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).

Therapeutic Exercise