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Manual
Equipment
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Wand or T-bar
Finger ladder, wall climbing, ball rolling
Pulleys
Skate board/powder board
Reciprocal exercise devices
Self-Asisted ROM (S-AROM) should be part
of the home exercise program
 Done as soon as the individual is able to
understand and learn what to do
 used to protect the healing tissues when more
intensive muscle contraction is contraindicated


Manual

Equipment
◦
◦
◦
◦
◦
Wand or T-bar
Finger ladder, wall climbing, ball rolling
Pulleys
Skate board/powder board
Reciprocal exercise devices
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

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Educate the patient on the value of the motion.
Ensure correct body alignment, stabilization, and
performance
If equipment is used, ensure safe application.
Provide drawings and clear guidelines for number of
repetitions and frequency.
Review the exercises at a follow-up session.
Modify or progress based on the patient response
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cases of unilateral weakness or paralysis, or during
early stages of recovery after trauma or surgery
The effects of gravity with patient positioning
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Shoulder flexion and extension.
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Shoulder horizontal abduction
and adduction.
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Shoulder rotation.
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Elbow flexion and extension.
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Pronation and supination of
the forearm.
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Wrist flexion and extension and
radial and ulnar deviation.
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Finger flexion and extension.
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Thumb flexion with opposition
and extension with reposition.
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Hip and knee flexion.
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Hip abduction and
adduction.
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Combined hip
abduction with
external rotation.
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Ankle and Toes
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Patient has voluntary muscle control in an involved
upper extremity but needs guidance or motivation to
complete the ROM
◦ provide the patient with objective
reinforcement and motivation for
performing shoulder ROM
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arm may be moved into flexion
or abduction
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utilize significantly more muscle
activity than therapist-assisted
ROM and CPM machines
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A pulley may also be attached to
an overhead bar or affixed to the
ceiling
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a friction-free surface may encourage movement
without the resistance of gravity or friction
◦ skate with rollers
◦ using powder
◦ placing a towel under the extremity
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Providing some flexion and
extension to an involved extremity
using the strength of the normal
extremity
◦ bicycle, upper body, or lower body
ergometer, or a reciprocal exercise unit
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reciprocal exercise unit can be used
also for reciprocal patterning,
endurance training, and
strengthening
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passive motion performed by a mechanical device
that moves a joint slowly and continuously through a
controlled ROM.
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It has beneficial healing effects on diseased or injured
joint structures and soft tissues
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Prevents development of adhesions and contractures
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Provides a stimulating effect on the healing of tendons
and ligaments
Enhances healing of incisions over the moving joint
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Increases synovial fluid lubrication of the joint
Prevents the degrading effects of immobilization
Provides a quicker return of ROM
Decreases postoperative pain
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Apply immediately after surgery or as soon as possible
use low arc of motion (20°-30°) initially and progress
to 10°-15°/day as tolerated
Use 1 cycle/45 sec or 2 min
continuous for 24 hrs - continuous for 1 hr 3x day
PT is done when pt. is not on CPM
The duration is usually less than 1 week
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determine what pattern of movement is desired and
then move the extremity through that pattern
beneficial in initiating the teaching of ADL
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helps the patient to:
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◦ recognize the purpose and value of ROM exercises
◦ develop motor patterns
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Grasping an eating utensil
Eating (hand to mouth)
Reaching to various shelf heights
Brushing or combing back of hair
Holding a phone to the ear
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Donning or doffing a shirt or jacket
Reaching out a car window to an ATM machine
Going from supine to sitting at the side of a bed
Standing up/sitting down and walking
Putting on socks and shoes