Passive Range of Motion Exercises

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Perform hand hygiene.
Explain the procedure to the patient and ask for his or her assistance in following directions.
Raise the bed to a comfortable working height.
Assist the patient into a supine position.
In the following exercises, move the patient’s joints in a natural motion and stop at the point of resistance. Do not continue the motion if the patient reports pain.
Repeat each exercise a minimum of three times.
To exercise the shoulder, keep the arm straight and support the patient’s arm by holding the elbow and wrist.
- Raise the arm above the patient’s head (flexion) and return arm in the same path to the patient’s side (extension).
- Move the arm laterally away from the patient’s body (abduction) and return arm to patient’s side (adduction).
To exercise the elbow and forearm, hold the patient’s wrist and elbow.
- Bend at the elbow to allow the patient’s hand to touch the shoulder (flexion). Straighten the arm (extension).
- Turn the palm downward (pronate) and rotate it upward (supinate).
To exercise the wrist, fingers, and thumb, hold the patient’s wrist with one hand and use the other hand to guide the fingers.
- Bend the hand up (extension) and down (flexion).
- Turn hands inward toward the thumbs (radial flexion) and outward toward the pinky (ulnar flexion).
- Keep the thumb parallel to the index finger (adduction) and move the thumb laterally away from the index finger (abduction).
- Turn the thumb inward toward the palm (flexion) and back out (extension).
- Touch each finger to the thumb (opposition).
- Make a fist (flexion) and straighten fingers (extension).
- Separate the fingers (abduction) and bring them back together (adduction).
To exercise the hip, straighten the leg and support at the knee and ankle.
- Slightly raise the leg off the bed and move the leg away laterally away from the other leg (abduction). Bring the legs back together (adduction).
- Carefully rotate the leg inward (internal rotation) and outward (external rotation).
To exercise the knee, support under the knee and ankle. Slide the patient’s ankle toward the thigh (flexion) and straighten the leg (extension).
To exercise the ankle and toes, support the ankle and use the other hand to guide the toes.
- Pull the patient’s toes up toward the legs (dorsiflexion) and push down toward the ground (plantar flexion).
- Bend the sole of the foot inward (supination) and outward (pronation).
- Curl the toes down (flexion) and straighten them (extension).
- Separate the toes (abduction) and return them (adduction).
Assist the patient into a comfortable position and lower the bed.
Perform hand hygiene.
Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations. To avoid injuring the patient, always follow the correct procedure, make natural motions, and stop when resistance is encountered.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482407/

More Resources

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Applying Elastic Support Hose

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Rectal Temperature with Electronic Thermometer

A rectal temperature provides the most accurate core body temperature reading compared to other non-invasive methods. This makes a rectal temperature desirable; however, this procedure comes with more patient discomfort and more safety risks (bowel perforation, mucosal damage, and/or vagus nerve stimulation) than the other temperature measurement methods.

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).