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EXERCISE - Definition
Exercise is physical activity for conditioning the body, improving health, and maintaining fitness.
Benefits of Physical Exercise
1. Improved cardiopulmonary function
2. Reduced blood pressure
3. Increased muscle tone and strength
4. Greater physical endurance
5. Increased weight loss
6. Reduced blood glucose level
Benefits of Physical Exercise
7. Decreased low-density blood lipids
8. Improved physical appearance
9. Increased bone density
10.Regularity of bowel elimination
11.Promotion of sleep
12.Reduced tension and depression
CLASSIFICATION OF EXERCISE
EXERCISE
BASED ON MUSCLE
CONTRACTION
ISOTONIC
ISOMETRIC
ISOKINETIC
BASED ON SOURCE OF
ENERGY
ACTIVE
PASSIVE
BASED ON MUSCLE CONTRACTION
Isotonic exercise : cause muscle contraction and active
movement.Example: walking, aerobics, moving arms &
Legs.
Isometric exercise: tightening or tensing of muscles without
shortening (there is no movement). This increases muscle tension but do not change the length of muscle fibers.
Example: contraction of gluteal muscles.
BASED ON MUSCLE CONTRACTION
Isokinetic Exercise:Involves muscle contractions with
resistance. Resistance is provided by an external
sourceExample: movement of leg against
resistance.
BASED ON SOURCE OF ENERGY
• Active exercise is therapeutic activity that the client performs independently.
• Passive exercise is therapeutic activity that the client performs with assistance and is provided when a client cannot move one or more parts of the body.
Range Of Motion Exercises
Definition: The movement of a joint to
the extent possible without causing pain
Purposes:• Promote and maintain joint mobility• Prevent contractures and shortening
of muscles and tendons• Increase circulation to extremities.• Facilitate comfort for the patient
Contraindications To ROM
• Any illness/disorder where increased use of energy or increased circulation is hazardous.
• Example: Myocardial infarction. swollen, inflamed joints
Types Of ROM Exercises• Active ROM exercises – Exercises the
client is able to perform independently.
• Passive ROM exercises – Exercises performed for the client by someone else.
• Active assisted ROM exercises – Performed by a client with some assistance. Client can move a limb partially through its ROM, but needs help completing the ROM.
Guidelines For Performing ROM Exercises
Start with the head and move down, always do bilaterally
Do not grasp the joint directly
Do not grasp fingernail or toenail. Be sure to support the distal and proximal end of the
limbs
Important joints – thumb, hip, knee, ankle
Move joint through movement 5 times/session
Guidelines For Performing ROM Exercises
Return body part to normal anatomical position
Move each joint through full range of motion
Move to point of resistance not pain
Allow for rest periods whenever required
Avoid friction LIFT body part don’t drag
Note drastic change in vital signs, extreme fatigue.
Guidelines For Performing ROM Exercises
Should not disrupt the healing process
Warm water relaxes the muscles and joints, bathing is an ideal time to perform ROM
Patient Preparation Explain and steps and advantages of
ROM exercises.
Remove all restrictive clothing, linen, splint, and dressings.
Drape appropriately
Raise the bed to comfortable height.
Position the patient comfortably- preferably supine position.
JOINT MOVEMENTS• ABDUCTION - MOVING A BODY PART AWAY FROM THE
MIDLINE OF THE BODY
• ADDUCTION - MOVING A BODY PART TOWARD THE MIDLINE OF THE BODY
• EXTENSION - STRAIGHTENING A BODY PART
• FLEXION - BENDING A BODY PART
• ROTATION - TURNING THE JOINT
• INTERNAL ROTATION - TURNING THE JOINT INWARD
• EXTERNAL ROTATION - TURNING THE JOINT OUTWARD
• PLANTAR FLEXION - BENDING THE FOOT DOWN AT THE ANKLE
• PRONATION - TURNING THE JOINT DOWNWARD
• SUPINATION - TURNING THE JOINT UPWARD
• INVERSION- TURNING THE SOLE OF THE FOOT TOWARDS THE MIDLINE
• EVERSION- TURNING THE SOLE OF THE FOOT AWAY FROM THE MID LINE
Range Of Motion Of Various Joints
JOINT MOVEMENTS POSSIBLE
EXAMPLE
Temporo mandibular Open
Close
Protrusion
Retraction
Lateral deviation
Opening mouth
Closing mouth
Bringing lower jaw forward
Taking lower jaw inside
Moving jaw to a side
Range Of Motion Of Various Joints
JOINT MOVEMENTS POSSIBLE
EXAMPLE
Neck Flexion
Extension
Hyperextension
Lateral flexion
Look @ the toes
Look straight ahead
Look up @ ceiling
look straight ahead, tilt head to shoulder
Joint Movements possible
Example
Shoulder Flexion
Extension
Abduction
Adduction
Internal rotation
External rotation
Circumduction
Raise arm forward & overhead
Return arm to side of body
Raise arm to side to position above head with palm away from head
Return arm & bring across chest
Elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor)
Elbow flexed, move arm until thumb is lateral to head. (Fingers point up)
Move arm in full circle
Range Of Motion Of Various Joints
Joint Movements possible Example
Elbow Flexion
Extension
Hyperextension
Bend elbow
Straighten elbow
Bend lower arm back as far as possible
Range Of Motion Of Various Joints
Joint Movements possible
Example
Forearm Supination
Pronation
Turn lower hand so palm is up
Turn lower hand so palm is down
Joint Movements possible
Example
Wrist Flexion
Extension
Hyperextension
Abduction
Adduction
Bend wrist forward
Straighten wrist (fingers, wrist & arm in same plane)
Bring dorsal surface of hand as far back as possible
Bring wrist medially towards the thumb
Bend wrist laterally towards 5th finger
Joint Movements possible Example
Fingers & Thumb
Flexion
Extension
Hyperextension
Abduction
Adduction
Circumduction
Opposition
Bend fingers & thumb into palm make a fist
Straighten fingers & thumb
Bend fingers as far back as possible
Spread fingers apart / extend thumb laterally
Bring fingers together/ thumb back to hand
Move finger/thumb in circular motion
Touch thumb to each finger of same hand
Range Of Motion Of Various Joints
Joint Movements possible Example
Hip Flexion
Extension
Hyperextension
Abduction
Adduction
Move leg forward
Move leg back beside other leg
Move leg backwards
Move leg laterally away from body
Move leg back to medial position & beyond if possible
Range Of Motion Of Various Joints
Joint Movements possible Example
Knee Flexion
Extension
Bring heel toward back of thigh
Return leg to floor
Range Of Motion Of Various Joints
Joint Movements possible Example
Ankle Dorsiflexion
Plantar flexion
Move foot so toes are pointed upward
Move foot so toes are pointed downward
Range Of Motion Of Various Joints
Joint Movements possible Example
Foot Inversion –
Eversion –
Flexion –
Extension –
Abduction –
Adduction –
Turn sole of foot medially
Turn sole of foot laterally
Curl toes downward
Straighten toes
Spread toes apart
Bring toes together
Range Of Motion Of Various Joints
Joint Movements possible Example
Spine Flexion
Extension –
Hyperextension –
Lateral flexion –
Rotation –
When standing – bend forward from the waist
Straighten up
Bend backward
Bend to the side
Twist from the waist