SHS.

206 KINESIOLOGY II

SADIA SHAHEEN
REFERENCE TEXT: DENA GARDINER
SEMESTER: SPRING 2019
.

 .
 .
GRADES OF MUSCLE STRENGTH

RESISTANCE BY WEIGHTS

PROGRESSIVE RESISTANCE TRAINING

o Delorme & Watkins

o Zinovieff’s Technique
o Macqueen’s Technique
 .

CHAPTER No: 07
PASSIVE MOVEMENTS
 INTRODUCTION

 PASSIVE MOVEMENT

 CLASSIFICATION

 JOINT MOBILIZATION

 GRADES

 PRINCIPLES OF GIVING RELAXED PASSIVE MOVEMENTS

PASSIVE MOVEMENT
These movements are produced by external

force

Activity is voluntarily reduced as much as

possible to permit movement

 CLASSIFICATION

RELAXED PASSIVE MOVEMENTS

PASSIVE MANUAL MOBILISATION TECHNIQUES

– Mobilisation of joints

– Manipulation of joints

– Controlled sustained stretching of tightened structures

 RELAXED PASSIVE MOVEMENTS

Movements performed by Physiotherapist or any other

person

Performed in same range and direction as active movements

Moved in existing free range with in the limits of pain

 ACCESSORY MOVEMENTS

 Occur as part of any normal joint movement

 Consist of gliding or rotational movements which

cannot be performed in isolation as voluntary

movement

 Can only be isolated by second person i.e

physiotherapist or other professionals

 PASSIVE MANUAL MOBILISATION
TECHNIQUES
 Mobilisation of joints

 Manipulation of joint performed by

– Physiotherapist

– Surgeon/physician

 Controlled sustained stretching of tightened structures

 JOINT MOBILIZATION

Joint mobilisation is a technique physiotherapists use to

restore the small Involuntary movements

Assist joints to perform to their optimum

 JOINT MOBILIZATION

Joint mobilisation involves performing a back

and forth oscillation of the joint in order to

restore motion
 JOINT MOBILIZATION

Joint mobilization is a manual therapy

intervention

A type of passive movement of a skeletal joint

It is usually aimed at a 'target' synovial joint

Aim of achieving a therapeutic effect

 WHY?

Pain relief

Decrease muscle guarding or spasm

Treat reversible joint hypo mobility

 CLASSIFICATION
• Grade – I

• Grade – II

• Grade – III

• Grade – IV

• Grade - V
 MANIPULATION OF JOINT
These are acuurately localized, single quick decisive
movements of small amplitude and high velocity
completed before the patient can stop it

MANIPULATION UNDER ANESTHESIA (MUA)

• The movements are performed under anesthesia by a

surgeon or physician to gain further range

• The increase in range should be maintained by

physiotherapist
CONTROLLED SUSTAINED STRETCHING
Passive stretching of muscles or other soft
tissues can be given to increase range of
movement
 PRINCIPLES OF GIVING RELAXED
PASSIVE MOVEMENTS
RELAXATION

FIXATION

SUPPORT

TRACTION

RANGE

SPEED AND DURATION

RELAXATION
 .

Patient education

Relax voluntarily

Position of comfort and support

FIXATION
 .
Where movement is to be limited to specific

joint

Proximal joint is fixed

Otherwise compensatory movements

occurring at other joints

 .

Full and comfortable support is to be given to the

part moved

Patient remain relaxed

Part may be grasped by hand or axial suspension in

slings
TRACTION
Given in long axis of joint

Traction facilitate the movement by reducing

interarticular friction
RANGE
 .

According to the condition of joints

Without eliciting pain or spasm in

surrounding muscles
 FLAIL JOINT

A JOINT THAT HAS AN EXCESSIVE OR

ABNORMAL DEGREE OF MOBILITY

 RANGE

Slight overpressure can be given to ensure

full range – normal joint

Care is needed to move the joint beyond

normal anatomical limit – flail joint

 SPEED AND DURATION

Relaxation should be maintained throughout

the movement

Speed uniform, slow, rhythmical

EFFECTS AND USES OF RELAXED
PASSIVE MOVEMENTS
PREVENTION FROM ADHESION
FORMATION

ADHESION FORMATION PREVENTED

MAINTAIN PRESENT FREE RANGE

 PRESERVE THE MEMORY OF
MOVEMENT

ACTIVE MOVEMENT NOT POSSIBLE

MUSCULAR INEFFICIENCY
 .

SO TO PRESERVE THE MEMORY OF MOVEMENT

STIMIUALTE RECEPTORS OF KINESTHETIC SENSE

 KINESTHETIC SENSE

AN ABILITY TO BE AWARE OF MUSCULAR

MOVEMENT AND POSITION

 .
By providing information through receptors
about muscles, tendons, joints, and other body
parts

The kinesthetic sense helps control and

coordinate activities such as walking and
talking
 ADAPTIVE SHORTENING

Adaptive Shortening is muscle tightness

resulting from a muscle being forced to
remain in a shortened position for a
prolonged period of time
 .

Being unable to lengthen

Adaptive shortening of muscles causes

postural distortions which result in
further imbalance between opposing
pairs of muscle
 PREVENTION FROM ADAPTIVE
SHORTENING

IT IS PREVENTED BY MAINTAINING FULL

RANGE MOVEMENT
 VENOUS AND LYMPHATIC RETURN

It is assisted by

Mechanical pressure

Stretching of thin walled vessels which pass

across the joint moved

Quick, rhythmical and continued passive

movements are required to produce these

effects
Used in conjunction with elevation of the part

to relieve edema, when the patient is unable

to perform active movement

 INDUCE RELAXATION

The rhythm of continued passive movements

have a soothing effect and induce further

relaxation and sleep

Tried in training relaxation

If successful made progressively slower as the

patient relaxes
 EFFECT & USE OF CONTROLLED
SUSTAINED STRETCHING
Overcome Spasticity patterns of limbs e.g.
hemiplegic patients

Relaxation and lengthening of stretched muscle

Overcome the resistance of shortened

ligaments, fascia and fibrous sheaths of muscles
 CHA # 7 .
PASSIVE MOVEMENT
.
 .
 PASSIVE MOVEMENT

 CLASSIFICATION

 JOINT MOBILIZATION

 GRADES

 PRINCIPLES OF GIVING RELAXED PASSIVE MOVEMENTS

.