4/7/2022 Aerobic Exercise

-activity during which the amount of oxygen taken in the

Range of Motion (ROM) Exercises body is greater than that used to perform the activity

5. Anaerobic Exercise Lo
45°
-involves activity which the muscles cannot draw out
Extemal
enough oxygen from the blood stream, and anaerobic
rotation
pathways are used to provide additional energy for a
to 45°
short time
40°
Internal
RANGE OF MOTION
rotation
maximum movement that is possible for that
to 40°
joint
EXERCISE
ROM Exercises
- is a type of physical activity.
- joint movements performed by the patient himself or
- is a planned, structured, and repetitive bodily
by a nurse to move joints in its full range without
movement done to improve or maintain one or more
causing pain
components of physical fitness.
Flexion
Extension
Hyper extension
Benefits of EXERCISE
Rotation
Musculoskeletal System
Lateral flexion
Cardiovascular System
to prevent contractures
Respiratory System
Metabolic/Endocrine System
TYPES OF ROM EXERCISES
Urinary System
Active or Isotonic
Immune System
► to increase & maintain muscle tone and joint mobility
Psychoneurologic System
• Active-assistive
Cognitive Function
➤ encourages normal muscle function
Spiritual Health

• Passive
TYPES OF EXERCISES
► maintains joint mobility only
1. Isotonic (Dynamic)
Exercise
INDICATIONS AND GOALS FOR ROM
-muscle shortens to produce muscle contraction &
Indications for Active ROM (AROM)
active movement
whenever a patient is able to contract the muscles
actively and move a segment with or without assistance
TYPES OF EXERCISES
• can be used for aerobic conditioning programs
2. Isometric (Static or Setting) Exercise
• when a segment of the body is immobilized for a
-there is muscle contraction without moving the joint
period of time - used on the regions above and below
***
the immobilized segment
3. Isokinetic (Resistive) Exercise -involves muscle
INDICATIONS AND GOALS FOR ROM
contraction or tension against resistance
Goals for AROM
4.
BY: 3408102–MTC-MDCON
• maintain physiological elasticity and contractility of
the participating muscles
• provide sensory feedback from the contracting
muscles
• provide a stimulus for bone and joint tissue integrity
• increase circulation and prevent thrombus formation
• develop coordination and motor skills for functional
activities
INDICATIONS AND GOALS FOR ROM
Indications for Active-Assistive ROM (A-AROM)
when a patient has weak musculature and is unable to
move joint through the desired range
INDICATIONS AND GOALS FOR ROM
Indications for Passive ROM (PROM)
in regions where there is acute and/or inflamed tissue
when a patient is not able to or not supposed to actively
move a segment or segments of the body
5. When exercising extremities, work from the proximal
joints toward the distal joints.
6. Every joint should receive adequate exercise, but it is
crucial that several particular joints remain functional.
Time of Exercise
Bath time
Other appropriate times might be when the patient is:
rested in the morning
before bedtime
Evaluate the effectiveness of the ROM regimen. Then
adjust the regimen to the individual needs of the patient.
Time of Exercise
Bath time
Other appropriate times might be when the patient is:
rested in the morning
before bedtime
Evaluate the effectiveness of the ROM regimen. Then
adjust the regimen to the individual needs of the patient.

INDICATIONS AND GOALS FOR ROM JOINT MOVEMENTS

Goals for PROM Types of Joint Movements
• maintain joint and connective tissue mobility TABLE 44-1
• minimize the formation of contractures Movement
• maintain mechanical elasticity of muscle Flexion
• assist circulation and vascular dynamics Action
• enhance synovial movement for cartilage nutrition and Decreasing the angle of the joint (e.g.. bending the
diffusion of materials in the joint elbow)
• decrease or inhibit pain Extension
assist with the healing process after injury or surgery Increasing the angle of the joint (e.g., straightening the
help maintain the patient's awareness of movement arm at the elbow)
Hyperextension
CONTRAINDICATIONS OF ROM EXERCISES Further extension or straightening of a joint (e.g.,
any illness or disorder in w/c increasing the level of bending the head backward)
energy needed or increasing the demand for circulation Abduction
is potentially hazardous Movement of the bone away from the midline of the
• if the joints are swollen or inflamed or if there has been body
injury to the musculo skeletal system in the vicinity of Adduction
the joint Movement of the bone toward the midline of the body
Rotation
Reminders in performing ROM Exercises Movement of the bone around its central axis
1. Joints move in different ways. Circumduction
2. Several movements can be done together. Movement of the distal part of the bone in a circle while
3. Discontinue exercises if client complains of pain or the proximal end remains fixed
discomfort. Eversion
4. Do not grasp the fingernails or toenails.

