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PASSIVE MOVEMENT
By: - K.MALLESH
BATCH -2019

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DEFINITION: -
➢ These movements are produced by an external force during
muscular in activity (or) when range of motion is reduced to any cause.
➢ Carried out either by the therapist or machine.
CLASSIFICATION:-
A) Relaxed passive movements including accessory movements.
B) Passive manual mobilisation techniques
I. Mobilisation of joints.
II. Manipulation of joints.
III. Controlled sustained stretching of tightened
structures.
A) RELAXED PASSIVE MOVEMENTS:-
➢ These are movements performed accurately, rhythmically and smoothly
by the physiotherapist through available range of motion.
➢ The movements are performed in the same range and direction as active
movements.
➢ The joint is moved through the full range and within the limits of pain.

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ACCESORY MOVEMENTS :-
• These occur as part of any normal joint movement but may be
limited (or) absent in abnormal joint conditions.
• They consist of gliding (or) rotational movements which cannot
performed isolation as a voluntary movement but can be isolated by
the physiotherapist.
B) PASSIVE MANUAL MOBILISATION TECHNIQUE:-
i. MOBILISATION OF JOINTS :
• These are usually “small repetitive rhythmical, oscillatory, localised
accessory, functional movements performed by the physiotherapist
various amplitude with the available range under patients control.
• These can be done “very gently” (or) “quite strongly” are graded as
according to the part of available range in which they are performed.
ii. MANIPULATION OF JOINTS PERFORMED BY:
a) physiotherapist:- These are accurately “localised”, “single”,
“quick” , “decisive movements” of small amplitude and high velocity
completed before the patient can stop it.
b) surgeon(or)physician :- These are performed under anaesthesia
by a surgeon (or) physician to gain further range. Increase in
movements must be maintained by the physiotherapist.

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iii. CONTROLLED SUSTAINED STRETCHING OF TIGHTENED STRUCTURE:
• Passive stretching of muscles and other soft tissues can be given to
increase range of movement.
• Movements can be gained by stretching adhesions in these
structure (or) by lengthening of muscle due to inhibition of tendon
protective reflex.
PRINCIPLES OF GIVING RELAXED PAASIVE MOVEMENT:-
1. RELAXATION: - The selection of a suitable starting position ensures
comfort and support for both patient and physiotherapist through the
movements.
2. FIXATION: - Good fixation for the proximal and distal joint by the
physiotherapist to ensure that the movements 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.
4. TRACTION: - The fixation of the bone proximal to the joint is providing an
opposing force to a sustained pull on the distal bone. Traction is thought to
facilitate the movement by reducing interarticular friction.
5. RANGE OF MOVEMENT: - The range of movements is done in painless
range to avoid spasm in the surrounding muscle.
6. SPEED AND DURATION: - As it is essential that relaxation is maintained
throughout the movement, the speed must be slow and rhythmical with
suitable repetitions of the movement.

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INDICATIONS:
1) The patient who cannot perform active movements.
2) The patient who cannot perform full range of movements.
3) Unconscious patients.
4) For relaxation.
5) To break adhesion formation through that joint range can be increased.
6) Edematous limb.
CONTRAINDICATIONS:
1) Recent fractures.
2) Recent dislocations.
3) Recently injuries and inflammation.
4) Early burns.
5) Immediately after any joint surgery.
6) Patient with pop plaster cast.
7) Haemophilic joints.

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PROCEDURE OF RELAXED PASSIVE MOVEMENT :-
➢ The therapist has to adopt the walk stand position and should face
the patients face. So, that he can observe the patients reaction
while performing movement.
EXAMPLE:
▪ ELBOW JOINT :-
Flexion and extension-
Position of patient: - supine lying.
Position of therapist: - standing beside the patient and facing
the patients elbow.
Therapist has to fix the arm of the patient with the
Couch by his left hand.
Therapist right hand grasps the wrist and hand of the patient.

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Holding: -Therapist has to fix the arm of the patient with the couch
by his left hand.
Therapist’s right hand is grasps the wrist and hand of the patient.
Procedure: - Therapists right hand is performing the elbow flexion and extension
PHYSIOLOGICAL THERAPEUTIC EFFECTS AND USES: -
➢ Maintain the muscle properties.
➢ Increase the ROM.
➢ Breaks the adhesion formations in the joints.
➢ Increase the venous and lymphatic drainage.
➢ Induces the relaxation.
PRECAUTIONS: -
➢ Immediately after acute tears, fractures, surgery.
➢ Severe sharp and acute joint pain.
➢ Signs of too much effusion (or) swelling (DVT).
➢ When bony block limit joint motions.
➢ Incase of increased joints hyper mobility (or) haematoma.

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CONTINUES PASSIVE MOTION (CPM):-
Definition: -
➢ A continues passive motion device maintains movements of a joint
after limb spacing surgery. This device usually called a CPM.
➢ Continues movement limits stiffness and pain.
➢ It is very important to keep joints moving following surgery so that
motion will not become limited.
➢ The CPM will move the involved leg through its full range of
motion.
➢ It is only used in bed, but can be used while relaxing, eating(or)
sleeping.
Benefits of CPM: -
➢ Decreasing the complication of immobilization.
➢ Decreasing the post operative complication and pain.
➢ Improving the recovery rate and ROM.
➢ Improving the circulation through pumping action.
➢ Prevent adhesions and contracture.
➢ Prevent joint effusion and wound oedema.
Procedure of CPM: -
➢ Therapists adjust the device to fit before surgery.
➢ CPM used right after surgery.
➢

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➢ Therapist has to give instructions and monitor how to use the
device.
➢ CPM is allowed to set at 45 degrees of motion night after surgery.
➢ Generally, motion is allowed to be increased 15 degrees a day.