Range of Motion

Medical Technologies
Skills
Purpose
• Musculoskeletal system must be exercised to remain
healthy.
• Exercises prevent joints from becoming stiff and
contractures (deformities) from developing.
• Exercises prevent muscles from losing strength and
shrinking (atrophy).
• ROM exercises prevent loss of minerals from bones
(osteoporosis).
• ROM exercises improve circulation.
• ROM exercises allow residents’ joints to move more freely
and as a result, the residents remain more independent.
Responsibilities
• Always handle the resident gently with open palms. Be aware
of the normal ROM for each joint.
• Exercise as many times as ordered, usually three to five times.
• Never exercise or stretch a joint to the point of pain. Exercise
joints only within the range of easy movement.
• Always stop the exercise if discomfort or pain develops and
report to the charge nurse.
Types of ROM
• Active – Resident performs exercises alone or uses a
device such as a pulley or bicycle.
• Active-assistive – The nurse assistant assists the resident
when performing the exercises.
• Passive – The exercise is done for the resident who is
unable to move independently; involves moving the
resident’s body parts through a series of exercises.
Definitions
• Abduction – away from the center
(midline) of the body
• Adduction – toward the center (midline) of
the body
• Eversion – a turning outward
• Extension – to straighten; to extend
Definitions
• External rotation – to move the extremity in a
circular motion away from the center of the
body
• Flexion – to bend
• Hyperextension – extensive extension, beyond
the normal range of the joint
• Internal rotation – to move the extremity in a
circular motion toward the center of the body
Definitions
• Inversion – a turning inward
• Lateral – to the side
• Pronation – to turn downward
• Rotation – to move a joint in a circular
motion
• Supination – to turn upward
Opening procedures
Wash hands
Gather supplies
Identify and greet resident. Identify self
Explain what you are going to do
Provide privacy
Assist resident into supine position
Shoulder Flexion and Extension: Support the arm at the wrist and
elbow and lift the arm toward the ceiling. Continue lifting the
arm over the resident’s head until you feel resistance. Slowly
lower the arm to the resident’s side.
Figure 5.1 – Shoulder Exercises
Shoulder abduction and adduction:
Support the arm at the elbow and shoulder and move the arm out to the side.
Continue moving toward resident’s head. Slowly move the arm back toward the center
of body.
External/ Internal rotation of shoulder: Move the arm away
from the body to shoulder level. Bring the hand forward to
touch the bed and then backward to touch the bed.
Flexion/ extension of elbow: Bend the arm at the elbow, touch the
shoulder, then straighten the arm. Bend the arm at the elbow and
touch the chin, then straighten the arm.
Figure 5.2 – Elbow Exercises
Supination/ pronation of the elbow: Hold the resident’s hand in a
handshake position; support the arm at the elbow point.
Figure 5.2 – Elbow Exercises
 Flexion/extension/hyperextension of the wrist: Support arm and
hand; bend the wrist forward, straighten it, and then bend it
backward.
Figure 5.3 – Wrist Exercises
Abduction/adduction of the wrist: Move the hand from side to side
at the wrist.

Figure 5.3 – Wrist Exercises

Flexion/ extension of the hip and knee: support the leg at the knee
and ankle joints and keep the knee straight. Raise and lower the
leg.Bend the knee and move toward the chest; slowly straighten
the knee.
Figure 5.5 – Hip and Knee Exercises
Abduction and adduction of the hip and knee: Move the leg straight
out to the side of the body until you feel some resistance. Slowly
move the leg back toward the center of the body.
Figure 5.5 – Hip and Knee Exercises
Internal/external rotation of the hip and knee: Support knee and
ankle joints; move the ankle in toward the opposite leg and then
outward.
Figure 5.5 – Hip and Knee Exercises
Dorsiflexion and plantarflexion of the foot: Ankle movement bringing
the foot towards the shin. Ankle movement pointing the foot
downward
Closing procedures
Explain procedure is complete
Remove gloves
Address the Four Ps
Pain – “How is your pain?”
Position – “Are you comfortable?” Move the patient up in bad. Rearrange pillows.
Offer extra blankets. Turn patients who are at high-risk for skin breakdown.
Potty – “Do you need to use the bathroom?” Assist the patient to the bathroom.
Possessions – “Do you need me to move the phone, call light, trash can, water or
your bedside table within reach?”
Why do ROM and turn patients regularly?