Mastering Rom, Prom, And Arom: Tips And Tricks

Range of motion (ROM) is the linear or angular distance that a moving object may travel while attached to another. In biomechanics and strength training, ROM refers to the angular distance and direction a joint can move between the flexed position and the extended position. There are three types of range of motion exercises: Passive Range of Motion (PROM), Active Assisted Range of Motion (AAROM), and Active Range of Motion (AROM). PROM is used when a patient is unable to move a joint themselves, AAROM is used when a patient can move a joint but requires assistance, and AROM is used when a patient can move a joint without assistance.

Passive Range of Motion (PROM)

During PROM exercises, the client applies no effort to move the joint, and a physical therapist or equipment moves the joint through a variety of stretching exercises. This is particularly useful when a person is unable to move due to an injury, illness, or accident, as it helps to maintain the elasticity of muscles and connective tissues, enhance synovial movement, and decrease pain. PROM can also be used to assist in healing after an injury or surgery and to maintain joint and tissue integrity.

One example of a PROM exercise is the piriformis stretch, also known as the Pigeon pose in yoga. This stretch targets the piriformis muscle in the hip area and can help increase hip flexibility and reduce lower back discomfort. To perform this stretch, one can lie down on the floor with the leg in a bent position and lean over the hips to stretch the piriformis muscle. A partner can also assist with this stretch by providing resistance and moving the leg through the passive range of motion.

It is important to note that while PROM exercises can be beneficial, there is a risk of injury if the movement is pushed too far. Therefore, it is crucial to work with trained professionals, such as physical therapists, who understand proper limits and can ensure the safety of the client during these exercises.

Active Range of Motion (AROM)

AROM exercises are particularly beneficial for those recovering from injuries or experiencing stiffness and pain due to ageing or a sedentary lifestyle. They can also be useful for those with hip, knee, or ankle issues, as well as past injuries. By improving joint flexibility and reducing pain, these exercises can help you regain your ability to perform daily tasks with ease.

There are various AROM exercises that you can incorporate into your routine. Here are some examples:

Head and Neck Exercises:

• Gently lower your chin towards your chest and hold this position for a few seconds. Then, slowly lift your head and look up at the ceiling, stretching the front of your neck.
• Tilt your head to one side, bringing your ear towards your shoulder. Repeat on the other side.
• Turn your head to the right, trying to touch your chin to your shoulder without moving your shoulder. Repeat on the left side.

Shoulder and Elbow Exercises:

• Stand or sit comfortably. Bring one arm forward and upward, extending it fully until your bicep touches your ear. Lower your arm back to the starting position and repeat with the other arm.
• Stand or sit with a straight back. Raise your arms to the sides and then up, as if you're reaching for something overhead. Bring your arms down and then reach for the opposite shoulder, creating a two-way stretch. Repeat with the other arm.
• Stand or sit and rotate your shoulders in a smooth circular motion, first clockwise, then anti-clockwise.

Arm and Wrist Exercises:

• Sit down. Bend your elbow and rest your forearm on a table or your lap. Keep your wrist loose.
• Extend your arm and bend your hand upward at the wrist, with your fingers pointing towards the ceiling. Then, bend your hand downward with your fingers pointing towards the floor.
• Move your wrist side to side and then in a circular motion, first clockwise, then anti-clockwise.

Hip and Knee Exercises:

• Lie down comfortably on a flat surface. Pull your knees towards your chest gently.
• Lift each leg alternately to a comfortable 30-degree angle. As you progress, try lifting both legs simultaneously.
• Lie on your back and move your legs out to the side, lowering them after a few seconds. Repeat with the other leg.

Ankle and Foot Exercises:

• Sit with both feet flat on the floor. Keep your toes on the floor and raise your heel as high as possible. Then, lower your heel and raise your toes.
• Raise your foot slightly off the floor and roll your ankle in circles, first in one direction and then the other.

