Range of Motion Exercise

INTRODUCTION
• Clients with restricted mobility face challenges in performing joint motion exercises
independently.
• Range of Motion (ROM) exercises are vital interventions to maintain or improve joint
mobility.
• Lack of movement can lead to joint stiffness and loss of normal joint function.
DEFINITION
• ROM is the maximum movement available at a joint in the body's three planes:
Transverse, Frontal, and Sagittal.
• It is measured in degrees and essential for maintaining muscle and joint flexibility.
TYPE OF PLANES
• Sagittal Plane
• Coronal Plane
• Transverse Plane
PURPOSES
• To prevent and restore normal movement of joints
• To prevent contractures
• To stimulate circulation
• To improve and maintain muscle strength
• To maintain or restore coordination
TYPES
Active
Active
Passive
assisted
Types
Types of ROM Exercises

1) Active ROM exercises - Exercises the client is able to perform independently.
2) Passive ROM exercises - Exercises performed for the client by someone else.
3) Active assisted ROM exercises- Performed by a client with some assistance. Client can
move a limb partially through its ROM, but needs help completing the ROM.
Flexion
Decrease in the angle between articulating bones.
Examples:
• Bending of the head towards the chest.
• Moving the palm toward the inner aspect of the forearm.
• Making a fist.
• Curling the toes downward.
Extension
Straightening of a joint, increasing the angle between articulating bones.
Examples:
• Holding the head in an erect position.
• Bringing the arm to a position at the side of the body.
• Straightening the toe
Hyperextension
Continuation of extension beyond the anatomical position.
Examples:
• Bending the head back as far as possible.
• Moving the arm behind the body while keeping the elbow straight.
• Bending fingers backward as far as possible.
Abduction
Moving a joint or extremity away from the midline of the body.
Examples:
• Moving the palm laterally at the wrist joint.
• Moving the leg laterally away from
the body.
Adduction
Moving a joint or extremity toward
the midline of the body.
Examples:
• Bringing fingers together.
• Moving the leg back toward the
medial position.
Circumduction
Moving a body part in widening
circles, involving continuous sequences of flexion, abduction, and adduction.
Examples:
• Moving the arm in a full circle.
• Moving the leg in a circle.
Rotation
Bone revolving around its own longitudinal axis.
Examples:
• Turning the head as far as possible in a
circular movement.
Supination
Turning the body or body part to face upward.
Examples:
• Turning the lower arm and hand so that the
palm is facing up.
Pronation
Turning the body or body part to face downward.
Examples:
• Turning the lower arm so that the
palm is facing down.
Inversion
Turning the feet inward, so toes point toward the
midline.
Examples:
• Turning the sole of the foot medially
Eversion
Turning the feet outward, so toes point away from
the midline.
Examples:
• Turning the sole of the foot laterally.
Dorsiflexion.
Bending of the foot at the ankle
towards the dorsum (superior
surface).
Examples:
• Standing on heels.
Plantar Flexion
Bending of the foot at the ankle
towards the plantar (inferior
surface).
Examples:
• Standing on toes.
Opposition
Movement of the thumb across the palm to
touch fingertips on the same hand.
Examples:
• Touching the thumb to each finger
of the same hand.
Lateral Flexion
Tilting of the head as far as possible toward each shoulder, occurring in the frontal plane and
involving intervertebral joints.
CONTRAINDICATIONS TO ROM
• ROM exercises require energy and increased circulation.
• Avoid in conditions where increased energy use or circulation is hazardous.
• Not recommended for swollen or inflamed joints due to potential strain on soft tissues and
bony structures.
POINTS TO REMEMBER
• Assess for stiffness, swelling, pain, and limited movements before starting ROM.
• Schedule exercises at specific times, possibly along with other nursing activities.
• Provide support for weak clients during movements.
• Perform movements slowly, smoothly, and without causing pain.
• Avoid forcing a joint beyond its capacity.
• Repeat each movement 5 times during exercises.
• Stand at the side of the bed closest to the joint during passive ROM exercises.
PREPARATION
• Assessment:
• Evaluate the patient's current range of motion and any limitations.
• Assess for any pain, swelling, stiffness, or joint deformities.
• Preparation:
• Explain the procedure to the patient and obtain consent.
• Ensure the patient is in a comfortable position, either lying in bed or sitting in a chair.
• Provide privacy and maintain dignity throughout the procedure.
• Gather necessary equipment, such as pillows
PROCEDURE
➢ Warm-up:
Begin with gentle warm-up exercises to prepare the muscles and joints for movement.
Encourage deep breathing to help relax the patient and improve circulation.
➢ Execution of ROM Exercises:
Perform each movement slowly and smoothly, avoiding jerky or forceful motions.
Support the limb or joint being moved to prevent strain or injury.
Communicate with the patient throughout the procedure, asking about any discomfort or pain.
➢ Range of Motion Movements:
Follow the prescribed sequence of movements for each joint, including flexion, extension,
abduction, adduction, rotation, etc.
Gradually increase the range of motion within the patient's comfort level.
➢ Repetitions:
Repeat each movement 5-10 times, depending on the patient's tolerance and the goals of the
exercise.
➢ Cool Down:
After completing the ROM exercises, perform gentle stretching or relaxation techniques to help
prevent muscle soreness.
➢ Documentation:
Record the patient's response to the ROM exercises, including any pain or limitations
encountered.
Document the range of motion achieved for each joint and any improvements observed over
time.
➢ Evaluation:
Reassess the patient's range of motion periodically to track progress and adjust the exercise
regimen as needed.
Modify the exercises based on the patient's individual needs and goals.
➢ Follow-up:
Provide feedback to the patient regarding their performance and progress.
Encourage the patient to continue with the prescribed ROM exercises.

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INTRODUCTION

Types of ROM Exercises

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