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ACTIVE MOVEMENT AND PASSIVE MOVEMENT

Range of Motion

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Range of motionRange of motion is a basic technique usedfor the examination of movement and forinitiating movement into a program of therapeutic intervention.The full motion possible is called the rangeof motion (ROM).Ranges of available joint motion are usuallymeasured with a goniometer and recorded

in degrees.2

If it contracts and moves the elbow into flexionand the forearm into supination whilesimultaneously moving the shoulder intoflexion, it shortens to a point known as activeinsufficiency , where it can shorten no more.

The muscle is lengthened full range byextending the elbow, pronating the forearm,and simultaneously extending the shoulder.When fully elongated it is in a position knownas passive insufficiency .

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To maintain normal ROM, the segments

must be moved through their availableranges periodically, whether it is theavailable joint range or muscle range.

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TYPES OF ROM EXERCISESPassive ROMPassive ROM (PROM) is movement of a segmentwithin the unrestricted ROM that is producedentirely by an external force; there is little to or novoluntary muscle contraction.Active ROMActive ROM (AROM) is movement of a segmentwithin the unrestricted ROM that is produced by

active contraction of the muscles crossing that joint.5

Active-Assistive ROMActive-assistive ROM (AAROM) is atype of AROM in which assistance isprovided manually or mechanically byan outside force because the primemover muscles need assistance tocomplete the motion.

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Passive ROM

Indications for PROMAcute, inflamed tissueWhen a patient is not able to or notsupposed to actively move a segment orsegments of the body, as whencomatose, paralyzed, or on completebed rest.

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• To decrease the complications that would occur withimmobilization, such as cartilage degeneration, adhesionand contracture formation, and sluggish circulation.

• Maintain joint and connective tissue mobility• Minimize the effects of the formation of contractures• Maintain mechanical elasticity of muscle• Assist circulation and vascular dynamics• Enhance synovial movement for cartilage nutrition and• diffusion of materials in the joint• Decrease or inhibit pain• Assist with the healing process after injury or surgery• Hel maintain the atient’s awareness of movement

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• When a therapist is examining inert structures,PROM is used to determine limitations of motion,to determine joint stability, and to determinemuscle and other soft tissue elasticity.

• When a therapist is teaching an active exerciseprogram, PROM is used to demonstrate the desiredmotion.

• When a therapist is preparing a patient forstretching, PROM is often used preceding thepassive stretching techniques.9

Indications for AROMWhenever a patient is able to contract the muscles

actively and move a segment with or withoutassistance, AROM is used.When a patient has weak musculature and isunable to move a joint through the desired range(usually against gravity), A-AROM is used toprovide enough assistance to the muscles in acarefully controlled manner so the muscle canfunction at its maximum level and beprogressively strengthened.10

AROM is used on the regions above andbelow the immobilized segment to maintainthe areas in as normal a condition aspossible and to prepare for new activities,such as walking with crutches.

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Maintain physiological elasticity andcontractility of the participating musclesProvide sensory feedback from thecontracting musclesProvide a stimulus for bone and joint tissueintegrityIncrease circulation and prevent thrombusformationDevelop coordination and motor skills forfunctionalbactivities

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Limitations of Passive MotionPassive motion does not: Prevent muscleatrophy Increase strength or endurance

Assist circulation to the extent that active,voluntary muscle contraction does.Limitations of Active ROMFor strong muscles, active ROM does notmaintain orincrease strength. It also does not develop skillor coordination except in the movementpatterns used.

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