Exercise & Range Of Motion

ExercisesByMr. M. Shivanandha Reddy

EXERCISE - Definition

Exercise is physical activity for conditioning the body, improving health, and maintaining fitness.

Benefits of Physical Exercise

1. Improved cardiopulmonary function

2. Reduced blood pressure

3. Increased muscle tone and strength

4. Greater physical endurance

5. Increased weight loss

6. Reduced blood glucose level

Benefits of Physical Exercise

7. Decreased low-density blood lipids

8. Improved physical appearance

9. Increased bone density

10.Regularity of bowel elimination

11.Promotion of sleep

12.Reduced tension and depression

CLASSIFICATION OF EXERCISE

EXERCISE

BASED ON MUSCLE

CONTRACTION

ISOTONIC

ISOMETRIC

ISOKINETIC

BASED ON SOURCE OF

ENERGY

ACTIVE

PASSIVE

BASED ON MUSCLE CONTRACTION

Isotonic exercise : cause muscle contraction and active

movement.Example: walking, aerobics, moving arms &

Legs.

Isometric exercise: tightening or tensing of muscles without

shortening (there is no movement). This increases muscle tension but do not change the length of muscle fibers.

Example: contraction of gluteal muscles.

BASED ON MUSCLE CONTRACTION

Isokinetic Exercise:Involves muscle contractions with

resistance. Resistance is provided by an external

sourceExample: movement of leg against

resistance.

BASED ON SOURCE OF ENERGY

• Active exercise is therapeutic activity that the client performs independently.

• Passive exercise is therapeutic activity that the client performs with assistance and is provided when a client cannot move one or more parts of the body.

Range Of Motion Exercises

Definition: The movement of a joint to

the extent possible without causing pain

Purposes:• Promote and maintain joint mobility• Prevent contractures and shortening

of muscles and tendons• Increase circulation to extremities.• Facilitate comfort for the patient

Contraindications To ROM

• Any illness/disorder where increased use of energy or increased circulation is hazardous.

• Example: Myocardial infarction. swollen, inflamed joints

Types Of ROM Exercises• Active ROM exercises – Exercises the

client is able to perform independently.

• Passive ROM exercises – Exercises performed for the client by someone else.

• Active assisted ROM exercises – Performed by a client with some assistance. Client can move a limb partially through its ROM, but needs help completing the ROM.

Guidelines For Performing ROM Exercises

Start with the head and move down, always do bilaterally

Do not grasp the joint directly

Do not grasp fingernail or toenail. Be sure to support the distal and proximal end of the

limbs

Important joints – thumb, hip, knee, ankle

Move joint through movement 5 times/session

Guidelines For Performing ROM Exercises

Return body part to normal anatomical position

Move each joint through full range of motion

Move to point of resistance not pain

Allow for rest periods whenever required

Avoid friction LIFT body part don’t drag

Note drastic change in vital signs, extreme fatigue.

Guidelines For Performing ROM Exercises

Should not disrupt the healing process

Warm water relaxes the muscles and joints, bathing is an ideal time to perform ROM

Patient Preparation Explain and steps and advantages of

ROM exercises.

Remove all restrictive clothing, linen, splint, and dressings.

Drape appropriately

Raise the bed to comfortable height.

Position the patient comfortably- preferably supine position.

JOINT MOVEMENTS• ABDUCTION - MOVING A BODY PART AWAY FROM THE

MIDLINE OF THE BODY

• ADDUCTION - MOVING A BODY PART TOWARD THE MIDLINE OF THE BODY

• EXTENSION - STRAIGHTENING A BODY PART

• FLEXION - BENDING A BODY PART

• ROTATION - TURNING THE JOINT

• INTERNAL ROTATION - TURNING THE JOINT INWARD

• EXTERNAL ROTATION - TURNING THE JOINT OUTWARD

• PLANTAR FLEXION - BENDING THE FOOT DOWN AT THE ANKLE

• PRONATION - TURNING THE JOINT DOWNWARD

• SUPINATION - TURNING THE JOINT UPWARD

• INVERSION- TURNING THE SOLE OF THE FOOT TOWARDS THE MIDLINE

• EVERSION- TURNING THE SOLE OF THE FOOT AWAY FROM THE MID LINE

JOINT MOVEMENTS

Range Of Motion Of Various Joints

JOINT MOVEMENTS POSSIBLE

EXAMPLE

Temporo mandibular Open

Close

Protrusion

Retraction

Lateral deviation

Opening mouth

Closing mouth

Bringing lower jaw forward

Taking lower jaw inside

Moving jaw to a side

Range Of Motion Of Various Joints

JOINT MOVEMENTS POSSIBLE

EXAMPLE

Neck Flexion

Extension

Hyperextension

Lateral flexion

Look @ the toes

Look straight ahead

Look up @ ceiling

look straight ahead, tilt head to shoulder

Joint Movements possible

Example

Shoulder Flexion

Extension

Abduction

Adduction

Internal rotation

External rotation

Circumduction

Raise arm forward & overhead

Return arm to side of body

Raise arm to side to position above head with palm away from head

Return arm & bring across chest

Elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor)

Elbow flexed, move arm until thumb is lateral to head. (Fingers point up)

Move arm in full circle

Range Of Motion Of Various Joints

Joint Movements possible Example

Elbow Flexion

Extension

Hyperextension

Bend elbow

Straighten elbow

Bend lower arm back as far as possible

Range Of Motion Of Various Joints

Joint Movements possible

Example

Forearm Supination

Pronation

Turn lower hand so palm is up

Turn lower hand so palm is down

Joint Movements possible

Example

Wrist Flexion

Extension

Hyperextension

Abduction

Adduction

Bend wrist forward

Straighten wrist (fingers, wrist & arm in same plane)

Bring dorsal surface of hand as far back as possible

Bring wrist medially towards the thumb

Bend wrist laterally towards 5th finger

Joint Movements possible Example

Fingers & Thumb

Flexion

Extension

Hyperextension

Abduction

Adduction

Circumduction

Opposition

Bend fingers & thumb into palm make a fist

Straighten fingers & thumb

Bend fingers as far back as possible

Spread fingers apart / extend thumb laterally

Bring fingers together/ thumb back to hand

Move finger/thumb in circular motion

Touch thumb to each finger of same hand

Range Of Motion Of Various Joints

Joint Movements possible Example

Hip Flexion

Extension

Hyperextension

Abduction

Adduction

Move leg forward

Move leg back beside other leg

Move leg backwards

Move leg laterally away from body

Move leg back to medial position & beyond if possible

Range Of Motion Of Various Joints

Joint Movements possible Example

Knee Flexion

Extension

Bring heel toward back of thigh

Return leg to floor

Range Of Motion Of Various Joints

Joint Movements possible Example

Ankle Dorsiflexion

Plantar flexion

Move foot so toes are pointed upward

Move foot so toes are pointed downward

Range Of Motion Of Various Joints

Joint Movements possible Example

Foot Inversion –

Eversion –

Flexion –

Extension –

Abduction –

Adduction –

Turn sole of foot medially

Turn sole of foot laterally

Curl toes downward

Straighten toes

Spread toes apart

Bring toes together

Range Of Motion Of Various Joints

Joint Movements possible Example

Spine Flexion

Extension –

Hyperextension –

Lateral flexion –

Rotation –

When standing – bend forward from the waist

Straighten up

Bend backward

Bend to the side

Twist from the waist

• Thank you