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Jeannie
17th June 2011, 16:56
Not many people know about ROM exercises because they have never been told by their care team. I think it's important that you do ROM exercises because if you don't your joint's could fuse together like in my case, making it increasingly difficult and painful to move hip and arm joints beyond a certain point.

What are passive range of motion exercises?

Range of motion exercises are also called "ROM" exercises. ROM exercises may be active or passive. Active ROM is done when a person can do the exercises by himself. Active-assisted ROM exercises are done by the person and a helper. Passive ROM exercises are done for a person by a helper. The helper does the ROM exercises because the person cannot do them by himself. Do not do passive ROM exercises on a person without first talking to the person's caregiver. Together you can decide what exercise plan is best for the person.

Why is it important to do passive ROM exercises?

ROM exercises are very important if you have to stay in bed or in a wheelchair. ROM exercises help keep your joints and muscles as healthy as possible. Without these exercises, blood flow and flexibility (moving and bending) of your joints can decrease. Joints, such as your knees and elbows, could become stiff and locked without ROM exercises. Passive ROM exercises help keep joint areas flexible, but do not build up muscles or make them stronger.

How are passive ROM exercises done?

Do the exercises in the same order to keep it simple and easy to remember. Start exercises at the person's head and work down toward his toes. Use good posture while doing ROM exercises for the person. Standing or sitting as straight as possible will help your breathing while doing the exercises. It will also make your back, neck, and stomach muscles stronger. Keep your stomach muscles tight and pull your hips into a straight line under your shoulders. Leave the person in a comfortable position after you finish each exercise. Always wash your hands before and after doing ROM exercises for a person.
Head and Neck exercises:

How to start: Lay the person on his back with his head as flat (no pillow) as possible. Support the back of the person's head with one of your hands. Support the chin with your other hand.

* Chin-to-chest. Raise the back of the person's head up from the bed. Gently tip his chin toward his chest. Try to rest the person's chin on his chest if possible.

* Head turns. Put one hand on each side of the person's face. Turn the person's head toward the right as if he were looking over his right shoulder. Then slowly turn the person's head so he is looking over his left shoulder. Turn the head only far enough so that the person's nose is lined up above their shoulder.

* Head tilts. Put one of your hands on each side of the person's face. Tilt the head to the side, bringing the right ear toward the right shoulder. Then slowly tilt the person's head to bring the left ear toward the left shoulder.

Shoulder and Elbow exercises:

How to start: Put one hand under the person's elbow and hold his wrist with your other hand. Keep the person's elbow straight, or bend the elbow slightly if necessary.

* Shoulder movement, up and down. Turn the person's palm in toward the body. Bring the right arm forward and upward over the person's head until the inner arm touches his ear. Bring the arm back down to his side.

* Shoulder movement, side to side. Raise the right arm out to the side to shoulder level. Raise it upward over the person's head as far as possible. Bring the arm back down to his side and then swing across the body toward the left shoulder. Swing the arm back down to his side.

* Shoulder rotation (ro-TAY-shun). Bring the right arm out to the person's side. Bend the elbow so the thumb and fingers are pointing up. Rotate (turn) the arm so the thumb and fingers point down toward the person's toes.

* Elbow bends, up and down. With the person's right arm at his side, turn the palm of his hand face up. Bend the arm at the elbow so that the fingers are pointing toward the ceiling. If possible, continue bending the elbow and touch the hand (fingertips) to the front of the right shoulder. Move the hand back down to the person's side.

* Elbow bends, side to side. Hold the right arm out at shoulder level with the palm facing up. Bend the elbow. Try to make the person's fingertips touch the top of his right shoulder.

Repeat the above exercises with the left arm.
Forearm and Wrist exercises:

How to start: Start with the person's arms at his sides. Hold just below the person's wrist with one of your hands. Hold the person's hand with your other hand.

* Wrist rotation. Hold the wrist and hand of the right arm with the palm face down. Keeping his elbow on the bed, lift the forearm up. Hold the hand and bend it back toward the wrist. Then bend the hand down only until you feel resistance. Rock the hand back and forth sideways. Gently rotate the hand in smooth circles.

* Palm up, palm down. Keep the person's elbow and forearm on the bed and raise his hand. Gently twist it so his palm is up. Then twist it so his palm is down.

Repeat the above exercises with the left arm.
Hand and Finger exercises:

How to start: Hold the person's wrist to keep it straight. Use your other hand to do the hand and finger exercises.

* Finger bends. Place your hand on the back of the person's fingers. Gently bend his hand into a fist. Straighten the fingers again.

* Finger spreads. Gently straighten out his fingers. Spread the fingers wide apart, one at a time. Then bring the fingers back together.

