Range of motion exercises

This PPT explains various range of motion exercises used for patients to improve their mobility.

1. By Srividhya. N Range of Motion Exercise

2. 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.

3. 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.

4. Types of planes

5. Purpose Promote health by enhancing circulatory and lung functioning. Prevent joint stiffness and delay degenerative changes. Restore muscle function in diseases, injuries, and deformities. Improve physical mobility and gait. Prevent deformity, improve blood supply in vascular disorders, reduce stress, and rehabilitate patients.

6. Types of ROM Active Range of Motion (AROM): Exercises performed independently by the client with or without verbal cues from a physical therapist.

7. Passive Range of Motion (PROM): Conducted on an inactive joint, often with the assistance of a therapist, beneficial for clients unable to mobilize specific joints.

8. 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.

9. 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 toes.

10. 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. Moving the leg behind the body.

11. 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.

12. Adduction Moving a joint or extremity toward the midline of the body. Examples: Bringing fingers together. Moving the leg back toward the medial position.

13. 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.

14. Rotation Bone revolving around its own longitudinal axis. Examples: Turning the head as far as possible in a circular movement.

15. Supination Turning the body or body part to face upward. Examples: Turning the lower arm and hand so that the palm is facing up.

16. Pronation Turning the body or body part to face downward. Examples: Turning the lower arm so that the palm is facing down.

17. Inversion Turning the feet inward, so toes point toward the midline. Examples: Turning the sole of the foot medially.

18. Eversion Turning the feet outward, so toes point away from the midline. Examples: Turning the sole of the foot laterally.

19. Dorsiflexion Bending of the foot at the ankle towards the dorsum (superior surface). Examples: Standing on heels.

20. Plantar Flexion Bending of the foot at the ankle towards the plantar (inferior surface). Examples: Standing on toes.

21. 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.

22. Lateral Flexion Tilting of the head as far as possible toward each shoulder, occurring in the frontal plane and involving intervertebral joints.

23. 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.

24. 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.

25. 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 for support or towels for padding.

26. 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.

27. Procedure contn .. 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 as part of their daily routine.

28. Video demonstration Video link ROM Demonstration