1. Range of Motion (ROM) Exercises 🔄
ROM Types
- Passive ROM (PROM): External force moves joint; patient relaxed. Used for paralysis, coma, or when active movement is contraindicated
- Active-Assisted ROM (AAROM): Patient initiates movement with therapist assistance. For weak muscles (grades 2-3)
- Active ROM (AROM): Patient moves independently. Maintains strength and prevents atrophy
ROM Precautions
- Never force movement past comfortable range
- Watch for pain, swelling, inflammation
- Avoid ROM through osteoporotic bone areas
- Post-surgical ROM per surgeon protocol
2. Strengthening Exercises 🏋️
DeLorme & Oxford Technique
DeLorme (Progressive)
- Set 1: 50% of 10RM x 10 reps
- Set 2: 75% of 10RM x 10 reps
- Set 3: 100% of 10RM x 10 reps
Builds up intensity
Oxford (Regressive)
- Set 1: 100% of 10RM x 10 reps
- Set 2: 75% of 10RM x 10 reps
- Set 3: 50% of 10RM x 10 reps
Decreases as fatigue sets in
Exercise Based on Muscle Grade
- Grade 0-1: Electrical stimulation, PROM
- Grade 2 (Poor): Active exercise gravity-eliminated
- Grade 3 (Fair): Active exercise against gravity
- Grade 4 (Good): Resistive exercise
- Grade 5 (Normal): Full resistive exercise
3. Stretching & Balance Training 🧘
Stretching Techniques
- Static Stretching: Hold 15-30 seconds, repeat 3-5 times, low risk of injury
- PNF Hold-Relax: Isometric contraction then relax - most effective method
- PNF Contract-Relax: Isotonic contraction then relax
- Hold-Relax-Contract: Add agonist contraction after relaxation
Balance Progression
- Wide base of support → Narrow base
- Bilateral stance → Unilateral stance
- Eyes open → Eyes closed
- Stable surface → Unstable surface (foam, BOSU)
- Static balance → Dynamic balance
Pro Tip para sa Board Exam
Always match exercise prescription to muscle grade! Common board question: What exercise for Grade 2 muscle? Answer: Active exercise in gravity-eliminated position. Remember: DeLorme = progressive (increases), Oxford = regressive (decreases).