1. Health Skills II Unit 202 Range of Motion

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

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

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

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

6. 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

7. 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

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

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

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

11. 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

12. 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

13. 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

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

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

16. 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)

17. 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

18. Example of Flexion Elbow flexion bend

19. Example of Flexion Knee flexion bend

20. Example of Flexion Toes flexion bend

21. Example of Extension Knee extension straight

22. Example of Extension Head & Neck extension straight

23. Example of Abduction Hip abduction away from midline of body

24. Example of Adduction Toes adduction toward midline

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

26. Example of Rotation Hip internal rotation pivoting inward

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

28. Example of Supination Forearm supination rotate forearm, palm up

29. Example of Pronation Forearm pronation rotate forearm, palm down

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

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

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

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

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