It is recommended to perform these exercises daily or as prescribed by your healthcare provider. Remember to move slowly, gently, and smoothly, avoiding any fast or jerky motions. Stop the exercises if you feel pain. Consistency and gradual progression are key to improving your AROM.

Active Assisted Range of Motion (AAROM)

AAROM bridges the gap between the available passive range of motion and what the patient can achieve actively. It is particularly useful when a patient needs assistance due to weakness, pain, or changes in muscle tone. For example, if a patient has broken their ankle and has lost range of motion due to lack of use, a physical therapist can assist in stretching the joint and muscle to increase the range of motion.

The purpose of AAROM exercises is to help improve strength and flexibility in the injured area. They can also aid in healing and recovery from soft tissue and joint lesions, as well as maintaining existing joint and soft tissue mobility. Additionally, AAROM can help prevent the formation of contractures and adhesions between myo-fascia, as well as assist in neuromuscular re-education.

AAROM exercises can be performed with the help of a physical therapist or with the use of equipment such as a Continuous Passive Motion (CPM) machine. The CPM machine is often used to maintain and improve ROM, especially in post-operative patients.

Benefits of ROM exercises

Range of motion (ROM) exercises are important for maintaining and improving the flexibility and mobility of joints. They are particularly beneficial for individuals who are unable to perform active ROM exercises, as they can help to reduce joint stiffness and prevent joints from freezing due to a lack of movement.

ROM exercises are designed to assist in recovering or increasing a full range of motion in bending joints, such as shoulders, knees, and elbows. They are beneficial for those who have suffered joint injuries, undergone surgery, or experience pain during movement. By performing these exercises, individuals can decrease pain, strengthen the muscles surrounding the joints, and perform daily tasks with minimal discomfort.

There are several benefits to incorporating ROM exercises into one's routine:

Improves Circulation and Muscle Strength

ROM exercises help improve circulation and enhance muscle strength. This is particularly important for individuals recovering from injuries or surgeries, as it aids in the healing process and prevents muscle atrophy.

Maintains Flexibility and Joint Integrity

Regular ROM exercises help maintain and improve joint flexibility and integrity. This is crucial for overall joint health and can help prevent future injuries. Additionally, maintaining joint flexibility can improve one's posture and reduce pain associated with stiff joints.

Enhances Physical Performance and Decreases Injury Potential

ROM exercises can enhance physical performance by improving the range of motion in various joints. This is especially beneficial for athletes or individuals involved in sports, as it can help improve their performance and decrease the potential for injuries.

Assists in Healing and Recovery

For individuals with soft tissue and joint lesions, ROM exercises can aid in the healing and recovery process. They help maintain existing joint and soft tissue mobility, minimize the effects of contracture formation, and prevent adhesions between myo-fascia.

It is important to consult with a healthcare professional or physical therapist before starting ROM exercises to ensure they are done correctly and safely. Additionally, it is recommended to perform the exercises in a specific order, starting with neck stretches and then moving down to other body parts. Slow and gentle movements are advised, avoiding any fast or jerky motions.

When to use PROM, AAROM, or AROM

PROM (Passive Range of Motion) is used when a patient is unable to actively move a body part, for example, if they are comatose, paralysed, or on complete bed rest. In this instance, an external force, such as gravity, a machine, or a physical therapist, moves the body part for them. PROM is also beneficial after a stroke or accident, where the patient may be bedridden or using a wheelchair.

AAROM (Active Assisted Range of Motion) is used when a patient has weak musculature and is unable to move a joint through the desired range, usually against gravity. This often occurs in physical therapy when a patient needs to build up flexibility or strength in a particular body part. The assistance can be provided by a physical therapist or by the patient themselves, using devices such as towels, pulleys, or other assistive devices.

AROM (Active Range of Motion) is used when a patient can actively move a body part through a range of motion against gravity, without external assistance. This is usually one of the first modalities prescribed for arthritis. AROM exercises strengthen muscles when they are actively engaged in movement, which is good for overall health and improves mobility over time.

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