Passive training for joint movement range
The patient or with the help of therapist to complete the joint exercise, in order to maintain and increase the range of joint movement.
（1）Indications：due to contracture and adhesion of soft tissue, pain and muscle spasm caused by mechanical factors; reduced and limited range of joint movement caused by neurological disorders; the person who can not move, such as coma, can not get up from the bed and so on.
（2）Contraindications：a variety of causes of joint instability, incomplete healing of fractures within the joints, swelling, bone and joint tuberculosis and cancer caused by acute joint inflammation or trauma.
Equipment and appliances
No equipment required.
4. Operating methods and procedures
(1) Patients take comfortable, relaxed position, limbs fully relaxed.
(2) According to the disease to determine the order of motion, from proximal to distal (such as shoulder to elbow, hip to knee) order is conducive to the recovery of paralyzed muscle; from distal to proximal (such as hand to elbow, The order helps promote limb blood and lymph flow.
(3) Fixed proximal limbs, hold the distal limbs, to avoid alternative exercise.
(4) Slow, soft, smooth, rhythmic, to avoid the impact of exercise and violence.
(5) Operation in the painless range, the scope of movement gradually increased, so as to avoid injury.
(6) Passive exercise to increase the range of joint movement may present soreness or mild pain but may be tolerated; it should not cause significant reflex spasms in the muscles or persistent pain after training.
(7) From the beginning of a single joint, the gradual transition to multi-joint; not only unidirectional, and should be multi-directional passive movement.
(8) Patients with abnormal sensory function should be completed under the guidance of an experienced therapist passive exercise.
(9) Each action is repeated 10 to 30 times, 2 to 3 times / day.
(1) The patient should be in a comfortable position, and try to relax, if necessary, remove clothing or fixtures that interfere with the treatment.
(2) Should be painless or minor pain, the patient can tolerate the scope of training to avoid the use of violence, so as to avoid tissue damage.
(3) Those with functional impairments should be trained under the guidance of an experienced therapist during the range of joint movement.
(4) When training multiple range of joint movement, training may be performed one by one or several joints in the order from the distal end to the proximal end.
(5) In the training of joint movement, if combined with drugs such as analgesics and physical therapy or hyperthermia treatment, can increase the efficacy.
（II）Passive joint movement training with equipment
The use of special equipment to make joints for a long period of time and slow passive exercise training methods.
2. Indications and contraindications
(1) Indications: limb fractures after open reduction and internal fixation surgery; arthroplasty surgery, artificial joint replacement surgery, joint ligament reconstruction surgery; after synovectomy surgery; various types of arthritis, joint contracture adhesion release surgery.
(2) Contraindications：the healing tissue and the use of anticoagulant therapy, should not be used or used with caution.
3. Equipment and appliances
Continuous passive motion training for different joints, optional continuous passive exercise training equipment for each joint, including specialized training equipment for peripheral joints such as lower limbs, upper limbs and even fingers.
4. Operating methods and procedures
(1) Start training time: can be carried out immediately after the operation, even if the surgical site dressing thick, it should start within 3 days after surgery.
(2) Place the body to be trained on the bracket of the training equipment and fix it.
(3) Power on. Select the range of movement, speed and training time.
(4) Range of joint movement: usually within 20 ° ~ 30 ° short arc immediately after training; range of joint movement according to patient tolerance increased daily, until the maximum range of joint movement.
(5) Determine the speed of movement: the beginning of the speed of movement for every 1 to 2 minutes a movement cycle.
(6) Training time: according to different procedures, the use of training time is different. Each training time is 1 to 2 hours, you can also train for longer, according to the degree of patient tolerance selected 1 to 3 times / day.
(7) Closely observing the patient's reaction during training and the continuous operation of passive exercise training equipment.
(8) After the training, shut down, remove the fixed. Lower your body from the training equipment bracket.
(1) If there is a drainage tube in the wound after surgery, pay attention to exercise should not affect the drainage tube.
(2) If the surgical incision is perpendicular to the long axis of the limb, it is not appropriate to use the passive joint movement training in the early stage to avoid affecting the wound healing.
(3) If at the same time in training in the use of anticoagulant therapy, training time should be reduced to avoid local hematoma.
(4) Training procedures should be set according to the surgical approach, patient response and physical condition to be adjusted.