Range Of Motion Exercises

 DEFINITION-

 A device self imposed or set to keep the body and mind trim
or
 Exercise is the exertion of the body for maintenance of its health
or
 Exercise is a physical activity for conditioning the body, improving health and maintaining fitness

 PURPOSE-
In health-
 To promote health by improving functioning of the circulatory system and lung
 To retain movements in joints and normal tone in the muscles controlling them
 To prevent stiffness of joints
 To decrease cholesterol level and low density lipo-protines
 To decrease body weight of obese person by increasing caloric expenditure
 To delay degenerative changes
 To improve flexibility and overall muscle strength and endurance

In sickness-
 To prepare the patient for ambulation in-
 Orthopedic condition
 Deformity and fracture of extremities
 Cervical fracture
 Crutch walking
 Post operative period
 To restore muscle function in case of disease, injuries and deformities
 To strengthen weak muscle and to restore balance after disease or injury for control of joint movement
 To promote physical mobility and improve gait
 To prevent deformity.
 To improve blood supply
 To improve the functioning of lungs to expel secretion in case of post opertative period and lung
disorder
 To prevent constipation
 To reduce stress
 To prevent thrombus formation

 Movement of various joints-

 Abduction-Movement away from the midline of the body

 Adduction- Movement towards the midline of the body
 Flexion-bending of a joint so that the angle of the joint diminished
  Extention-the return movement fron flexion around joint angle is increased
 Rotation-turning or movement of a part around its axis
 Internal-turning inward,toward centre
 External- turning outward away from the centre
 Dorsiflexion-movement that flex or bend the hand back toward the body toward the body or foot toward
the leg
 Palmer flexion- movement that flex or bend the hand in the direction of the palm
 Planter flexion- movement that flex or bend the hand in the direction of the sole
 Pronation-rotation of the fore arm so that the palm of the hand is down
 Supination- rotation of the fore arm so that the palm of the hand is up
 Opposition-toughing thumb to each finger tip on the same hand
 Inversion-movement that turn the sole of the foot inward
 Eversion-movement that turn the sole of the foot outward

 INDICATION-
 To assess joint flexibility before initiating an exercise
 To maintain joint mobility and flexibility in inactive patients
 To prevent ankylosis (permanent loss of joint movement)
 To stretch joint before performing more strenuous activities
 To evaluate the patients response to a therapeutic exercise programe
 To prevent contracture and adaptive shorting

 ARTICLES-
 No equipment needed expect Gloves when body fluids is possible

 PROCEDURE-

S.NO. ACTION RATIONAL

1. Wash hands. Wear gloves if contact with Reduce transmission of microorganism
body fluid is possible
2. Explain procedure to client, including Decrease anxiety, encourage compliance and participation
estimated duration
3. Provide for privacy, including exposing Decreases embarrassment
only the extremities to be exercised
4. Adjust bed to comfortable height for prevent muscle strain and discomfort for nurse
performing ROM
5. Describe the passive ROM exercise Exercise all joint areas.
performing or verbally cue client.
6. Start at the clients head and perform Provide systematic method to ensure that all body parts are
ROM exercise down each side of the exercised
body.
7. Repeat each ROM exercise as the client Provide exercise to the clients tolerance
tolerates, to a maximum of 5 times.
Perform each motion in a slow, firm
 manner. Encourage full joint movement,
but do not go beyond the point of pain,
resistance, or fatigue
8. HEAD-
Perform these movement with the client To optimize the performance of
in sitting position, if possible the movements
ROTATION-Turn the head from side to To preserve muscle tone and
side joint flexibility
FLEXION AND EXTENSION- Tilt the
head towards the chest and then tilt
slightly upward.
LATERAL FLEXION- Tilt the head on
each so as to almost touch the ear to the
shoulder.
9. NECK-
Perform these movement with the client To optimize the performance of
in sitting position, if possible the movements
FLEXION- Rest chin on chest
EXTENTION-Return head to midline To preserve muscle tone and
HYPEREXTENTION-Tilt neck back joint flexibility
LATERAL FLEXION-Move head to
touch ear to shoulder

ROTATION-Rotate the neck in a

semicircle while supporting the head.
10. TRUNK-
Perform these movement with the client To optimize the performance of
in sitting position, if possible the movements
ROTATION-Turn the SHOULDER To preserve muscle tone and
FORWARD and return to the normal joint flexibility
position
FLEXION AND EXTENSION- Bend
the trunk forward,straighten the trunk and
then extend slightly backward
LATERAL FLEXION- Tilt trunk to the
left side, straighten the trunk,tilt to the
right side

11. ARM-
To preserve muscle tone and
FLEXION AND EXTENSION- joint flexibility
extend the arm in straight position
upward towards head the downward
along the side

ADDUCTION AND ABDUCTION-

extend the arm in straight position toward
the midline (ADDUCTION )and away
from the midline (ABDUCTION)
12. SHOULDER-
FLEXION- To preserve muscle tone and
Raise straight arm forward to a position joint flexibility
above the head

EXTENTION-
Return straight arm forward and down to
side of body

HYEREXTENTION-
Move straight arm behind body

ABDUCTION-
Move straight arm latterly from side to a
position above the head palm facing
away from hear.

