Passive range of motion, or PROM for short, is an assessment tool for the rehab vet as well as a treatment technique. Normal range of motion (ROM) of the joints is required for normal function. As defined by scientists, PROM is a passive, osteokinematic movement of bony segments around a joint axis performed by the rehab vet. This means that the rehab vet will gently move the joints through their normal flexion and extension to assess for pain, crepitus, popping, inflammation, restrictions, muscle tightness, and so on. During PROM, the patient is not contributing to the movement and thus no muscle contractions are taking place.

PROM should be performed immediately post-operatively. The benefits of this include decrease pain and improved rate of recovery. PROM helps scar tissue after an orthopedic surgery to strengthen and align along the lines of stress that the tissue normally undergoes. Another indication of PROM is the prevention of joint contracture during healing and recovery in paralyzed patients (intervertebral disc disease, degenerative myelopathy, fibrocartilaginous embolic myelopathy, nerve damage, etc.). A load is produced on the soft tissues that help maintain the articular cartilage, muscles, ligaments, and tendons in a healthy state. Once the patient can progress, we then move forward with active ROM-assisted, and then full on active ROM.

Proper technique is very important for performing PROM!

  • the patient should be relaxed and comfortable, preferably laying down

  • the joint in question should be supported above and below (ex: the knee; support above the knee on the femur and below the knee at the tibia)

  • moving through extension and flexion should be slow, smooth, and steady

  • if the patient starts to resist, or is painful, stop immediately, and contact your rehab vet.

There are WRONG ways to do PROM!

  • Do NOT pull on the joint! if the patient is resisting and you pull on it, the patient can be further injured.

  • Do NOT move the joint too fast or forceful!

  • Do NOT perform PROM on unstable joints or unstable fractures near a joint unless directed by your rehab vet.

How to perform PROM on your patient?

  • always start with a quick, gentle massage to help further relax your pet. This should take about 2-3 minutes, and apply a warm heating pad directly over the joint for 5-10 minutes.

  • place one hand above the joint, and the other hand below the joint. Be sure that the entire limb is supported to avoid adversely rotating or twisting the leg in an abnormal way.

  • After the hands are in the correct position and the limb is supported, begin by slowly and gently FLEXING the treated joint. Try not to move any other joints besides the joint you are focusing on.

  • slowly continue to flex the joint until the patient shows INITIAL signs of discomfort such as tensing the limb, moving, turning the head towards you, or trying to pull away.

  • with the hands maintained in the same positions, slowly extend the joint. Again, try to keep the other joints in a neutral position and minimize any movements of them.

  • slowly continue to extend the joint until your pet shows initial signs of discomfort.

  • the PROM session may be ended with a gentle massage for about 5 minutes. This helps with further relaxation. You can also apply an ice pack afterwards for about 5-10 minutes.

The number of PROM repetitions and the frequency of the treatment depend on the condition treated. Your rehab vet will tell you the exact amount of time needed for your pet. In general, for most routine postoperative conditions, 15-20 reps performed 2-4 times a day are most adequate.

Ready for PROM? Check out this YouTube of Dr. Richie performing PROM on her dog! LINK HERE.

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