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BY SANKARI NEDUNSALIYAN
DIP IN PT(MAL), BSC HONS APPLIED REHAB
(UK)
DEFINITION
• These movements are produced by an external force during
muscular inactivity or when range of motion is reduc...
GOALS AND USES
• Maintain joint and connective tissue mobility
• Maintain the physiological properties of the muscle (exte...
PRECAUTIONS AND
CONTRAINDICATIONS
• Immediately after acute tears, fractures, and surgery.
• Signs of too much effusion or...
LIMITATIONS OF PROM
Passive ROM will not:
• Prevent muscle atrophy
• Increase muscle strength and endurance
• Assist circu...
CLASSIFICATION OF PASSIVE
MOVEMENTS
1. Relaxed Passive Movements, including accessory
movements
2. Forced Passive Movement...
RELAXED PASSIVE MOVEMENTS -
DEFINITION
• These are movements performed accurately, rhythmically and
smoothly by the physio...
PRINCIPLES OF RELAXED PASSIVE
MOVEMENTS
1. Relaxation
The selection of a suitable starting position ensures comfort
and su...
PRINCIPLES OF RELAXED PASSIVE
MOVEMENTS
4. Traction
The fixation of the bone proximal to the joint providing an
opposing f...
7. Physiotherapist stance
In the direction of line of movement. Commonly used stances
are the walk stance and stride stand...
FORCED PASSIVE MOVEMENTS -
DEFINITION
• An exercise performed on a subject by a partner who exerts
an external force not o...
EFFECTS AND USES OF FORCED
PASSIVE MOVEMENTS
• As in relaxed passive movements (same effect and uses), but
specially incre...
CONTINUES PASSIVE MOTION (CPM) -
DEFINITION
• A continues passive motion device maintains movements of a
joint after limb ...
BENEFITS OF CPM
1. Decreasing the complication of immobilization
2. Decreasing the post operative complication and pain
3....
PROCEDURE OF CPM
• Therapist adjust the device to fit before surgery
• CPM used right after surgery
• Therapist has to giv...
CONTINUES PASSIVE MOTION
(CPM)
THANK YOU
Passive movements
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Passive movements

  1. 1. BY SANKARI NEDUNSALIYAN DIP IN PT(MAL), BSC HONS APPLIED REHAB (UK)
  2. 2. DEFINITION • These movements are produced by an external force during muscular inactivity or when range of motion is reduced for any cause • Carried out either by the therapist or a machine INDICATIONS In acute, inflamed tissues, where active movements is painful In comatose, paralytic, or complete bed redden patient. In muscle re-education as a first step
  3. 3. GOALS AND USES • Maintain joint and connective tissue mobility • Maintain the physiological properties of the muscle (extensibility, elasticity, etc.) and minimize the formation of contracture • Assist circulation and enhance synovial movement and diffusion of materials in the joint • Maintain range of motion and prevent formation of adhesions • Maintain the patient's awareness of movements by stimulating the kinaesthetic receptors • Decrease or inhibit pain
  4. 4. PRECAUTIONS AND CONTRAINDICATIONS • Immediately after acute tears, fractures, and surgery. • Signs of too much effusion or swelling (DVT) • Sever sharp and acute joint pain • When motion disruptive to the healing process. • When bony block limits joint motions • Acute infection around or in the joint ( arthritis) • In case of increased joint’s hypermobility or hematoma
  5. 5. LIMITATIONS OF PROM Passive ROM will not: • Prevent muscle atrophy • Increase muscle strength and endurance • Assist circulation as active exercises
  6. 6. CLASSIFICATION OF PASSIVE MOVEMENTS 1. Relaxed Passive Movements, including accessory movements 2. Forced Passive Movements 3. Continuous Passive Movements
  7. 7. RELAXED PASSIVE MOVEMENTS - DEFINITION • These are movements performed accurately, rhythmically and smoothly by the physiotherapist through available range of motion (according to anatomy of joints). • The movements are performed in the same range and direction as active movements. • The joint is moved through the free range and within the limits of pain.
  8. 8. PRINCIPLES OF RELAXED PASSIVE MOVEMENTS 1. Relaxation The selection of a suitable starting position ensures comfort and support, for both patient and physiotherapist through the movements 2. Fixation Good fixation for the proximal and distal joint by the physiotherapist to ensure that the movement is localized to the movable joint 3. Support Full and comfortable support is given to the part to be moved, so that the patient has confidence and will remain relaxed
  9. 9. PRINCIPLES OF RELAXED PASSIVE MOVEMENTS 4. Traction The fixation of the bone proximal to the joint providing an opposing force to a sustained pull on the distal bone. Traction is thought to facilitate the movement by reducing inter-articular friction. 5. Range of Movement The range of movements is done in painless range to avoid spasm in the surrounding muscles 6. Speed and Duration As it is essential that relaxation is maintained throughout the movement, the speed must be slow and rhythmical, with suitable repetitions of the movement
  10. 10. 7. Physiotherapist stance In the direction of line of movement. Commonly used stances are the walk stance and stride stand 8. Repetitions Usually 8-10 repetitions are given twice (02) a day 9. Sequence - Neurological cases: from proximal to distal joints - For draining fluids: from distal to proximal PRINCIPLES OF RELAXED PASSIVE MOVEMENTS
  11. 11. FORCED PASSIVE MOVEMENTS - DEFINITION • An exercise performed on a subject by a partner who exerts an external force not only to produce a passive movements of a joint. • The partner presses the joint into its end-position (i.e. end of range), while the subject’s muscles that normally carry out the movements are completely relaxed. • There is a danger of overextension beyond the range of movement and damage to the joint if the exercise is not carried out carefully
  12. 12. EFFECTS AND USES OF FORCED PASSIVE MOVEMENTS • As in relaxed passive movements (same effect and uses), but specially increasing the limited range of motion
  13. 13. CONTINUES PASSIVE MOTION (CPM) - DEFINITION • A continues passive motion device maintains movements of a joint after limb sparing surgery. This device is usually called a CPM • Continues movement limits stiffness and pain. • It is very important to keep joints moving following surgery so that motion will not become limited. • The CPM will move the involved leg through its full range of motion. • It is only used in bed, but can be used while relaxing, eating, or sleeping
  14. 14. BENEFITS OF CPM 1. Decreasing the complication of immobilization 2. Decreasing the post operative complication and pain 3. Improving the recovery rate and ROM 4. Improving the circulation through pumping action 5. Prevent adhesions and contracture 6. Prevent joint effusion and wound oedema
  15. 15. PROCEDURE OF CPM • Therapist adjust the device to fit before surgery • CPM used right after surgery • Therapist has to give instructions and monitor how to use the device • CPM is allowed to set at 45 degrees of motion right after surgery • Generally, motion is allowed to be increased 15 degrees a day
  16. 16. CONTINUES PASSIVE MOTION (CPM)
  17. 17. THANK YOU
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