RANGE OF MOTION
→ full movement or motion through which a joint can be moved either actively or passively
Contraindications → shouldn’t be done
Precautions → can be done but with caution
Indications → can be done freely
Movement through ROM affects and is affected by muscles, joint surfaces, capsules,
ligaments, fasciae & blood vessels, & nerves
TYPES OF MOVEMENTS:
Passive → external force
→ gravity, machine, therapist or self
Movements of a segment of the body via external force
Occurs without voluntary movement of the patient
Active → caused by muscle contraction (voluntary)
Unrestricted movement of parts of the body as a result of active muscle contraction
Active assisted → caused by muscle plus external force
Physiological → movements under voluntary control (natural movement)
Flexion of the elbow joint
Accessory → movements that take place in the joint that accompany physiological movements or
that can be obtained by an outside force (not under direct voluntary control)
Rotation of finger
Vertebral movements
Gliding movements in joints
Normal ROM
Varies from person to person ( some people are double jointed)
Active ROM and Passive ROM varies
MEASURING ROM
AL1 = hypomobility (not Full ROM)
AL2 = hypermobility (beyond normal ROM)
BO = unstable ROM → pathology
e.g. knee joint
, Movements & different starting positions affect the ROM at the knee
Knee flexion
When supine position, the muscle only stretches over the knee joint
Whereas pronate position, the muscle stretches over the knee joint & hip joint
o Range of motion is less → PASSIVE INSUFFICIENCY
ACTIVE INSUFFICIENCY
2 joint muscles cannot contract maximally across both joints at the same time
PASSIVE INSUFFICIENCY
Occurs with 2 joint muscles and refers to the fact that these muscles cannot stretch
maximally across both joints at the same time
o Wrist flexion & trying to clench fist, passive insufficiency around wrist joint & active
insufficiency at finger muscles → aren't able to contract (fist can't clench as tightly as
when wrist is at extension)
In a seated position, flexion of the hip with extension & flexion of the knee results in
insufficiency when the knee is extended
o It known as passive insufficiency, when someone assists you → your hamstring
stretches over two joints
o It is known as active insufficiency, if you are contracting your quad to lift your leg →
because your quad extends over two joints
FUNCTIONAL EXCURSION
Distance muscle can shorten after maximal elongation
o Full range of extensibility & contractility of a muscle
o It's amplitude
Is dependent on
o arrangement of muscle fibres
o Whether muscle is a one- or two- joint muscle
o If active insufficiency or passive insufficiency is present
INDICATIONS FOR PASSIVE ROM
Presence of acute inflamed tissue
not able to move joint actively
o Paralysis → damage to spinal cord or nerves
o Comatose → coming out of a coma
Teaching a movement or to get kinaesthetic input
o Kinaesthetic → a person's awareness of the position & movement of parts of the
body
In some cases the patient is not able to move limb and other cases the patient isn't aware of
their limb moving, have to actually look at limb
Preparing for stretching
EFFECTS OF IMMOBILISATION
If a muscle is maintained in a shortened position for 2 or 3 weeks:
o Muscle shortens → no. sarcomeres (contractile part of muscle) decreases
o Connective tissue or collagen (which supports muscle) stops moving freely & sticks
to itself
o Muscle wastes away & becomes weak → atrophies
If a joint is not moved regularly:
→ full movement or motion through which a joint can be moved either actively or passively
Contraindications → shouldn’t be done
Precautions → can be done but with caution
Indications → can be done freely
Movement through ROM affects and is affected by muscles, joint surfaces, capsules,
ligaments, fasciae & blood vessels, & nerves
TYPES OF MOVEMENTS:
Passive → external force
→ gravity, machine, therapist or self
Movements of a segment of the body via external force
Occurs without voluntary movement of the patient
Active → caused by muscle contraction (voluntary)
Unrestricted movement of parts of the body as a result of active muscle contraction
Active assisted → caused by muscle plus external force
Physiological → movements under voluntary control (natural movement)
Flexion of the elbow joint
Accessory → movements that take place in the joint that accompany physiological movements or
that can be obtained by an outside force (not under direct voluntary control)
Rotation of finger
Vertebral movements
Gliding movements in joints
Normal ROM
Varies from person to person ( some people are double jointed)
Active ROM and Passive ROM varies
MEASURING ROM
AL1 = hypomobility (not Full ROM)
AL2 = hypermobility (beyond normal ROM)
BO = unstable ROM → pathology
e.g. knee joint
, Movements & different starting positions affect the ROM at the knee
Knee flexion
When supine position, the muscle only stretches over the knee joint
Whereas pronate position, the muscle stretches over the knee joint & hip joint
o Range of motion is less → PASSIVE INSUFFICIENCY
ACTIVE INSUFFICIENCY
2 joint muscles cannot contract maximally across both joints at the same time
PASSIVE INSUFFICIENCY
Occurs with 2 joint muscles and refers to the fact that these muscles cannot stretch
maximally across both joints at the same time
o Wrist flexion & trying to clench fist, passive insufficiency around wrist joint & active
insufficiency at finger muscles → aren't able to contract (fist can't clench as tightly as
when wrist is at extension)
In a seated position, flexion of the hip with extension & flexion of the knee results in
insufficiency when the knee is extended
o It known as passive insufficiency, when someone assists you → your hamstring
stretches over two joints
o It is known as active insufficiency, if you are contracting your quad to lift your leg →
because your quad extends over two joints
FUNCTIONAL EXCURSION
Distance muscle can shorten after maximal elongation
o Full range of extensibility & contractility of a muscle
o It's amplitude
Is dependent on
o arrangement of muscle fibres
o Whether muscle is a one- or two- joint muscle
o If active insufficiency or passive insufficiency is present
INDICATIONS FOR PASSIVE ROM
Presence of acute inflamed tissue
not able to move joint actively
o Paralysis → damage to spinal cord or nerves
o Comatose → coming out of a coma
Teaching a movement or to get kinaesthetic input
o Kinaesthetic → a person's awareness of the position & movement of parts of the
body
In some cases the patient is not able to move limb and other cases the patient isn't aware of
their limb moving, have to actually look at limb
Preparing for stretching
EFFECTS OF IMMOBILISATION
If a muscle is maintained in a shortened position for 2 or 3 weeks:
o Muscle shortens → no. sarcomeres (contractile part of muscle) decreases
o Connective tissue or collagen (which supports muscle) stops moving freely & sticks
to itself
o Muscle wastes away & becomes weak → atrophies
If a joint is not moved regularly:
