Flexibility
Ability to move a joint smoothly and easily through an unrestricted, pain-free ROM
What 3 things determine flexibility?
Muscle length, Joint integrity, & Extensibility of periarticular soft tissues
Difference between functional and full ROM
Functional: enough available ROM for functional activities
Full/Normal: the normal value for ROM
Decreased flexibility is
decreased mobility or restricted motion caused by adaptive shortening of soft tissues
Decreased flexibility can range from mild muscle shortening to irreversible __________
contractures
Decreased flexibility may impair muscle performance and can lead to what?
activity limitations and participation restrictions
What are potential causes of decreased flexibility?
- prolonged immobilization of a body segment
- sedentary lifesyle
- postural malalignment and muscle imbalances
- impaired muscle performance associated with MSK or NM disorders
- Tissue trauma resulting in inflammation and pain
- Congenital or acquired deformities
Immobilization can lead to:
- decay of contractile protein in the immobilized muscle
- decreases in muscle fiber diameter
- decrease in number of myofibrils
- decrease in intramuscular capillary density
As immobilized muscle atrophies, an increase in fibrous and fatty tissue in muscle occurs –>
outcome of which is weakness and restricted ROM
Impact of immobilization
- deterioration in motor unit recruitment
- weakening of the tissue
- increased proportion of fibrous tissue and subcutaneous fat in muscle
- greater atrophy of muscle and loss of functional strength
- adhesion formation occurs
What is the best range to have someone resting in while they are immobilized (e.g. in a coma) and why?
mid range
-position of immobilization affects the extent of atrophy and loss of strength and power
Immobilization in a __________ position decreases the muscle’s capacity to produce maximum tension at its normal resting length as it contracts
shortened
Immobilization in a ________ position this occurs with some surgical procedures, serial casts, or the use of a dynamic splint to stretch a long-standing contracture and increase ROM
lengthened
Are stretching and ROM the same thing?
no
ROM
technique used for the examination of a movement
Factors of decreased ROM
systemic, joint, neuro, or muscular diseases; surgical or traumatic insults; or simpy inactivity or immobilization can lead to decreased ROM
ROM interventions are administered to…
maintain joint and soft tissue mobility to minimize loss of tissue flexibility and contracture formation; NOT improve ROM
Passive ROM
movement of a segment within the unrestricted ROM that is produced entirely by an external force; there is little to no voluntary muscle contraction
Active ROM
movement of a segment within the unrestricted ROM that is produced by active contraction of the muscles crossing that joint
Active-assistive ROM
type of AROM in which assistance is provided manually or mechanically by an outside force
Indications for PROM
- acute, inflamed tissue
- patient is not able to or not supposed to actively move a segment of the body
Goals for PROM
primary goal is to decrease the complications that would occur with immobilization (long laundry list of things in ppt slide 12)
What does PROM not do?
- prevent muscle atrophy
- increase strength or endurance
- assist in circulation to the extent that active, voluntary muscle contraction does
Indications for AROM
- patient is able to contract the muscles actively and move a segment with or without assistance
- when a segment is immobilized for a long time, AROM is used on the regions above and below that segment to maintain normal conditions
- no significant inflammation or contraindication to active motion
