LEVEL I – GRANT



TRINITY VALLEY COMMUNITY COLLEGE

ASSOCIATE DEGREE NURSING

RNSG 1216

PROCEDURE GUIDE AND CHECK-OFF SHEET

RANGE OF MOTION EXERCISES

Range of motion (ROM) exercises are performed to maintain joint mobility. These exercises can either be active (patient performs exercises) or passive (caregiver performs exercises). Perform exercises as appropriate or prescribed.

Delegation: This procedure can be delegated to unlicensed assistive personnel with proper training. An assessment of the patient’s joint mobility by a nurse should be completed prior to delegation.

|Procedure |Scientific Rationale |

|1. The following equipment is needed for this skill: | |

|a. bath blanket |a. Blanket used to provide privacy |

|pillows. |b. Pillows used to provide support |

|2. Clothe patient in a loose gown and cover with bath blanket. |Expose only limb being exercised to avoid embarrassment of patient. |

|3. Position bed at appropriate height and use proper body |Prevents muscle strain or injury to yourself and patient. |

|mechanics. | |

|4. Procedure: | |

|Support patient’s limbs above and below the joint by cupping joints |a. Prevents muscle strain or injury. |

|in palms of your hand or cradling limb along your forearm. | |

|Use a firm, comfortable grip when handling the limb. | |

|Move body parts smoothly, slowly, and rhythmically. |b. Ensures comfort of patient. |

|Perform using a systematic approach. | |

|Avoid moving or forcing a body part beyond the existing range of |c. Jerky movements can cause discomfort and injury. Fast movements can |

|motion. Move joint only to point of resistance not pain. |spasticity or rigidity. |

|Finish with joint in proper alignment. | |

|Assess for tolerance and fatigue throughout procedure. |e. Prevents muscle strain, pain and injury. |

|Frequency is determined by policy of facility. (typical procedure: | |

|four sets daily with five repetitions) | |

| |f. Prevents injury. |

| |g. Determines if procedure should be discontinued. |

| | |

| |h. Ensures full benefit of joint mobility. |

|5. Exercises: NECK | |

|a. flexion (move head from upright midline position forward, so | |

|chin rests on chest) | |

|b. extension (move head from flexed position to upright position) | |

|hyperextension (move head from upright position as far back as | |

|possible) | |

|lateral flexion (move head laterally to right and left shoulders) | |

|e. rotation (turn face as far as possible to right and left) | |

|6. Exercises: SHOULDER | |

|flexion (raise each arm from position by side forward and upward | |

|to a position beside the head) | |

|extension (move each arm from a vertical position beside head | |

|forward and down to resting position at side of body) | |

|hyperextension (move each arm from resting position to behind body) | |

|abduction (move each arm laterally from resting position at sides | |

|to a side position above head, palm of hand away from head) | |

|adduction (move each arm from position beside head downward | |

|laterally and across front of body) | |

|circumduction (move each arm forward, up, back, and down in full | |

|circle) | |

|external rotation (with each arm held out to side at shoulder level | |

|and elbow bent to right angle, fingers pointing down, move arm | |

|upward so fingers point out) | |

|internal rotation (with each arm held out to side at shoulder | |

|level and elbow bent to right angle, fingers pointing up, bring arm | |

|forward and down so fingers point down) | |

|7. Exercises: ELBOW | |

|flexion (bring each lower arm forward and upward, until hand is at | |

|shoulder) | |

|extension (bring each lower arm forward and downward, straighten | |

|arm) | |

|c. rotation for supination (turn each hand and forearm so palm is| |

|upward) | |

|rotation for pronation | |

|(turn each hand and forearm so palm is downward) | |

| 8. Exercises: WRIST | |

|flexion (bring fingers toward inner aspect of forearm) | |

|extension (straighten hand to same plane as arm) | |

|hyperextension (bend fingers back as far as possible) | |

|abduction (bend wrist laterally toward thumb side with hand | |

|supinated) | |

|adduction (bend wrist laterally toward fifth finger with hand | |

|supinated) | |

|9. Exercises: HANDS AND FINGERS | |

|flexion (make fist) | |

|extension (straighten fingers) | |

|hyperextension (bend fingers back as far as possible) | |

|abduction (spread fingers apart) | |

|adduction (bring fingers together) | |

|flexion of thumb (move thumb across palm toward fifth finger) | |

|extension of thumb (move thumb away from hand) | |

|abduction of thumb (move thumb laterally) | |

|i. adduction of thumb (move thumb back to hand) | |

|j. opposition of thumb (touch thumb to top of each finger) | |

|10. Exercises: HIP | |

|flexion (move each leg forward and upward) | |

|extension (move each leg back beside the other) | |

|hyperextension (move each leg back behind body) | |

|abduction (move each leg out to side) | |

|adduction (move each leg back to other leg and beyond) | |

|circumduction (move each leg backward, up, to side, and down in a | |

|circle) | |

|internal rotation (turn foot and leg inward, toes pointed toward | |

|other leg) | |

|external rotation (turn foot and leg outward, toes pointed away from| |

|other leg) | |

|11. Exercises: KNEE | |

|flexion (bend each leg, bringing heel toward back of thigh) | |

|extension (straighten each leg, returning foot to position beside | |

|the other foot) | |

|12. Exercises: ANKLE | |

|flexion (point toes up- ward) | |

|extension (point toes downward) | |

|13. Exercises: FEET AND TOES | |

|eversion (turn sole laterally) | |

|inversion (turn sole medially) | |

|flexion (curl toes downward) | |

|extension (straighten toes) | |

|abduction (spread toes apart) | |

|adduction (bring toes together) | |

|14. Exercises: TRUNK | |

|flexion (bend at waist toward toes) | |

|extension (straighten trunk at waist) | |

|hyperextension (bend trunk backwards) | |

|lateral flexion (bend trunk to right and left) | |

|rotation (turn upper part of body from side to side) | |

|15. Document mobility of joints and patient’s tolerance of |All data must be entered into patient’s record. |

|procedure. | |

N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - ROM Reviewed 04/16

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