this topic deals with the exercise, various types of exercise, advantages of exercise and how to perform range of motion exercises.

1. By
Mr. M. Shivanandha Reddy

2. EXERCISE - Definition
Exercise is physical activity for
conditioning the body, improving health,
and maintaining fitness.

3. 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

4. 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

5. CLASSIFICATION OF EXERCISE
EXERCISE
BASED ON
MUSCLE
CONTRACTION
ISOTONIC
ISOMETRIC
ISOKINETIC
BASED ON
SOURCE OF
ENERGY
ACTIVE
PASSIVE

6. 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.

7. BASED ON MUSCLE CONTRACTION
Isokinetic Exercise:
Involves muscle contractions with
resistance.
Resistance is provided by an external source
Example: movement of leg against
resistance.

8. 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.

9. 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

10. Contraindications To ROM
• Any illness/disorder where increased use
of energy or increased circulation is
hazardous.
• Example: Myocardial infarction.
swollen, inflamed joints

11. 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.

12. 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

13. 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.

14. 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

15. 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.

16. • 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

17. • 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

19. 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

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. Range Of Motion Of Various
Joints
Joint Movements possible Example
Knee Flexion
Extension
Bring heel toward back of thigh
Return leg to floor

28. 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

29. 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

30. 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

31. • Thank you