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– To increase ROM.
I. Manual assistance:
When the assistance is provided by
a. The P.T.
b. The pt’s sound limb (self assisted).
1. Starting position:
Complete stability & comfort must be provided to the
body to ensure complete pt’s attention, concentration
& maximum effort required for performance.
2. Fixation:
The proximal part & joint of the exercised limb should
be adequately fixed by the PT to improve the
efficiency of the agonist muscles.
3. Support:
Full support must be given to the exercised
part or limb by means of:
• Pillows.
• Boards.
• Slings.
• Manually.
Support → eliminate any force or load on the
weak ms by counterbalancing the effects of
gravity (eliminate effect
of gravity).
4. Characteristics of active assistive
ex:
a. The assistance should be sufficient to give adequate
help to the working ms, it must not be allowed to
exceed this level or a passive mov. will result.
b. As the m. power increases (↑), the given assistance
must be decreased (↓) proportionally.
5. Direction:
The assistance or external force employed is
applied in the direction of m. action.
6. Repetition:
Depends on the level of m. fatigue. So the cause
& extent of weakness must be known &
understood.
Understanding the pattern of
movement:
Clear information must be given & understood
by the pt about what is expected from him to
perform.
1. Wand Exs.:
a wooden stick, cane or similar objects may be used.
2. Finger Ladder:
with wall climbing are tools used to assist shoulder &
hand movs.
4. Shoulder Wheel:
provide assistance for the ULs.
5. Skate Board & Powder Board:
a board is placed under the affected limb to assist :
a. Isolate the effect of gravity.
b. Help post surgery cases.
c. After removal of plaster cast.
6. Suspension:
the involved segment is suspended in a sling attached
to a rope fixed to a point above the body segment.
* Precaution:
The pt must be taught the proper motions
& not allowed to substitute with trunk
side bending, toe raising, or scapular
elevation.
Overhead Pulleys
Pulley Exercises:
1. Shoulder flex & abd.
2. Shoulder int. & ext. rot.
3. Elbow flex. & ext.
Shoulder Wheel
Set-up:
1. A shoulder wheel is permanently attached to
a wall.
Exercises:
1. Hip abd. & add.
2. Hip flex. & ext.
3. Knee flex. & ext.
Suspension
1. Vertical suspension
The point of attachment of the rope is over the center of
gravity of the moving segment.
The part can move like a pendulum.
The mov. in a small ROM.
Used for support.
1. Axial suspension
The point of attachment of all ropes supporting the part is
above the axis of the joint to be moved.
The part will move on a flat plane parallel to the floor.
Used to allow maximum mov. of a joint.
Benefits of suspension for ROM
exs.
1. Active participation is required, thus the pt learns to use
the appropriate ms. for the desired mov.
* It improves endurance.