Range of Motion

Lesson Plan and Speaking Notes

Range of Motion describes the amount of motion a person has at a joint.

Joints that are not moved will lose their normal range of motion. Many of our patients have limited mobility, and do not move their extremities enough to maintain normal range of motion.

This varies from patient to patient, and one patient may have greater range of motion in some joints and less in others:

Limitation on one side
Limitation on both sides
Partial loss
Full loss

Neck
Shoulders
Arms
Hands
Fingers
Hips
Knees
Ankles

Consequences of Losing Normal Range of Motion
Limited mobility and dexterity
Stiffness
Pain
Contractures
Skin Breakdown
Loss of ability to perform Activities of Daily Living
Loss of ability to ambulate

We certainly want to prevent any loss of range of motion, and we can almost always gradually increase the range of motion in joints. Every increase in range of motion will be an increase in the patient's quality of life.

Orders for Range of Motion
Many of our patients are evaluated by the Physical Therapy, and will have range of motion orders for every day exercises. This will be recorded in the patient's plan of care and on the home health aide assignment sheet. Stay informed of the patient's current orders, and if you have any doubts, discuss them with the charge nurse.

Active Range of Motion
Exercises patient does without any physical help or support Most patients though will need reminding to do the exercises, cueing, or supervision of the entire exercise sequences.

Passive Range of Motion
Performed for the patient by a caregiver A patient may require a combination of active and passive range of motion exercises.

General Instructions

Perform all exercises in moderation

Move slowly and gently

Never force movements

Move only to the point of slight resistance

Stop whenever there is any pain or if the patient shows any expression of pain

Perform on one joint at a time

Always do each exercise on both sides of the body, right and left

Place one hand just above the joint to stabilize it, and place the other hand below the joint to support it while it is moved

Do the exercises once per day, and only more if specifically prescribed

If the patient's endurance is low, break the exercises down into segments over the day

Gradually build up repetitions

Try to incorporate the exercises into other daily activities, such as while watching television or after bath