Range of Motion Exercises PDF

Range of Motion (ROM) Exercises Presented by: Dr. Wafaa Mohamed Elsayed Associated professor of Medical Surgical Nursing Date: 24-11-2024  Outline: Definition Objectives Types of ROM Exercises  Definition Range of motion is how far you can move your joints in different...

Range of Motion (ROM) Exercises Presented by: Dr. Wafaa Mohamed Elsayed Associated professor of Medical Surgical Nursing Date: 24-11-2024  Outline: Definition Objectives Types of ROM Exercises  Definition Range of motion is how far you can move your joints in different directions  Objectives 1. To improve the circulation of involved part 2. To restore joint function 3. To promote joint mobility 4. To prevent joint contracture 5. To promote muscles strength 6. To prevent muscles atrophy  Purpose in Nursing: In nursing, ROM exercises are important for preventing complications, such as joint contractures, and enhancing circulation, especially in patients who are bedridden or have limited mobility.  Objectives of ROM Exercises To Improve Joint Mobility: Regular ROM exercises help maintain or improve the flexibility and function of joints. To Prevent Contractures: Contractures are the abnormal shortening of muscles or tendons that can occur due to immobility. ROM exercises help reduce the risk of contractures. To Maintain Muscle Tone and Strength: ROM exercises contribute to the overall health of muscles and tissues, which helps maintain tone and prevent atrophy.  To Enhance Circulation: ROM exercises can improve blood circulation by promoting the movement of blood through the body. To Improve Functional Independence: By improving mobility, ROM exercises help patients retain their ability to perform activities of daily living (ADLs) independently.  Types of ROM Exercises  There are three main types of ROM exercises that can be used based on the patient's condition:  Active Range of Motion (AROM) Exercises: o Definition: The patient performs the exercises on their own, moving their joints through their full range of motion. o Indications: For patients who are able to move their joints without assistance (e.g., ambulatory patients). o Benefits: Enhances muscle strength and joint mobility.   Passive Range of Motion (PROM) Exercises: o Definition: A caregiver or healthcare provider moves the patient's joints through their full range of motion without any effort from the patient. o Indications: For patients who cannot move their limbs independently due to paralysis, weakness, or immobility. o Benefits: Prevents joint stiffness, maintains flexibility, and improves circulation. Active Assistive Range of Motion (AAROM) Exercises: o Definition: The patient moves the joint as much as possible with assistance from a healthcare provider or equipment. o Indications: For patients who can perform some movement but need help to complete the motion fully. o Benefits: Encourages participation while maintaining the safety of the joint and muscle function.  Patients in need for exercise 1-weak and inactive individuals 2-Elderly individuals 3-Paralyzed patients  Principles to remember when performing ROM 1. The therapist should be in a proper position. 2. Place the patient in proper comfortable position with proper body alignment and stabilization to perform the exercise. 3. Free the region from linen, splints, and dressings. 4. Drape and cover the patient as necessary. 5. Do all ROM exercises smoothly and gently. Never force, jerk, or over-stretch a muscle. This can hurt the muscle or joint instead of helping. 6. Stop ROM exercises if the person feels pain. The exercises should never cause pain or go beyond the normal movement of that joint. 7. Repeat the exercise 5 to 10 according to the patient condition and response  Techniques for Performing ROM Exercises Positioning: o Ensure the patient is comfortable and in a proper position (e.g., supine, seated, or side-lying). o Support the joint above and below the area being moved to avoid unnecessary strain. Movement: o Perform movements gently and slowly to avoid injury. o Encourage smooth and controlled movements to ensure that the full range of motion is achieved. Frequency: o Perform ROM exercises 2-3 times per day, or as recommended by the healthcare provider. Precautions: o Avoid overstretching or forcing the joint. o Monitor for signs of pain or discomfort and stop the exercises if pain occurs.  