- Reduces or inhibits pain
What are the 6 principles for PROM exercises?
- Provide gentile, firm support and proper stabilization
- Move through the entire unrestricted, normal ROM of a joint
- Give special consideration to multi-joint muscles
- Give special consideration to how the patients diagnosis affects the exercise program (ex: SCI, THA, CVA)
- Position patient properly
- Determine purpose (goals) and sequence
What are 3 indications for AROM exercises?
- Patient is able to voluntarily contract, control, and coordinate muscles
- No contraindications or precautions
- Contributes to fulfilling patients goals
When should you use caution with AROM?
Use caution when soft tissue, joint pain, or joint swelling is apparent
What are the 6 benefits of AROM exercises?
- Maintain physiologic elasticity, strength, and endurance of muscle
- Increase local circulation
- Increase sensory awareness
- Prevent complications in the cardiovascular system
- Maintain structural integrity
- Improve muscle strength
What 6 things should you do in order to prepare for AROM exercises?
- Evaluate the patient
- Complete a thorough chart review
- Determine goals and appropriate types of exercise to use
- Give proper introduction including an explanation of the purpose, risks, and desired outcomes of AROM
- Obtain informed consent
- Position the patient and yourself
There are 3 types of muscle contractions, what are they?
- Isotonic: visible joint motion when muscle contracts
- Concentric: shortening
- Eccentric: lengthening - Isometric: little or no observable joint motion and change in length of muscle
- Isokinetic: requires specialized equipment
What is the sagittal plane?
Vertical plane that divides the body into left and right components
What is the frontal plane?
Vertical plane that divides the body into front (anterior) and back (posterior)
What is the transverse plane?
Horizontal plane that divides the body into upper and lower components
What is a part of your UE basic gross assessment?
- Scapular Elevation
- Shoulder Flexion
- Shoulder Extension
- Shoulder Abduction
- Shoulder External Rotation
- Shoulder Internal Rotation
- Elbow Flexion
- Elbow Extension
- Forearm Supination
- Forearm pronation
- Wrist Flexion
- Wrist Extension
- Thumb and Finger Flexion
- Thumb and Finger Extension
- Opposition
- Gross Grasp
What is a part of your LE basic gross assessment?
- Hip Flexion
- Hip Abduction
- Hip Adduction
- Hip External Rotation
- Hip Internal Rotation
- Knee Flexion
- Knee Extension
- Ankle Dorsiflexion
- Ankle Plantar Flexion
- Ankle Inversion
- Ankle Eversion
What insurance company uses GG levels of assist?
Medicare
Describe the scores on the GG scale.
1: Dependent
2: Substantial Assistance
3: Partial Assistance
4: Supervision/ Touching
5: Setup
6: Independent
7: Refused
9: Not Applicable
10: Not attempted due to environmental limitations
88: Not attempted due to medical condition/ safety
What does independent on the GG scale mean?
Patient/ resident safely completes the activity by themselves with no assistance from a helper (ex: gets out of bed and showers)
What does setup or clean up assistance mean on the GG scale?
Helper sets up or cleans up; patient/ resident completes activity. Helper assists only prior to or following the acitivity (Ex: PT or OT come in to move sheets so pt can get out of bed and set up shower, but pt gets out of bed and showers on their own and PT/OT are able to leave)
What does supervision or touching assistance mean on the GG scale?
Helper provides verbal cues and/ or touching/ steading and/ or contact guard (ex: PT or OT are within arms reach for getting out of bed and showering but pt is able to do with with verbal cues and steading hand from PT as needed)
What does Partial/moderate assistance on the GG scale mean?
Helper does less than half the effort. Helper lifts, holds or supports trunk or limbs but provides less than half the effort
What does substantial/ maximal assistance mean on the GG scale?
Helper does more than half of the effort. helper lifts or holds the trunk or limbs and provides more than half the effort