ADDUCTION-
Move straight arm major download
laterally and across front of body as far
as possible

CIRCUMDUCTION-
Move straight arm in a full circle

INTERNAL AND EXTERNAL

ROTATION-
Bend the elbow at 90 degree angle with
upper arm parallel to the shoulder; rotate
the shoulder by moving the lower arm
upward and downward.
13. ELBOW-
FLEXION AND EXTENSION- To preserve muscle tone and
Supporting the arm ,flex and extend the joint flexibility
elbow
PRONATION AND SUPINATION-
Flex elbow ,move the hand in palm-up
and palm-down position
14. WRIST-
FLEXION AND EXTENSION- To preserve muscle tone and
Supporting the wrist , flex and extend the joint flexibility
wrist

ADDUCTION AND ABDUCTION-

Supporting the lower arm, turn wrist right
to left, left to right the rotate the wrist in
a circular motion.

15. HAND-
FLEXION AND EXTENSION- To preserve muscle tone and
Supporting the wrist , flex and extend the joint flexibility
finger

ADDUCTION AND ABDUCTION-

Supporting the wrist spread finger apart
and then bring them close together.

OOPOSTION-
Supporting the wrist,touch each finger
with the tip of the thumb.

THUMB ROTATION-
Supporting the wrist , the rotate the
thumb in a circular manner.

16. HIP AND LEG-

Perform these movement with the client To optimize the performance of
in sitting position, if possible the movements
FLEXION AND EXTENSION-
Supporting the lower leg,flex the leg To preserve muscle tone and
toward the chest and the extend the leg. joint flexibility

INTERNAL AND EXTERNAL

ROTATION-
Supporting the lower leg, angle the foot
inward and outward

ADDUCTION AND ABDUCTION-

Slight the leg away from the clients’
midline and the back to the midline.
 17. KNEE-
FLEXION AND EXTENSION- To preserve muscle tone and
Supporting the lower leg ,flex and extend joint flexibility
the knee

18. ANKLE-
FLEXION AND EXTENSION- To preserve muscle tone and
(Planter and dorsiflexion) joint flexibility
Supporting the lower leg ,flex and extend
the Ankle

19. FOOT-
FLEXION AND EXTENSION- To preserve muscle tone and
Supporting the ankle, extend the toes joint flexibility
upward and then flex the toe downward

ADDUCTION AND ABDUCTION-

Supporting the ankle spread toe apart and
then bring them close together.

20. TOE-
FLEXION-Curve toes downwards To preserve muscle tone and
joint flexibility
EXTENSION-Straighten toes

ADDUCTION –Bring toes together

ABDUCTION- Spread toes apart

21. Observe client joint and face for sign of Alert nurse to discontinue exercise
exertion, pain or fatigue during
movement.
22. Replace covers and position client in Promote comfort
proper body alignment

23. Place side rails on original position Prevents fall

24. Place call light within reach Facilitates communication
25. Wash hands Reduce the transmission of microorganisms

PATIENT CARE AFTER PROCEDURE-

 Make sure that the client is in correct body alignment and is comfortable.
 Replace the pillow and other comfort devices as needed.
  Raise the side rail if necessary for the safety of the client.
 Assess the client for pain or discomfort caused or relieved by the movement. Assess the skin condition
 The nurse should remain with the client in front of him when the client assumes a sitting or standing
position. Check clients pulse and blood pressure if indicated.
 Return to supine position if there is any untoward reaction.
 Tidy up the unit

DOCUMENTATION-

 The length of time the client was up in bed

 Amount of assistance or instruction needed
 Pulse rate and BP if taken
 Reactive to activity
 Evidence of orthostatic-hypotension and corrective measure used
 Observation if any
 Recommendation for progressive activity and independence.
REFERENCE-

 Kozier Barbara et.al. (2003). Fundamentals of Nursing, concept process and practice, Delhi, Pearson
publication

 The trained nurses association of India (2007),Fundamentals of Nursing, a procedure manual,Newdelhi,

Secretary general publication.