Benefits of ROM Exercises . Prevention of Complications: ROM exercises reduce the risks of joint contractures, muscle atrophy, and deep vein thrombosis (DVT). Enhancement of Functional Ability: Regular ROM exercises improve mobility, which helps patients retain independence and perform daily activities. Pain Reduction: ROM exercises can help reduce stiffness and pain in joints, particularly in patients with arthritis or immobilization. Psychological Benefits: Being involved in their care through exercises helps patients maintain a sense of control, improving their mental well-being.  Case Scenarios Scenario 1: A bedridden patient recovering from hip surgery may benefit from PROM exercises to prevent hip contractures and maintain joint flexibility. Scenario 2: A patient with stroke-related hemiparesis may need AAROM exercises to regain strength and mobility in the affected limb.  Scenario 3: An elderly patient with osteoarthritis can engage in AROM exercises to maintain joint mobility and decrease discomfort.  Performing range of motion exercise  Range of Motion & Motor Function of the Neck | Nursing Health Assessment   https://www.youtube.com/watch?v=t6hE_ntz4Ho  Performing Passive Range of Motion Exercises   https://www.youtube.com/watch?v=A_NPkuK_33g  https://www.youtube.com/watch?v=LGtSL-GRxzs   Prometric CNA Skill: Range of Motion to the Upper and Lower Extremities  https://www.youtube.com/watch?v=67HbfxgMxQg Range of Motion Exercises Performing Passive Range of Motion Exercises Range of Motion & Motor Function of the Neck Prometric CNA Skill_ Range of Motion to the Upper and Lower Extremities  1-Assessment  1-Review medical history to determine specific limitations to joint mobility  2-Assess patients’ level of consciousness and physical ability to assist or independently perform range of motion exercise  3-Assess for redness, tenderness, pain, swelling or deformities around joints  2- Preparation  -Prepare myself hand washing Wear the gloves Body mechanics  Prepare the patient Identify the patient Introduce myself to the patient Neck Explain the procedure  -Prepare the environment Flexion Extension Close the doors windows and curtains Hyperextension  -Prepare the bed Lateral flexion Close the brakes Raise the bed to waist level Rotation Lower the side rails Shoulder Flexion Extension Hyperextension Adduction Abduction Inward rotation outward rotation complete rotation Forearm Supination Pronation Wrist Flexion Extension Hyperextension Radial flexion Ulnar flexion Fingers Flexion Extension Adduction Abduction Thumb Flexion Extension Adduction Abduction Opposition Hip Flexion Extension Adduction Abduction Outward rotation Inward rotation Knee Flexion Extension Ankle Dorsiflexiion Plantarflexion Rotation o Inversion o Eversion o Flexion o Extension o Adduction o abduction Foot Post procedure  -Reposition the patient to comfortable position  -wash hands  -Record in nurse notes  The joints exercised  Type of exercise  Extent to which joints can be moved  Any joint abnormalities  Report  Resistance on performing ROM exercise  Patient complains of pain  Signs of inflammation; redness, swelling, hotness and tenderness.  Conclusion ROM exercises play a crucial role in patient care by improving mobility, preventing complications, and enhancing overall well- being. Nurses must understand the different types of ROM exercises and tailor them to each patient's needs for optimal outcomes. References 1. Hassan, E. M., & Al-Harbi, M. (2020). Effectiveness of Range of Motion Exercises in Reducing Muscle Atrophy and Improving Circulation in Bedridden Patients. Journal of Rehabilitation Research, 32(3), 400-408. 2. American Occupational Therapy Association (AOTA). (2023). Range of Motion (ROM) Exercises and their Role in Rehabilitation. Retrieved from https://www.aota.org 3. National Institutes of Health (NIH). (2022). Physical Activity and Mobility for People with Disabilities. Retrieved from https://www.ninds.nih.gov 3. Hockenberry, M. J., & Wilson, D. (2020). Wong’s Nursing Care of Infants and Children (11th ed.). Elsevier. 4. Barton, S., & Marquez, M. (2015). Understanding ROM Exercises and Their Benefits in Preventing Bedsores and Contractures. The Journal of Nursing Care, 43(8), 15-18. 5. Berman, A., Snyder, S. J., & Frandsen, G. (2016). Kozier & Erb’s Fundamentals of Nursing (10th ed.). Pearson. 6. Potter, P. A., & Perry, A. G. (2017). Fundamentals of Nursing (9th ed.). Elsevier. 7. Linton, A. D. (2019). Nursing Care Plans: Diagnoses, Interventions, and Outcomes (9th ed.). Elsevier. Thank you