BY: 3408102–MTC-MDCON
Turning the sole of the foot outward by moving the Clients who experience restrictions in activity are at risk
ankle joint for impaired joint mobility.
Inversion Promoting exercise to maintain a client's muscle tone
Turning the sole of the foot inward by moving the ankle and joint mobility is an essential function of nursing
joint personnel. When clients are ill, they may need to
Pronation perform ROM exercises until they can regain their
Moving the bones of the forearm so that the palm of the normal activity levels.
hand faces downward when held in front of the body
Supination FLEXION
Moving the bones of the forearm so that the palm of the Move the head from the upright midline position
hand faces upward when held in front of the body forward, so that the chin rests on the chest.
45° from the midline
PROCEDURE Example: nodding head "yes"
1. Perform hand washing. EXTENSION
2. Check two forms of client ID & introduce yourself. Move the head from th flexed position to the upright
Explain rationale for procedure to client. position
3. Put all joints through ROM slowly and gently. Start at 45° from the midline
neck. Example: nodding head "yes"
4. Protect against gravity and detrimental movement HYPEREXTENSION
when performing ROM exercises. Move the head from the upright position back as far as
5. possible
Never grasp joints directly. 45° from the midline
6. Gently cup your hand under the joint and allow the
joint to rest on the palm of the hand. LATERAL FLEXION as
7. All joints should be put through five-range-of-motion posible to the right and left.
exercises to each joint at least BID. Move the head laterally to the right and left Exam
shoulders. head
5. 40° from the midline
Never grasp joints directly.
6. Gently cup your hand under the joint and allow the ROTATION
joint to rest on the palm of the hand. Turn the face as far as possible to the right and left./
7. All joints should be put through five-range-of-motion 70° from midline
exercises to each joint at least BID. Example: shaking head "no"
8.
Encourage client to do active exercises as soon as FLEXION
possible. Raise each arm from a position by the side forward and
upward to a position beside the head.
9. Perform the exercises using different joint 180° from the side
movements for different Example: reaching to urn on overhead light
body parts. EXTENSION
10. Reassess client's ability to perform ROM exercises Raise each arm from a position by the side forward and
and adjust schedule accordingly. upward to a position beside the head.
11. Reposition client comfortably. 180° from vertical position beside the head
12. Perform hand washing. HYPEREXTENSION
. Move each arm from a resting side position to behind
PROVIDING ROM EXERCISES the body

BY: 3408102–MTC-MDCON
50° from side position With each arm held out to the side at shoulder level and
the elbow bent to a right angle, fingers pointing up, bring
ABDUCTION the arm forward and down so that the fingers point
Move each arm laterally from a resting position at the down.
sides to a side position above the head, palm of the 90°
hand either toward or away from the head Example: reaching to scratch
180° same side lower back
Example: reaching to bedside stand on same side of
bed as arm ROTATION FOR SUPINATION
ADDUCTION Turn each hand and forearm so that the palm is facing
Move each arm from a position at the sides across the upward
front of the body as far as possible. The elbow may be 70° to 90°
straight or bent. ROTATION FOR PRONATION
50° With each arm held out to the side at shoulder level and
Example: reaching across body toward opposite side of the elbow bent to a right angle, fingers pointing up, bring
bed the arm forward and down so that the fingers point
down.
CIRCUMDUCTION 70° to 90°
Move each arm forward, up, back, and down in a full
circle. FLEXION
360° Bring the fingers of each hand toward the inner aspect
of the forearm.
EXTERNAL ROTATION 80° to 90°
With each arm held out to the side at shoulder level and Example: eating, bathing, shaving, writing
the elbow bent to a right angle, fingers pointing down, EXTENSION
move the arm upward so that the fingers point up Straighten each hand to the same plane as the arm
90° 80° to 90°
Example: reaching over opposite shoulder to scratch Example: eating, bathing, shaving
upper back HYPEREXTENSI ON
INTERNAL ROTATION . Bend the fingers of each hand back as far as possible
With each arm held out to the side at shoulder level and JOINT
the elbow bent to a right angle, fingers pointing up, bring 70° to 90°
the arm forward and down so that the fingers point
down. RADIAL FLEXION (ABDUCTION)
90° Bend each wrist laterally toward the thumb side with
Example: reaching to scratch hand supinated
same side lower back 0° to 20° ULNAR FLEXION (ADDUCTION)
Bend each wrist laterally toward the fifth finger with the
EXTERNAL ROTATION hand supinated.
With each arm held out to the side at shoulder level and 30° to 50°
the elbow bent to a right angle, fingers pointing down,
move the arm upward so that the fingers point up FLEXION
90° Make a fist with each hand
Example: reaching over opposite shoulder to scratch 90°
upper back ample: squeezing, gripping, writing
INTERNAL ROTATION EXTENSION

