Range of motion (exercise machine)

Last updated • 4 min readFrom Wikipedia, The Free Encyclopedia

Range of motion (ROM) is when a person has become injured in some way, most times the doctor's advice the patients to exercise and stretch the back muscles. For this purpose a form of exercises called range of motion exercises which are used to keep the muscles and joints in the patients back strong and flexible. These exercises can be done by the patient himself, or with a physical therapist. If these exercises are done alone they would be called active range of motion (AROM) exercises and if they require assistance they would be called active-assisted range of motion (AAROM) exercises.

Contents

A range of motion exercise machine won the 1991 Popular Science award for "Best of what's new" in leisure products. [1]

Users

Range of motion therapy is used largely for two distinct subgroups: temporary users and long term users.

Temporary users

Typically, a temporary user of ROM therapy is affected by a cause that will be resolved in the short term. These causes can be varied but mainly fall into three categories.

  1. Injury
  2. Surgery
  3. Temporary immobility

In each case the user is expected to make a full recovery, and over time will no longer need ROM to ensure the proper function of their musculoskeletal structure.[ citation needed ]

Long-term users

A long-term range of motion user will usually need ROM therapy for life. These are users affected by permanent disability that ROM will not resolve. In large part long term users continue ROM therapy daily for the quality of life improvements they see. Users typically suffer from,

  1. Spinal cord injury
  2. Multiple sclerosis [2]
  3. Parkinson's disease [2]
  4. Arthritis
  5. Wheelchair users
  6. TBI
  7. Stroke [3]
  8. Daily ROM exercise

One of the major benefits of range of motion therapy for those users confined to wheelchairs is the daily movement of their limbs. This movement helps circulate the blood to extremities helping reduce the risks of blood clots, sores, and muscle tone reduction. With the help of ROM therapy, quality of life for such users can be greatly improved. [4] For elderly users, a ROM therapy program will help improve their quality of life though exercise. [5]

Range of motion exercises

Range of motion exercise refers to activity aimed to improving movement of a specific joint. This motion is influenced by several structures: configuration of bone surfaces within the joint, joint capsule, ligaments, tendons, and muscles acting on the joint. [6] Range of motion exercises are also called "ROM" exercises. There are three types of ROM exercises: passive, active, and active assists. Passive range of motion is movement applied to a joint solely by another person or persons or a passive motion machine. When passive range of motion is applied, the joint of an individual receiving exercise is completely relaxed while the outside force moves the body part, such as a leg or arm, throughout the available range. Injury, surgery, or immobilization of a joint may affect the normal joint range of motion. [7]

Active range of motion is movement of a joint provided entirely by the individual performing the exercise. In this case, there is no outside force aiding in the movement. Active assist range of motion is described as a joint receiving partial assistance from an outside force. This range of motion may result from the majority of motion applied by an exerciser or by the person or persons assisting the individual. It also may be a half-and-half effort on the joint from each source. [6] [7]

Types of passive range of motions

Medical devices

Ex N' Flex Active/Passive Range of Motion medical device, Model EF-250. Manufactured in Canada by Tecogics Scientific Ltd. EF-250 ROM Medical Device.jpg
Ex N' Flex Active/Passive Range of Motion medical device, Model EF-250. Manufactured in Canada by Tecogics Scientific Ltd.

There are several Range of Motion medical devices on the market. Designed with the goal of facilitating repetitive ROM therapy, they are mainly employed by users who require long term ROM therapy in a home setting where access to a Physiotherapist for daily ROM therapy is not feasible. In the context of Long Term users, there are a small variety of ROM Therapy devices on the market designed for home use.

Not all devices seen on the market are Medical Devices, something prospective users should be aware of before purchasing their new ROM device. Due to the niche market of ROM therapy devices, the manufacturing market is rather small. These ROM therapy devices are designed to be either Active, Passive, or Active/Passive in nature. Costs range from $3,000-$15,000 for motorized Active/Passive devices, while non motorized devices can range from $200-$5,000 depending on supplier. Purchasing direct from a manufacture is difficult, but some do allow private sales direct to users.

ROM therapy and COVID-19

The global COVID-19 Pandemic has introduced more people to Range of Motion therapy. Due to the varying global lockdowns, many people became significantly less mobile and began to lose their ROM. This was especially prevalent in Long Term Care homes where elderly residents where confined to their rooms, there by losing the ability to actively move. [9] [10] This new sedentary lifestyle has led to an increase demand for ROM therapy in the hopes of getting elderly patients their range of motion back.

Related Research Articles

<span class="mw-page-title-main">Physical therapy</span> Profession that helps a disabled person function in everyday life

Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion. Physical therapists are known as physiotherapists in many countries.

