ROM

• Range of Motion (ROM)


  the maximum amount of movement available at a joint in one of the three planes of the body sagittal, frontal or transverse
• Active ROM


  instructs the client to perform the movements of the non- functioning joint independently.
• Passive ROM


  Performed by the nurse or other health care provider on a

  client’s immobilized joints.
• Active Assisted ROM


  carried out with both client and nurse participating. Encourage the client to carry out as much of each movement within limitations of strength and mobility.The nurse supports or completes the desired movement.
• Three planes of the body

  Saggital, frontal, and transverse
• The act of drawing away from the median line or center of

  the body

  Abduction
• The act of drawing toward the median line or center of the

  body

  Adduction
• a circular movement of the body part

  Circumduction
• bending or moving a part toward the dorsum or back

  Dorsiflexion
• the act of straightening the joint

  Extension
• bending of a joint

  Flexion
• extension of the joint beyond the straight position

  Hyperextension
• bending a joint toward the side or away from the midline of the body

  Lateral Flexion
• positioned opposite one another; for example, the thumb to the fingers

  Opposition
• bending the foot so that the toes point downward

  Plantar Flexion
• a circular movement around a fixed axis

  Rotation
• Purposes of ROM


  ▪To maintain present level of functioning and mobility of joints and muscle ▪To prevent contractures and shortening of musculoskeletal

  structures

  ▪To facilitate circulation and to prevent vascular complications

  of immobility

  ▪To facilitate comfort.
• Equipment

  ▪No special equipment or supplies are necessary to perform ROM exercises. Wear non-sterile gloves and/or other PPE, as appropriate
• Assessment of ROM

  1. Review the medical record and nursing plan of care for any conditions or orders that will limit mobility 2. Perform a pain assessment before the time for the exercises. If the patient reports pain, administer the prescribed medication in sufficient time to allow for the full effect of the analgesic 3. Assess the patient’s ability to perform ROM exercises. 4. Inspect and palpate joints for redness, tenderness, pain, swelling, or
• Implementation

  1. Perform hand hygiene and put on PPE, if indicated 2. Introduce self to client. 3. Verify the client using at least two identifiers (i.e. name and birth date or name and identification number). Compare identifiers with information on the client’s medical record/client’s identification band. 4. Explain the procedure to the client and encourage to participate as appropriate. 5. Close the room door and/or curtains around the bed if possible. 6. Position patient in supine or sitting position.
• Bring chin to rest on the chest. (45°)

  Flexion (Neck)
• Gently tilt head backwards. (10°)

  Hyperextension (Neck)
• Lateral Flexion (Neck)


  Tilt head toward each shoulder (40°- 45°)
• Rotation (Neck)


  Rotate head in circular motion. (360°)
• Flexion (Shoulder)


  Raise arm from side-position forward to above head. (180°)
• Extension (Shoulder)


  Return arm to position at side of body. (180°)
• Hyperextension (Shoulder)


  In standing position, move arm behind, keeping the elbow straight (45°- 60°)
• Vertical abduction (Shoulder)


  Raise arm from side to position above head with palm away from head. (180°)
• Vertical adduction (Shoulder)


  Lower arm sideways and across body as for as possible. (320°)
• External rotation (Shoulder)


  With elbow flexed, move arm until thumb is upward and lateral to head (90°)
• Internal Rotation (Shoulder)


  With elbow flexed rotate shoulder by moving arm until thumb is turned inward and toward back (ROM: 90°)
• Circumduction (Shoulder)


  Move arm in full circle. (360°)
• Flexion (Elbow)


  Bend below so that lower arm moves toward shoulder joint and hand is aligned with the shoulder. (ROM: 150°)
• Extension (Elbow)


  Straighten elbow by lowering hand. (150°)
• Flexion (Wrist)


  Move palm toward inner aspect of forearm. (ROM: 80° - 90°)
• Extension (Wrist)


  Move palm so fingers, hands and forearm are in the same plane. (ROM: 80°-90°)
• Hyperextension (Wrist)


  Gently bring dorsal surface of the hand back (80-90°)
• Radial Flexion (Wrist)


  Bend wrist medially toward thumb. (30°)
• Ulnar Flexion (Wrist)


  Bend wrist laterally toward fifth finger . (30-50°)
• Flexion (Fingers & thumb)


  Make a fist. (ROM: 90°)