fundamentals
Physical Therapy (PT)
Range of motion exercises
Range of motion commonly becomes restricted after a Overview of Stroke or prolonged bed rest. Restricted range of motion can cause pain, interfere with a person's ability to function, and increase the risk of skin being worn away (skin breakdown) and A therapist stabilizes the person's shoulder with one hand while slowly raising the person's elbow as high as possible with the other. Over several sessions, the elbow is gradually moved higher, increasing the joint's range of motion. Before beginning therapy, the physical therapist often evaluates range of motion with an instrument called a goniometer, which measures the largest angle a joint can move through. The therapist also determines whether restricted motion results from tight muscles or from tight ligaments and tendons. If tight muscles are the cause, a joint may be stretched more vigorously. If tight ligaments or tendons are the cause, gentle stretching is attempted, but surgery is sometimes needed before progress can be made with range-of-motion exercises. Stretching is usually most effective and least painful when tissues are warmed up. Thus, therapists may apply heat first. There are three types of range-of-motion exercises: Active exerciseis for people who can exercise a muscle or joint without help. They must move their limbs themselves. Active-assistive exerciseis for people who can move their muscles with a little help or who can move their joints but feel pain when they do. People move their limbs themselves, but a therapist helps them do so, by hand or with bands or other equipment. Passive exerciseis for people who cannot actively participate in exercise. No effort is required from them. The therapist moves their limbs to prevent contractures (the permanent stiffening of muscles resulting from lack of movement), among other goals. Active-assistive and passive range-of-motion exercises are done gently to avoid injury, although some discomfort may be unavoidable. To increase range of motion, the therapist must move an affected joint beyond the point of pain, but the movement should not cause residual pain (pain that continues once the movement is stopped). Sustained moderate stretching is more effective than momentary forceful stretching. 