<span class="mw-page-title-main">Rotator cuff</span> Group of muscles

The rotator cuff is a group of muscles and their tendons that act to stabilize the human shoulder and allow for its extensive range of motion. Of the seven scapulohumeral muscles, four make up the rotator cuff. The four muscles are:

Activities of daily living is a term used in healthcare to refer to people's daily self-care activities. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status. The concept of ADLs was originally proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, Ohio. The concept of ADLs has been added to and refined by a variety of researchers since that time. For example, many indexes that assess ADLs now include some measure of mobility. Additionally, to be more inclusive of the range of activities that support independent living, in 1969, Lawton and Brody developed the instrumental activities of daily living (IADLs). ADLs are often used in the care of people with disabilities, people with injuries, and elderly people. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.

<span class="mw-page-title-main">Shoulder problem</span> Medical condition

Shoulder problems including pain, are one of the more common reasons for physician visits for musculoskeletal symptoms. The shoulder is the most movable joint in the body. However, it is an unstable joint because of the range of motion allowed. This instability increases the likelihood of joint injury, often leading to a degenerative process in which tissues break down and no longer function well.

<span class="mw-page-title-main">Stretching</span> Form of physical exercise where a muscle is stretched to improve it

Stretching is a form of physical exercise in which a specific muscle or tendon is deliberately expanded and flexed in order to improve the muscle's felt elasticity and achieve comfortable muscle tone. The result is a feeling of increased muscle control, flexibility, and range of motion. Stretching is also used therapeutically to alleviate cramps and to improve function in daily activities by increasing range of motion.

Hypotonia is a state of low muscle tone, often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases and disorders that affect motor nerve control by the brain or muscle strength. Hypotonia is a lack of resistance to passive movement, whereas muscle weakness results in impaired active movement. Central hypotonia originates from the central nervous system, while peripheral hypotonia is related to problems within the spinal cord, peripheral nerves and/or skeletal muscles. Severe hypotonia in infancy is commonly known as floppy baby syndrome. Recognizing hypotonia, even in early infancy, is usually relatively straightforward, but diagnosing the underlying cause can be difficult and often unsuccessful. The long-term effects of hypotonia on a child's development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. Some disorders have a specific treatment but the principal treatment for most hypotonia of idiopathic or neurologic cause is physical therapy and/or occupational therapy for remediation.

<span class="mw-page-title-main">Adhesive capsulitis of the shoulder</span> Painful disease restricting movement

Adhesive capsulitis, also known as frozen shoulder, is a condition associated with shoulder pain and stiffness. It is a common shoulder ailment that is marked by pain and a loss of range of motion, particularly in external rotation. There is a loss of the ability to move the shoulder, both voluntarily and by others, in multiple directions. The shoulder itself, however, does not generally hurt significantly when touched. Muscle loss around the shoulder may also occur. Onset is gradual over weeks to months. Complications can include fracture of the humerus or biceps tendon rupture.

Range of motion is the linear or angular distance that a moving object may normally travel while properly attached to another.

<span class="mw-page-title-main">Anterior cruciate ligament reconstruction</span> Surgical process

Anterior cruciate ligament reconstruction is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after an injury. The torn ligament can either be removed from the knee, or preserved before reconstruction through an arthroscopic procedure. ACL repair is also a surgical option. This involves repairing the ACL by re-attaching it, instead of performing a reconstruction. Theoretical advantages of repair include faster recovery and a lack of donor site morbidity, but randomised controlled trials and long-term data regarding re-rupture rates using contemporary surgical techniques are lacking.

Hypertonia is a term sometimes used synonymously with spasticity and rigidity in the literature surrounding damage to the central nervous system, namely upper motor neuron lesions. Impaired ability of damaged motor neurons to regulate descending pathways gives rise to disordered spinal reflexes, increased excitability of muscle spindles, and decreased synaptic inhibition. These consequences result in abnormally increased muscle tone of symptomatic muscles. Some authors suggest that the current definition for spasticity, the velocity-dependent over-activity of the stretch reflex, is not sufficient as it fails to take into account patients exhibiting increased muscle tone in the absence of stretch reflex over-activity. They instead suggest that "reversible hypertonia" is more appropriate and represents a treatable condition that is responsive to various therapy modalities like drug or physical therapy.

Kinesiotherapy or Kinesitherapy or kinesiatrics, literally "movement therapy", is the therapeutic treatment of disease by passive and active muscular movements and of exercise. It is the core element of physiotherapy/physical therapy.

<span class="mw-page-title-main">Continuous passive motion</span>

Continuous passive motion (CPM) devices are used during the first phase of rehabilitation following a soft tissue surgical procedure or trauma. The goals of phase 1 rehabilitation are: control post-operative pain, reduce inflammation, provide passive motion in a specific plane of movement, and protect the healing repair or tissue. CPM is carried out by a CPM device, which constantly moves the joint through a controlled range of motion; the exact range is dependent upon the joint, but in most cases the range of motion is increased over time.

