Range of Motion Exercises: Active, Passive and Assisted

Range of motion is very essential for the normal functioning of our body parts. Range of motion refers to how far one can move or stretch a joint. It is the distance and direction, the joint moves between a bent position and an extended position. This range of motion is restricted in various health problems like inflammation, injury, disease, muscle cramps, ligament strain, etc. The limitation differs from person to person. In this blog, we will throw some light on the various types of range of motion exercises that can be recommended by your physiotherapist to regain the movement and functionality of the affected joint. The physiotherapist designs therapeutic exercises to increase the range of motion and flexibility of the involved joint.

The range of motion exercises refers to the activity that is aimed to improve the movement of the joint. The movement of the joints is influenced by many structures like the bone surfaces within the joint, ligaments, joint capsules, tendons, and muscles acting on the joint. The range of motion exercise is the capability of the joint to go through its complete spectrum of motion.

The range of motion therapy is beneficial in recovery as well as healing from soft tissue and joint lesions, maintaining existing joint as well as soft tissue mobility, minimizing the effects of contracture, increasing synovial movement, and helping in Neuro-muscular re-education.

Regaining the range of motion in the joint is one of the first phases of injury rehabilitation, as well as an individual, can avoid injury and maintain well-being if he is aware of the range of motion exercises (ROM). ‌

The physiotherapist assesses the range and quality of the motion. The treatment plan involves many kinds of range of motion exercises. Among these, the most useful and common exercises are those which increase as well as facilitate a range of motion(ROM). ROM is used by physiotherapists to describe how much motion the patient makes with the joint or the part of the body. When the range of motion is affected, the patient finds it difficult to move the particular body part comfortably around the joint.

The ROM may be affected because of different causes like pulled muscles, sprained joints due to an accident or a sports injury, post-surgical, as well as the general lack of exercise, which may also result in a reduction in the range of motion. The ROM exercises target these injured areas. There are mainly three basic kinds of range of motion exercises for restoring and correcting the range of motion. These types of exercises are designed to treat the kind of problem the patient has and to assist him to rebuild strength as well as the range of motion without doing further damage. Depending on the injury, the patient is asked to do one or a combination of these various types of exercises:

• Passive range of motion.
• Active-assisted range of motion.
• Active range of motion.

 

Passive Range of Motion (PROM)

This is the space in which the part of the body is moved with the help of someone or something creating the movement, such as a physiotherapist or equipment. The patient does not engage himself i.e., the patient makes no effort to move the joint. PROM exercises are beneficial when a situation such as an accident has left the patient bedridden or wheelchair-bound or paralyzed. If the patient cannot move, the physiotherapist will move the patient's muscles and bend his joints for him daily. The physiotherapist may even teach the patient's family members how to help him.

 

Assisted Active Range of Motion (AAROM)

This is the movement that occurs when someone helps the patient to do the movement. For example, an individual sits on a chair and lifts one leg in front of him as far as he can. Another person who may be a therapist or any helper can help the patient stretch his leg more than he would be able to if the leg is flexed by the patient alone by his muscles. The patient uses the muscles around the weak joint to complete stretching exercises with the help of a physiotherapist or equipment. Stretching a little beyond the limit is good for increasing the range of motion. But pushing too far may lead to a muscle tear or damage to a joint, while doing active assisted movement no one should push the patient to the point of pain.

 

Active Range of Motion (AROM)

This is the space in which the part of the body is moved by using the muscles and the effort is made by the individual himself without outside help. With AROM, the patient performs stretching exercises, moving the muscles around the weak joint without any aid. For example, lifting the leg above the hip to stretch the muscles happens within the active range of motion. The active range of motion is performed by holding movements or stretches for at least 30 seconds. By doing this, the strength of the muscles is built needed for a particular movement. The patient is made to do a variety of range-of-motion exercises that challenge his entire body and not a single muscle group alone. AROM exercises, strengthen the muscles when actively engaged in movement. This is good for overall health and improves mobility over time. ‌Range-of-motion exercises are done to maintain mobility and flexibility. In case of stiffness, mobility decreases, and in such cases range of motion, exercises may help regain the lost mobility. For example, if the patient's knee was injured, he must have stopped moving his knee during the immobilization period. Once the knee heals and is ready to bear weight, the patient finds it hard to move. That's because the knee has lost its range of motion due to the lack of use. The patient may bend and extend the knee but does not move to the full range of motion. The physiotherapist can apply pressure to the knee to move it just a little more than the body allows. This stretches the muscle and joints, thus increasing the range of motion.‌ Care should be taken to keep in mind that no range of motion exercise should cause pain also, while using a passive or active range of motion, stretching beyond the limit may cause damage. The patient should listen to his body and stop when he reaches the limit.

The range of motion is the measurement of the motion around a body part or a specific joint. There are established ranges that are considered normal for various joints in a body. For the joint to have a full range of motion, it must have good flexibility and each joint has its level of flexibility, expressed in the degrees.

