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Mechanisms underlying acute changes in range of motion
Published in David G. Behm, The Science and Physiology of Flexibility and Stretching, 2018
Greater stretch tolerance or neural inhibition should allow the muscle to be elongated to a greater degree. Maintaining this greater elongation over an extended period (i.e. 20–60 seconds) might be expected to affect the properties of the musculotendinous tissues. What musculoskeletal components restrict our ROM? ROM is affected by skeletal structures, joint capsules, ligaments, muscles, tendons, aponeuroses, and fat. What factors can we modify with stretching? If we stretch until a bone is fractured, we can get an acute increase in ROM but at the cost of excessive pain, inflammation, and loss of function. Within moments, the pain and inflammation will then decrease the ROM! The glenoid fossa or cavity of the shoulder (glenohumeral) joint is a relatively flat surface, allowing the shoulder a great deal of unrestricted movement for flexion/extension, abduction/adduction, horizontal abduction/adduction, medial and lateral rotation, and circumduction (Figure 4.7a). In contrast, the acetabulum of the hip joint is deeper and more cup-like, restricting ROM compared with the glenoid fossa (Figure 4.7b). It can also perform flexion/extension, abduction/adduction, medial and lateral rotation and circumduction. Whereas shoulder motion is expansive, hip ROM is quite limited compared with the shoulder.
How to assess response/efficacy of manual lymphatic drainage and compression therapy
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Range of motion (ROM) is a measurement of the distance and direction a joint can move to its full potential. In lymphedema, ROM is often found to be restricted and therefore serves as a good indicator of therapeutic efficacy.11
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
Reducing physical suffering Alleviating lassitude as a result of immobility When impaired circulation as a result of immobility causes suffering, such as fatigue or stiffness, it is sometimes possible to alleviate fatigue, stiffness, or pain temporarily by massage, stretching, or ROM exercise, promoting circulation in the muscles around the scapula. Moreover, when respiratory discomfort develops, pain and stiffness often occur because patients must spend more time sitting, and their antigravity muscles, such as the cervical-upper spinal erector spinae muscles, become constantly hypertonic. Heat may be used (with contraindications, such as avoiding the application of heat directly over tumors, kept in mind), and support to promote blood circulation can be performed in an attempt to relax the muscles.Protecting upper limbs that are difficult to move When an upper limb is heavy and difficult to move freely because of brachial plexus paralysis or some other form of paralysis of the upper limb or because of lymphedema or some other type of edema of the upper limb, an attempt should be made to maintain the upper limb in the correct position through the use of an arm sling so as to protect it from hazards, such as wound during housework, and to prevent secondary suffering.Positioning in a comfortable posture Sometimes pain occurs as a result of a tumor metastasizing to the axillary lymph nodes or lymph nodes around the collarbone, with subsequent growth compressing the nerves, or because the tumor has invaded a nerve. Although drug therapy is the mainstay of pain treatment, since the degree of pain likely varies with the position of the shoulder joint or the scapula, methods such as appropriate positioning so that the shoulder joint is unlikely to be subjected to excessive traction should be considered.Alleviation of suffering and restricted movements as a result of edema during the terminal period In patients in the terminal phase of their illness, venous and lymphatic displacement, hypoproteinemia, or paralytic edema tends to develop as a result of advanced cancer. It is also often difficult to improve the edema itself, and because the body movements are limited by the edema and ROMs are limited, these limitations often become causes of patient suffering. It is important to minimize movement limitations by preventing fibrosis around joints and performing ROM exercises to maintain the ROM of major joints.
Efficacy of proprioceptive neuromuscular facilitation compared to other stretching modalities in range of motion gain in young healthy adults: A systematic review
Published in Physiotherapy Theory and Practice, 2019
Débora Wanderley, Andrea Lemos, Eduarda Moretti, Manuella Moraes Monteiro Barbosa Barros, Marcelo Moraes Valença, Daniella Araújo de Oliveira
Range of motion (ROM) is an outcome often researched in physiotherapy (Khodayari and Dehghani, 2012; Mallmann et al, 2011; Moesch et al, 2014; Puentedura et al, 2011; Zakaria, Melam, and Buragadda, 2012) and is related to the displacement or full motion of a joint or of a group of muscles (Zakaria, Melam, and Buragadda, 2012). Among the individual factors that affect the extension of motion are the structural joint characteristics and the mechanical properties of muscle tendons (Zakaria, Melam, and Buragadda, 2012), in addition to age, race and sex (Fasen et al, 2009). In this context, stretching is used in clinical practice because it could promote ROM gains and also to prevent injuries and muscle imbalances, which may improve musculoskeletal function and sports performance (Funk et al, 2003; Khodayari and Dehghani, 2012; Schuback, Hooper, and Salisbury, 2004). Thus, in addition to individual factors in maintenance of flexibility, other aspects must be considered such as: stretching duration; the number of sets (Malliaropoulos, Papalexandris, Papalada, and Papacostas, 2004; Taylor, Dalton, Seaber, and Garrett, 1990); the weekly frequency (Wallin, Ekblom, Grahn, and Nordenborg, 1985) and stretching types, where protocols widely differ among studies (Fasen et al, 2009; Khodayari and Dehghani, 2012; Mallmann et al, 2011; Moesch et al, 2014; Puentedura et al, 2011; Schuback, Hooper, and Salisbury, 2004; Yuktasir and Kaya, 2009; Zakaria, Melam, and Buragadda, 2012).
A comparison of two manual physical therapy approaches and electrotherapy modalities for patients with knee osteoarthritis: A randomized three arm clinical trial
Published in Physiotherapy Theory and Practice, 2018
Ebru Kaya Mutlu, Ersin Ercin, Arzu Razak Ozdıncler, Nadir Ones
All participants received the same standardized exercise program. The exercises included aerobic, active ROM, strength, and stretching exercises. Aerobic exercise consisted of a static cycle for up to 10 min. The active ROM exercise was performed via knee in extension to full-flexion, then knee in flexion to full-extension exercises, repeated 10 times. The strengthening exercises consisted of quadriceps strengthening by holding maximal isometric contractions for 10 s and performing 10 repetitions. Stretching targeted the gastrocnemius-soleus and hamstring muscle and was performed by asking the patient to stretch the muscle for 30 s and to complete three repetitions for each muscle group. All exercises were supervised by the same physiotherapist and lasted 20 min. In addition, all groups performed a home exercise program twice per day of each movement. The patients were advised to continue the home exercise program for at least 1 year after the treatment. To control adherence to the home exercise program, the patients were invited to the clinic in the third and sixth month. Adherence to the home exercise program was obtained verbally.
Shoulder and elbow range of motion for the performance of activities of daily living: A systematic review
Published in Physiotherapy Theory and Practice, 2018
A.M Oosterwijk, M.K Nieuwenhuis, C.P van der Schans, L.J Mouton
ROM is usually assessed as the degree of maximal mobility of a specific joint in a particular plane of movement. Although these measurements provide clinicians with valuable data, they do not specify information regarding the functional capacities of the individual patient in daily living. For instance, one patient with impaired shoulder flexion motion may not be able to raise an upper limb as far as unimpaired participants but may still be able to normally execute almost all ADL tasks. Whereas, on the other hand, another patient with approximately the same impairments can be physically disabled due to different demands of daily activities, for example, living in a house with many high cupboards. Furthermore, information concerning activity limitations is often gathered by questionnaires and/or by assessing a patient’s performance on a small set of ADL tasks. However, from questionnaires, no insight into possible harmful movement patterns can be gained and, when using a small set of ADL tasks, knowledge on which set is most appropriate should be available.