ACTIVE FREE ACTIVE FREE EXERCISESEXERCISES

Definition: Free active exercises are those which

are performed by the pt’s own

muscular efforts without the

assistance or resistance of any external

force, other than that of the gravity.

Active free ex’s vary widely in Active free ex’s vary widely in character & effect because of:character & effect because of:

1.1. The nature & extent of the movement.The nature & extent of the movement.

1.1. The manner in which they are The manner in which they are performed. performed.

* * Active free ex’s can be used to obtain Active free ex’s can be used to obtain any effects which are produced by ex’s any effects which are produced by ex’s as a whole, if it is performed & used as a whole, if it is performed & used judiciously.judiciously.

Indications of active free exercises:Indications of active free exercises:

• In cases of In cases of m. weaknessm. weakness..

• After After removal of plaster castremoval of plaster cast following following surgical procedures (surgical procedures (tendon or m. tendon or m. transplantationtransplantation).).

• Muscle Muscle re-educationre-education..

• LimitationLimitation of ROM. of ROM.

• CardiovascularCardiovascular or or respiratory disordersrespiratory disorders..

• InabilityInability to do basic functional to do basic functional ADL ADL independentlyindependently..

Goals of active free exercises:Goals of active free exercises:

1.1. To improve To improve circulationcirculation..

1.1. To To ↑ rate & depth of respiration↑ rate & depth of respiration..

2.2. To mobilize To mobilize stiff jointsstiff joints..

3.3. To improve To improve ROMROM..

4.4. To strengthen To strengthen weak msweak ms..

5.5. To improve To improve co-ordinationco-ordination & & balancebalance..

6.6. To achieve To achieve ADL independentlyADL independently..

7.7. To correct To correct deformitiesdeformities..

8.8. To improve To improve postureposture..

9.9. To improve To improve gaitgait & & ambulationambulation..

Contra-indications of active free movementsContra-indications of active free movements::

1.1. Immediately after cardiovascular disorders e.g. Immediately after cardiovascular disorders e.g. myocardial myocardial infarction & angina pectoris.infarction & angina pectoris.

2.2. Immediately after recent tear to Immediately after recent tear to ligamentligament, , mm., or ., or injured jointsinjured joints..

3.3. At the At the site of #.site of #.

4.4. Recent Recent surgical proceduressurgical procedures to to tendonstendons, , ligamentsligaments, , musclesmuscles, , joint capsulesjoint capsules or or skinskin..

5.5. Diseases of bone (e.g. TB)Diseases of bone (e.g. TB) & & pathological #pathological # (e.g. (e.g. osteoporosisosteoporosis & & tuberculosistuberculosis of bone). of bone).

6.6. Acute joint inflammationAcute joint inflammation..

7.7. Acute muscle inflammationAcute muscle inflammation..

8.8. Muscle Muscle swellingswelling..

9.9. Severe Severe joint painjoint pain..

10.10. Acute Acute m. painm. pain..

Classification of active free Classification of active free exercisesexercises::

It may be classified according to the It may be classified according to the extent of the part involved into:extent of the part involved into:

1.1.Localized.Localized.

2.2.General.General.

1.1. LocalizedLocalized::

Are designed primarily to produce some Are designed primarily to produce some local & specific effects. local & specific effects.

E.g.:E.g.:

a. Ma. Mobilization of obilization of pparticular articular jjointoint or or

b. Sb. Strengthening of trengthening of pparticular articular mm. group. group. .

E.g.: Pendulum exs. for the shoulder. E.g.: Pendulum exs. for the shoulder.

2.General:2.General:

– Are free exercises that usually involve Are free exercises that usually involve the use of the use of many joints & musclesmany joints & muscles allover the body.allover the body.

– Their effect is wide spread.Their effect is wide spread.

E.g.: E.g.: a. Coordination exs.a. Coordination exs.

b. Respiratory exs.b. Respiratory exs.

Rules & principles of active Rules & principles of active free exs.free exs. (procedures): (procedures):

1.1. Instructions:Instructions:

Instructions are given in a manner Instructions are given in a manner which will gain the interest & which will gain the interest & cooperation of the pt.cooperation of the pt.

2. Starting position

• Is selected & taught with care to insure the maximum postural efficiency as a basis for the movement .

• The P.T. must choose it according to:

• The pt’s condition

• Type of active ex.

• The type of m. contraction desired.

3. Speed of movement3. Speed of movement

The speed at which the exercises are done The speed at which the exercises are done depends on the effects required.depends on the effects required.

It is usually slow during the period of It is usually slow during the period of learning & later the pt. is either allowed learning & later the pt. is either allowed to find his own natural rhythm or the to find his own natural rhythm or the speed desired is dictated by the P.T.speed desired is dictated by the P.T.

It often helps the pt to maintain his It often helps the pt to maintain his natural rhythm at home.natural rhythm at home.

During practice under the P.T. supervision During practice under the P.T. supervision the pt. is encouraged to count loudly. the pt. is encouraged to count loudly.

44. Progression. Progression

An active free ex program must be An active free ex program must be progressive & as soon as the pt. is progressive & as soon as the pt. is capable of performing a more capable of performing a more difficult task, he should be difficult task, he should be encouraged to do it.encouraged to do it.

Constant re-evaluation of the pt’s Constant re-evaluation of the pt’s abilities is essential to allow the re-abilities is essential to allow the re-education to be progressive.education to be progressive.

5. Repetitions5. Repetitions

The number of times the movement is The number of times the movement is repeated depends on:repeated depends on:

A- The aim A- The aim (strengthening or endurance).(strengthening or endurance).

B - The fatigue of the ms.B - The fatigue of the ms.

* The condition which has caused the m * The condition which has caused the m weakness must be known & understood weakness must be known & understood as in some conditions m. fatigue can be as in some conditions m. fatigue can be injuriousinjurious..

Group TherapyGroup Therapy

1. Goals of group therapy.1. Goals of group therapy.

2. Rules of choosing the members of 2. Rules of choosing the members of the group.the group.

3. Location of group therapy.3. Location of group therapy.

4. Tools used in group therapy.4. Tools used in group therapy.

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