BY: 3408102–MTC-MDCON
Straighten the fingers of each hand Example: moving leg away from body
90° ADDUCTION
HYPEREXTENSI ON . Move each leg back to the other leg and beyond in
Bend the fingers of each hand back as far as Possible. front of it.
30° 20° to 30° beyond other leg Example: moving leg over
the other leg toward the middle of the body
ABDUCTION
Spread the fingers of each hand apart CIRCUMDUCTION
20° Move each leg backward, up, to the side, and down in a
ADDUCTION circle.
Bring the fingers of each hand together. 360°
20° Example: leg circles clockwise and counterclockwise.

FLEXION INTERNAL ROTATION

Move each thumb across the palmar surface of the Flex knee and hip to 90°. Place the foot away from the
hand toward the fifth finger. midline. Move the thigh and knee toward the Midline.
90° EXTERNAL ROTATION
EXTENSION Flex knee and hip to 90°. Place the foot toward the
Move each thumb away from the hand midline. Move the thigh and knee away from the
90° Midline.
45°
OPPOSITION
.Touch each thumb to the top of each finger of the same FLEXION
hand. The thumb joint movements involved are Bend each leg, bringing the heel toward the back of the
abduction, rotation, and flexion thigh
120° to 130°
Example: knee bends, walking
FLEXION EXTENSION
Move each leg forward and upward. The knee may be Straighten each leg, returning the foot to its position
extended or flexed. beside the other foot.
Knee extended, 90°; knee flexed, 120° 120° to 130°
Example: walking, leg lifts in front of the body Example: straightening leg from bent position, walking

EXTENSION EXTENSION - PLANTAR

Move each leg back beside the other. FLEXION
90° to 120° Point the toes of each foot Downward
Example: walking, lining the leg up with the body 20⁰
HYPEREXTENSION Example: pressing toes away from face,
Move each leg back behind the body walking
30° to 50° FLEXION - DORSIFLEXION
Example: walking; lying on side, reach the leg behind the Point the toes of each foot upward
body 45° to 50°
Example: pulling toes toward face, walking
ABDUCTION 's
. Move each leg out to the side.
45° to 50° EVERSION

BY: 3408102–MTC-MDCON
Turn the sole of each foot laterally.
5°
Example: foot circles clockwise and counterclockwise
INVERSION Turn the sole of each foot medially.
5°
Example: foot circles clockwise and counterclockwise
Example: walking, wiggling toes

FLEXION
Curl the toe joints of each foot downward
35° to 60°
EXTENSION
Straighten the toes of each foot.
35° to 60°

FLEXION
Bend the trunk toward the toes
70° to 90°
Example: touching toes
EXTENSION Straighten the trunk from a flexed position.
HYPEREXTENSION Bend the trunk backward.
20° to 30°
Example: gentle supported back bend with hands on
buttocks

LATERAL FLEXION
Bend the trunk to the right and to from the left side
35° on each side
Example: gently allow right hand to slide down right side
of thigh, repeat on left side

LATERAL FLEXION
Bend the trunk to the right and to from the left side
35° on each side
Example: gently allow right hand to slide down right side
of thigh, repeat on left side

BY: 3408102–MTC-MDCON