Passive movement
Passive ROM Exercises
• Movement produced by an external force
within the unrestricted range of motion of a
segment by :
• Gravity
• Machine
• Therapist or another person
• Another part of the individual’s own body
Classification of Passive Movement
• 1- Relaxed Passive Movements, including
accessory movements.
• 2- Forced Passive movement.
• 3- continuous Passive movement.
RELAXED PASSIVE MOVEMENT :
These are movements performed accurately,
rhythmical and smoothly by the physiotherapist
through available range of motion( according to
anatomy of joints) .
Indications of relaxed passive movement
• 1- Acute or inflamed tissue where active motion may disrupt the
normal healing process
2- Patients who are unable to move or are not allowed to move such
as when comatose, paralyzed, or on complete bed rest
3- For assessment purposes
4- When teaching a patient movement
5- To prepare a patient for stretching
6- relaxation as a factor helping to reduce spasm in group of muscles.
Contra-indications of relaxed passive movement
1-unhealed fracture, recent fracture, at the site of fracture.
2-At site of effusion or swelling.
3-Immediately following surgical procedure to tendon,
ligaments, joint capsule.
4-Immediately after recent tear to ligament, tendon.
5-when a bony block limits joint motion e.g. myositis
ossificans.
6-Recent injuries
7-sever muscle weakness.
8-Acute inflammation or infection as arthritis,
osteomylities.
• Technical Principles during Application of
Passive Exercises
1. Place the patient in proper comfortable
position with proper body alignment and
stabilization to perform the exercise.
2. The therapist should be in a proper
position and effective stance.
3. Free the region from restrictive closes,
linen, splints, and dressings.
4. Drape and cover the patient as
necessary
5. Utilize the proper hand holds or grasps by the
therapist.
6. Perform the exercise slowly, smoothly with rhythm
within the available pain free range of motion
without any force behind the range.
7. Do all ROM exercises smoothly and gently. Never
force, jerk, or over-stretch a muscle. This can hurt the
muscle or joint instead of helping.
8. Stop ROM exercises if the person feels pain. The
exercises should never cause pain or go beyond the
normal movement of that joint.
9. Repeat the exercise 5 to 10 repetitions according to
the patient condition and response
Principles of relaxed passive mov
1-Relaxation:
The selection of a suitable starting position
ensures comfort and support, for both patient
and physiotherapist through the movement.
2-Fixation:
Good fixation for the proximal and distal
joint by the physiotherapist to ensure that the
movement is localized to the movable joint.
3-Support:
Full and comfortable support is given to the
part to be moved, so that the patient has
confidence and will remain relaxed.
5-Range of movement :
The range of movement is done in painless
range to avoid spasm in the surrounding
muscles. So, stop ROM exercises if the person
feels pain. Never go beyond the normal
movement of that joint.
• Shoulder joint :
• 1- flex and ext
• From zero to 180 degree with elbow flex using
proximal hand and distal proximal to wrist joint
• Abd and add :
• Rom from zero to 180 degree
• Proximal hand above clavicle and distal hand
grasp upper limb from elbow
• External and internal rotation :
• Start from 90 degree abduction 90 degree
elbow flex
• One hand grasp elbow and other on distal
radius
• Internal rotation
• Rom is 90 degree , same as external rotation
• Elbow joint :
• Flex and ext :
• Rom is from zero to 135 degree
• One hand on posterior aspect of elbow and
other on distal radius
• Radioulnar supination pronation
• Start from mid-position
• Supination 70 degree
• Pronation 80 degree
• Wrist flex , ext :
• Starting from 90 degree elbow flex and resting
on table
one hand on radius and other grasp wrist
• Cervical region : flexion
• From zero extension tell reach mandible to
sternum
• Extension :
• From natural position
• Rotation :
• From zero to
• 45 degree
• Side bending :
• The less limited ROM in cervical
II- Forced passive movement
• An exercise performed on a subject by a partner
who exerts an external force not only to
produce a passive movement, but also to
increase the range of movement of a joint. The
partner presses the joint into its end-position.
• There is a danger of overextension beyond the
range of movement and damage to the joint if
the exercise is not carried out carefully.
111- Continuous passive motion (CPM)
• A continuous passive motion device maintains
movement of a joint after limb sparing surgery.
1-decreasing the complication of immobilization.
2-decreasing the post operative complication and
pain.
3-improving the recovery rate and ROM.
4-improving the circulation through pumping action.
5-prevent adhesions and contracture.
6-prevent joint effusion and wound oedema.
Continuous passive mov Passive forced mov Passive relaxed mov
Done by device Done by therapist Done by therapist
According to surgeon Through end position Through free painless rom
instructions
Through out the day Done 5 to 10 repitetion Done 5 to 10 repetition
To maintain mobility and To increase rom in the joint Goal to avoid bedridden
avoid post operative stiffness complication
Increase ROM Increase ROM Maintain ROM
Minimum force Use force NOT use force
Use for treatment Use for treatment Use for assessment
