Range of motion ( ROM) is the measurement of the range of motion that a particular joint or body part can make. It is a feature that is frequently evaluated in the first examination and subsequent follow-ups of patients who apply to physical therapy and rehabilitation clinics and are treated. Joint range of motion (ROM) exercise is one of the basic exercises recommended to be done both in the problems affecting the musculoskeletal system and in the recovery period in neurological diseases.
How to Measure Joint Range of Motion?
Joint range of motion is usually measured with an instrument called a goniometer. The goniometer is a metal or plastic protractor with two arms that can rotate around an axis. The axis of the goniometer aligns with the axis of the joint where the movement takes place; The angle of the arms of the instrument indicates the degree of movement of the body parts. Joint range of motion can be measured actively and passively. Active range of motion is the movement that the person can do with his/her own strength. Passive range of motion is the degree of motion obtained by applying an external force (push or pull) to the joint. Features such as the differences between passive and active range of motion, and varying degrees of pain in these two conditions can sometimes provide valuable diagnostic information.
Joint Range of Motion Exercises
Joint range of motion exercises are among the most basic treatments applied in the physical therapy and rehabilitation process after orthopedic or neurological problems. The purpose of these exercises is to keep the joints in their normal range of motion, to prevent pain, edema and limitation. These exercises can be done for all movable joints. These exercises are often used for toes, ankles, knees, hips, fingers, wrists, elbows, shoulders, and neck. Joint range of motion exercises are applied according to the motion directions that the joint normally has. For example, the tip joint of the index finger has only bending and opening movements, but the shoulder joint opens both up and to the side, and makes an inward and outward rotation movement. Exercises are applied in such a way that they do not skip any normal movements. Some movements may be inconvenient in cases such as after surgery. For this reason, you should consult your doctor and physiotherapist before exercising for therapeutic purposes.
Joint range of motion exercises are also very important in diseases such as stroke, brain damage, spinal cord paralysis, ALS . In these diseases, due to muscle weakness, the person may not be able to move normally as they should. Immobility of the joints for a long time can lead to shortening and contraction of the muscles, ligaments and joint capsule. After a while, permanent limitation of movement called contracture occurs. Later, even if the person’s muscle strength improves and becomes able to move, he may not be able to move normally due to the contracture. Also, staying still causes pain and edema. Exercising can prevent these problems.
Physical therapy programs after sports injury or surgery are generally started with passive ROM exercises. Thus, joint movements can be performed without too much strain on structures such as muscles and tendons. If passive ROM exercises are not started in the early period after orthopedic surgeries, adhesion (adhesion) between the tissues may occur and this may manifest itself as stiffness later on. As the treatment program progresses, assisted (assisted) and active ROM exercises are started as the tissues heal. In assisted exercises, the person does the exercise himself as much as he can, and the therapist provides support for the missing part. In active exercises, all exercise is done by the patient. Assistive and active exercises are useful in preventing muscle wasting. In passive exercises, such a benefit is not expected as the muscles do not work.
Starting to exercise on your own for treatment purposes can lead to negative results. For example, starting exercises uncontrollably after a hand tendon injury may cause the tendon to rupture. Performing joint range of motion exercise in the wrong direction after hip replacement surgery may cause the prosthesis to come off. We recommend that you consult your physical therapist and physiotherapist before starting a new exercise.