 

Top Active Range of Motion Exercises for Upper and Lower Body

Have you heard of someone complaining of tired legs, aching ankles or stiffness, while getting out of bed? These are all common symptoms of past injuries or aging. Decreased movement at a joint can cause many problems, ranging from functional disability to psychological fears. Active ranges of motion (AROM) exercises are done by the individual, by using their own muscle strength and power, without external help. These exercises are prescribed by a trained physiotherapist who helps to increase joint flexibility, and overall functionality. In this blog, we have mentioned the benefits of doing active range of motion exercises, and a few easy-to-do range of motion exercises are given below.

 

Benefits

There are many benefits of doing AROM exercises if the movement is decreased at a joint. Some of them are:

• Increases joint range of motion
• Increases the functionality
• Improves and maintains joint integrity
• Improves movement efficiency
• Increases  independence

 

Upper Body Exercises:

Starting position:

• Sit or stand in a comfortable position.
• Face forward. 
• Shoulders should be straight and relaxed.

 

Head forward and backward movement:

·    Gently bend the head and try to touch the chin to the chest.  Raise the chin back to the starting position. Tilt the head backward and look up towards the ceiling and return to the starting position.

 

Head side to side movement:

·    Tilt the head to the side, by bringing the ear towards the shoulder. Do not raise the shoulder towards the ear, return to the starting position.

 

Head turns:

·    Turn the head to look over at the shoulder. Tilt the chin down and try to touch the shoulder without raising the shoulder to the chin, return to the starting position.

 

Shoulder and elbow exercises:

Starting position:

• Stand or sit on a chair without the arms.
• Hold the arms straight down by the side
• Palms facing towards the body.

 

Shoulder up and down movement:

·    Raise the arm forward and then up over the head, such that the inner arm touches the ear. Bring the arm down to the side. Bring it back as far as possible behind the body, return to the starting position.

 

Shoulder side to side movement:

·    Raise the arm by the side and then up over the head as far as possible. Return the arm to the side. Bring the arm across the front of the body and reach for the opposite shoulder, return to the starting position.

 

Shoulder rotation:

·    Raise both shoulders up toward the ears. Bring them back to the starting position, and relax the shoulders. Pull the shoulders back. And relax them again. Roll the shoulders in a smooth circular motion and then repeat the same in the opposite direction.

 

Elbow bends:

·    With the palm facing forward, bend the elbow. Try to touch the shoulder with the fingertips and return to the starting position.

 

Arm and wrist exercises:

Starting position:

• Sit down.
• Bend the elbow and rest the forearm on a flat surface, such as a table. Make sure the wrist hangs loosely over the side.

 

Wrist bends:

·    Bend the hand back towards the wrist, so that the fingers point toward the ceiling. Then bend the hand down with fingers pointing towards the floor.

 

Wrist rotation:

·    Move the hand from side to side. Then roll the hand in a circular motion in one direction and repeat the same in the other direction.

 

Palm up and down movement:

·    Stay in the same position, but tuck the bent elbow against the side. Face your palm down. Turn the palm so that it faces up towards the ceiling. Then turn the palm so that it faces down.

 

Hand and finger exercises:

Starting position:

• Sit or stand.
• Place the hand out in front.

 

Finger bends:

·    Make a tight fist, open and relax the hand.

 

Finger spreads:

·    Open the hand and stretch the fingers as far apart as possible, bringing them together again.

 

Finger-to-thumb movement:

·    Touch each fingertip to the pad of the thumb, one at a time.

 

Thumb-to-palm movement:

·    Move the thumb and rest it across the palm. Move it out and repeat again.

 

Lower Body Exercises

Hip and knee exercises:

Starting position

·    Lie on the bed with legs extended.

 

Hip and knee bends:

·    Slowly bend the knee up as close to the chest as possible. Straighten the leg and return  to the starting position

 

 Leg lifts:

·     Raise the leg to 300. And hold it in the same position for a few seconds and then return to the bed.

 

Leg side to side movement:

·    Flex the foot with toes pointing up towards the ceiling. Move the leg out to the side as far as possible and return to the starting position.

 

Leg in and out movement:

·    Put the leg extended on the bed. Bring the leg towards the middle, so that the big toe touches the bed. Then roll the leg out and try to make the smallest toe touch the bed.

 

Knee in and out movement:

·    Lie on the back of the bed. Bend the knee so that the bottom of the foot is flat on the bed. Slide the heel towards the buttocks and then return to the starting position.

 

Ankle and foot exercises:

Starting position:

·    Sit in a chair, place your feet on the floor.

 

Ankle bends:

·    Keep the toes on the floor and raise the heel as high as you can. Lower the heel and keep it on the floor and raise the toes as high as you can.

 

Ankle rotation:

·    Raise the foot slightly off the floor. Move the ankle in a circular motion then repeat the same in the other direction.

 

Toe bends:

·    Curl the toes down toward the bottom of the foot. Straighten them. Curl them up toward the ceiling. Then straighten them again.

 

Toe spreads:

·    Spread the toes apart. Bring them together again.

 

Avoid fast or jerky movements, the movements should be smooth and gentle. In case of pain or discomfort while doing the exercises, consult your physiotherapist.