Health Skills II Unit 202 Range of Motion

Range of Motion (ROM) definition: exercising joints through the available motion to maintain available range and flexibility of joint structures

Purpose of ROM maintain joint movement and integrity prevent deterioration of joint structures, ankylosis and contractures

Indications for ROM patients on prolonged bed rest prevention of contracture stimulates circulation

Types of ROM active (AROM) performed by patient patient moves the joints through available ROM maintains muscle strength and joint mobility

Types of ROM active assistive (AAROM) performed by patient with assistance from another person or mechanical device patient uses stronger limb to move or support weaker limb practitioner completes movement through full available ROM

Types of ROM passive (PROM) performed for patient by healthcare worker or caregiver moves all muscle groups within each plane over each joint does not maintain muscle strength maintains joint flexibility & integrity

Types of ROM stretching forcing movement beyond the available ROM contraindicated for most healthcare personnel

Principles of ROM Check doctor’s orders Know the patient diagnosis and rationale for ROM Explain the procedure to the patient

Principles of ROM use good body mechanics expose limb being exercised support body part proximal to joint use slow smooth rhythmic motion

Key Factors for ROM start ROM exercises on the unaffected side start each movement in neutral position use a firm comfortable grip while maintaining support of the extremity avoid forcing beyond range avoid overexerting patient avoid skin friction exercise just below point of pain, NOT beyond

Key Factors for ROM if rigidity occurs slightly decrease ROM until it subsides stop if spastic contraction occurs talk to patient to help them relax expect heart rate and respirations to rise exercise 2-3x’s daily, 5-10 movements(see physician’s or Physical Therapist orders) document procedure & patient reaction

Basic Terminology - ROM Flexion to bend a joint Extension to straighten a joint Abduction move away from midline of body Adduction move toward midline of body

Basic Terminology - ROM Horizontal Abduction moving away from body in a transverse plane Horizontal Adduction moving toward body in a transverse plane

Basic Terminology - ROM Rotation internal (medial) pivoting inward along an axis external (lateral) pivoting outward along an axis

Basic Terminology - ROM Supination rotate forearm, palm up Pronation rotate forearm, palm down Opposition oppose thumb tip to base of little finger (may be done to each individual finger tip)

Basic Terminology - ROM Eversion sole of foot turned outward at the ankle Inversion sole of foot turned inward at the ankle Dorsiflexion an upward or backward motion of the ankle towards the hips Plantar Flexion a toe down motion of the foot at the ankle

Example of Flexion Elbow flexion bend

Example of Flexion Knee flexion bend

Example of Flexion Toes flexion bend

Example of Extension Knee extension straight

Example of Extension Head & Neck extension straight

Example of Abduction Hip abduction away from midline of body

Example of Adduction Toes adduction toward midline

Examples of Rotation Head and Neck rotation turning part on its axis Left Right

Example of Rotation Hip internal rotation pivoting inward

Example of Horizontal Adduction Shoulder horizontal adduction toward body in transverse plane

Example of Supination Forearm supination rotate forearm, palm up

Example of Pronation Forearm pronation rotate forearm, palm down

Example of Opposition Thumb opposition oppose thumb tip base of little finger or to finger tip of each individual finger

Example of Eversion Ankle eversion sole of foot turned outward at the ankle

Example of Inversion Ankle inversion sole of foot turned inward at the ankle

Example of Dorsiflexion Ankle dorsiflexion an upward or backward motion of the ankle toward the hips

Example of Plantar Flexion Ankle plantar flexion a toe down motion of the foot at the ankle