Passive Movements
PASSIVE MOVEMENT
OBJECTIVES
At the end of this lesson, students will be able to:
1. Define passive movement.
2. Classify the types of passive movements.
3. List the techniques of passive movements.
4. Principles of giving passive movements.
5. Indications, contra indications, Effects and uses of each
variety of passive movements.
PASSIVE MOVEMENT
PASSIVE MOVEMENT
DEFINITION:
These are movements produced by an
external force during muscular inactivity or when
muscular activity is voluntarily reduced as much as
possible to permit movement.
PASSIVE MOVEMENT
CLASSIFICATION OF PASSIVE MOVEMENTS
a. Relaxed passive movements, including accessory
movements.
b. Passive manual mobilization technique:
1. Mobilization of joints
2. Manipulation of joints
3. controlled sustained stretching of tightened
structures
PASSIVE MOVEMENT
SPECIFIC DEFINITIONS
Relaxed passive movements:
These are movements performed accurately and smoothly by the physiotherapist.
The movements are performed in the same range and direction as active movements.
The joint is moved through the existing free range and within the pain limits.
Accessory movements:
These occur as a part of any normal joint movement but may be limited or absent in
abnormal joint conditions.
They consists of gliding or rotational movements which cannot be performed
voluntarily.
eg: gliding or rotational movement isolated by physios.
PASSIVE MOVEMENT
Passive manual mobilization technique:
1. Mobilization of joints:
These are small repetitive rhythmical oscillatory, localized
accessory or functional movements performed by the
physiotherapist in various amplitudes with in the available
range, and under the patients control.
2. Manipulation of the joints:
a. By physiotherapists:
These are accurately localized, single, quick decisive
movements of small amplitude and high velocity completed
before the patient can stop it.
PASSIVE MOVEMENT
2. b. By surgeon/Physician:
The movements are performed under surgical anesthesia by a
surgeon, or physician to gain further range. The increase in the
movement must be maintained by the physiotherapist.
3. Controlled sustained stretching of tightened structures:
Passive stretching of muscles and other soft tissues can be
given to increase range of movements.
PASSIVE MOVEMENT
PRINCIPLES OF GIVING RELAXED PASSIVE MOVEMNTS
1. RELAXATION:
• A suitable starting position of comfort and support is
chosen.
• Patient must be taught to relax completely except in
cases of flaccid paralysis, in which it is unnecessary.
• Inspiring confidence, gaining cooperation in maintaining
relaxation through movements is done by the
physiotherapist
PASSIVE MOVEMENT
2. FIXATION:
• To localize the movement to a specific joint, the bone which lies
proximal to it is fixed by the physiotherapist as close to the joint line
as possible to avoid the compensatory movements in other near by
joints.
3. SUPPORT:
• Full and comfortable support is given to the part to be moved.
• Physiotherapist either grasps firmly the part to be moved or it may
be supported by axial suspension in slings in case of trunk or heavy
limbs. This will free the physiotherapist’s hands to assist fixation and
to perform movement.
PASSIVE MOVEMENT
4. TRACTION:
• Traction is thought to facilitate the movement by reducing interarticular
friction.
• Traction force is applied in the direction of the long axis of the joint where
the fixation of the bone proximal to the joint providing an opposing force
to a sustained pull on the distal bone.
5. RANGE:
• The ROM is as full as the condition of the joints permits without eliciting
pain or spasm in the nearby muscles.
• In normal joints slight overpressure may be added to ensure full range,
but not in flial joints.
• Special consideration to be given for two joint muscles to ensure that the
muscle is fully extended during movement.
PASSIVE MOVEMENT
6. SPEED AND DURATION:
• Speed must be uniform, fairly slow and rhythmical to
allow for relaxation.
• Number of repetitions depends on the purpose for
which it is used.
EFFECTS AND USES OF RELAXED PASSIVE
MOVEMENTS
1. Prevent adhesion formation and maintain present range of
movement. One passive movement., well given and at
frequent intervals, is sufficient for this purpose, but the usual
practice is to put the joint through two movements twice daily
2. When active movement is impossible, passive movements
help to preserve the memory of movement.
3. To assist the venous and lymphatic return by mechanical
pressure and stretching of the thin walled vessels which
passes across the joint moved.
PASSIVE MOVEMENT
4. To maintain the elasticity of the muscles (muscle
properties) and to minimize the risk of contracture
formation.
5. When full range active movement is impossible the
extensibility of muscle is maintained, and adaptive
shortening prevented.
6. To decrease pain in the joints due to immobilization
7. The rhythm of continued passive movements can have a
soothing effect and induce further relaxation and sleep.
PASSIVE MOVEMENT
PRINCIPLES OF GIVING ACCESSORY MOVEMENTS
1. Relaxation and fixation
2. Full and comfortable support
3. Range of movement is as full as the condition of the joint permits
EFFECTS AND USES:
1. They compliment to the physiological movements to ensure a smooth
movement.
2. It is performed by the physiotherapist to increase lost range of
movement and to maintain joint mobility.
PASSIVE MOVEMENT
PRINCIPLES OF PASSIVE MANUAL MOBILISATIONS AND
MANIPULATIONS
• Manipulative therapy is a separate specialty in physiotherapy which
deals with the techniques of manipulation and its effects and uses.
• Manipulation that are performed by surgeons are usually under a
local or general anesthesia to avoid pain and protective spasm and
allows the use of greater force.
• It helps to regain full ROM, progressively by a series of
manipulations.
• And it is followed up by the physiotherapist.
PASSIVE MOVEMENT
PRINCIPLES OF CONTROLLED SUSTAINED STRETCH OF
TIGHTENED STRUCTURE
• Patient is positioned in a comfortable starting position and is well
relaxed.
• With suitable fixation the part is grasped by the physiotherapist and
moved in such a way that a sustained stretch is applied to the
contracted structures for a period of time within a functional pattern of
movement.
• Mechanical means can be used
PASSIVE MOVEMENT
EFFECTS AND USES OF CONTROLLED SUSTAINED
STRETCH
1. Steady and sustained stretching is used to overcome spastic
pattern of limbs, e.g., hemiplegics patient.
The slow stretch produces a relaxation and lengthening of the
muscle.
2. Steady and prolonged passive stretch overcomes the resistance of
shortened ligaments, fascia and fibrous sheaths of muscles.
e.g., controlled stretching and progressive splintage of talipes
equino varus.
THANK YOU