A selective dorsal rhizotomy (SDR), also known as a rhizotomy, dorsal rhizotomy, or a selective posterior rhizotomy, is a neurosurgical procedure that selectively cut problematic nerve roots of the spinal cord. This procedure has been well-established in the literature as a surgical intervention and is used to relieve negative symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy. The specific sensory nerves inducing spasticity are identified using electromyographic (EMG) stimulation and graded on a scale of 1 (mild) to 4. Abnormal nerve responses are isolated and cut, thereby reducing symptoms of spasticity.

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<span class="mw-page-title-main">Meniscus tear</span> Rupturing of the fibrocartilage strips in the knee called menisci

A tear of a meniscus is a rupturing of one or more of the fibrocartilage strips in the knee called menisci. When doctors and patients refer to "torn cartilage" in the knee, they actually may be referring to an injury to a meniscus at the top of one of the tibiae. Menisci can be torn during innocuous activities such as walking or squatting. They can also be torn by traumatic force encountered in sports or other forms of physical exertion. The traumatic action is most often a twisting movement at the knee while the leg is bent. In older adults, the meniscus can be damaged following prolonged 'wear and tear'. Especially acute injuries can lead to displaced tears which can cause mechanical symptoms such as clicking, catching, or locking during motion of the joint. The joint will be in pain when in use, but when there is no load, the pain goes away.

An isometric exercise tool is a device used to exercise most body parts including the wrist and is often used as part of physical therapy or in order to build muscle strength in a low impact manner. Devices can range in size from large bulky machines used by physicians to small hand-held devices that can be used by an individual. Isometric devices have been used for centuries. The first devices did not display the users' output; nowadays there are devices that can digitally output the users force. Before that some devices used an analog format.

Rehabilitation robotics is a field of research dedicated to understanding and augmenting rehabilitation through the application of robotic devices. Rehabilitation robotics includes development of robotic devices tailored for assisting different sensorimotor functions(e.g. arm, hand, leg, ankle), development of different schemes of assisting therapeutic training, and assessment of sensorimotor performance of patient; here, robots are used mainly as therapy aids instead of assistive devices. Rehabilitation using robotics is generally well tolerated by patients, and has been found to be an effective adjunct to therapy in individuals with motor impairments, especially due to stroke.

When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.

The Bad Ragaz Ring Method (BRRM) is a type of aquatic therapy used for physical rehabilitation based on proprioceptive neuromuscular facilitation (PNF). BRRM is a water-based technique in which therapist-assisted strengthening and mobilizing exercises are performed while the patient lies horizontally in the water, with support provided by rings or floats around the neck, arms, pelvis, and legs.

Nerve glide, also known as nerve flossing or nerve stretching, is an exercise that stretches nerves. It facilitates the smooth and regular movement of peripheral nerves in the body. It allows the nerve to glide freely along with the movement of the joint and relax the nerve from compression. Nerve gliding cannot proceed with injuries or inflammations as the nerve is trapped by the tissue surrounding the nerve near the joint. Thus, nerve gliding exercise is widely used in rehabilitation programs and during the post-surgical period. In addition to rehabilitating purposes, nerve gliding exercise is also used alongside other treatments to relieve the symptoms and faster recovery.

References

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  3. Hurwitz, L. J. (1969). "Practical Neurology: Management Of Major Strokes". The British Medical Journal. 3 (5672): 699–702. ISSN   0007-1447. JSTOR   20377788.
  4. "Passive/Active Exercise". Abilities Canada - Abilities Magazine. 1999-11-30. Retrieved 2020-11-27.
  5. Aveiro, Mariana Chaves; Driusso, Patricia; Santos, Julia Gianjoppe dos; Kiyoto, Viviane Dassi; Oishi, Jorge (September 2013). "Effects of a physical therapy program on quality of life among community-dwelling elderly women: randomized-controlled trial". Fisioterapia em Movimento. 26 (3): 503–513. doi: 10.1590/S0103-51502013000300004 . ISSN   0103-5150.
  6. 1 2 "range of motion exercise - definition of range of motion exercise in the Medical dictionary - by the Free Online Medical Dictionary, Thesaurus and Encyclopedia". Medical-dictionary.thefreedictionary.com. Retrieved 2012-07-19.
  7. 1 2 "Passive Range Of Motion Exercises - Care Guide". Drugs.com. Retrieved 2012-07-19.
  8. "Ex N' Flex EF-250". Ex N' Flex. Retrieved 2020-11-27.
  9. "How physiotherapists are getting coronavirus patients moving again". Global News. Retrieved 2020-11-27.
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