* Finger-to-thumb touches. One at a time, bring each fingertip to touch the thumb.

* Thumb-to-palm. Move the person's thumb across his palm. Bring it back out again.

* Thumb circles. Use the thumb to make wide circles.

Repeat the above exercises with the left thumb and fingers.
Hip and Knee exercises:

If the person has had a hip injury or surgery, only do hip exercises with instructions from a caregiver.
How to start: Place the person's right leg flat on the bed. Put one hand under the ankle and your other hand under the knee. Straighten the leg and return it to a flat position on the bed after each exercise.

* Hip and knee bends. Slowly bend the hip and knee up toward the chest as much as possible. Slide your hand out from under the knee and toward the upper thigh (leg). Do this to help the knee bend completely.

* Leg movement, side to side. Move the right leg out to the right side as far as possible. Then return the leg to the middle and cross it over the left leg.

* Leg rotation, in and out. With the leg flat on the bed, roll the leg toward the middle so the big toe touches the bed. Roll the leg outward so the little toe touches the bed.

* Knee rotation, in and out. Bend the person's knee so the bottom of the right foot is flat on the bed. Roll the leg inward as far as possible. Try to touch the bed with the big toe. Roll the leg outward as far as possible. Try to touch the bed with the small toe.

Repeat the above exercises with the left leg.
Ankle and Foot exercises:

How to start: Hold the right ankle with one hand. Put your other hand on the bottom of the foot.

* Ankle bends. Push the person's foot so his toes point up toward the ceiling. Then put your hand on top of the foot and push the foot down again.

* Ankle rotation. Hold the ankle with one hand. Hold the person's upper foot with your other hand. Gently turn the foot and ankle in circles.

* Toe bends. With your palm on top of the person's foot, curl the toes down toward the sole (bottom) of the foot. Then straighten and stretch the toes.

* Toe spreads. Use your fingers to spread the toes apart one at a time. Then bring them together again.

Repeat the above exercises with the left ankle and foot.

Robin142857
17th June 2011, 17:31
BH Jeannie, that's more than I get each week in pills from my doctor! I've printed it off ready to try iy out. How often - once a week enough? Thanks, anyway, will give it a go.

Vane
17th June 2011, 22:07
Fantastic Jeannie,thank you, really really helpful, vanessa

computatec
21st June 2011, 18:21
Hi Jeannie,

Do these positions need to be held, like for 5 seconds for instance, and is it good to do repetitions?

Clive

Jeannie
21st June 2011, 19:08
Hi Robin, 2-3 times a week is usually recommended, I know many do them daily.

Hi Clive, You don't need to hold the positions, and yes repetitions are good, I'd say 3-5.

If you are unsure how to perform roms, there are many videos on youtube, here is just one of many


http://youtu.be/O_weF6LkKdE


I'm glad these roms are of help ;-)

computatec
25th June 2011, 21:29
Hi Jeannie

A really big thankyou for this and many other important high quality articles you have posted recently! After a few weeks of badgering I got a visit by a Physio to bring me a Foot Up to stop me tripping all the time. This one is very knowledgable, so I asked about ROM. She said they are vital, but we have to do them ourselves because there is no funding for NHS Physios to provide passive ROM and the carers are not allowed to help us with them as they are not trained Physios!

I think there is a business oportunity for an unemloyed Physio to train up on ROM and hit the road with a home visiting service. Where we would get the funding to buy the service would be a whole new can of worms, but there must be a way.

Clive

MikeFD
26th June 2011, 00:02
Hi Clive,

On the question of funding physio treatments, you could try putting a request in to your local branch for help. It's not guaranteed that you'll get a positive response since these decisions are made locally and may be dependent on the funds in hand at the time, but I know my branch has funded home visits by a physio. I think it was restricted to one visit per week per person, because of the level of fees, but every little helps.

Ask your regional care development adviser (RCDA) for their input. I believe that because the RCDAs are in touch with the MND care centres and other health charities and professionals, they can very often source reliable services at, let's say preferential rates - and enlisting the help of your RCDA in presenting your case to the branch can only boost your chances of success.

Good luck with it,

Mike.

PS. The list of Regional Care Development Advisers can be found here:
http://www.mndassociation.org/for_professionals/local_support/regional_care.html

It looks like Hertfordshire and Essex is covered by Liz Pybus
Tel: 08453 751840

Jeannie
16th March 2012, 16:50
Bump for newbies

magic
16th March 2012, 19:31
Jeannie, thank you so much for,this. PeterV, my husban has been doing these for the last two months. Hei is often reluctant and needs prompting. I have just read him the bones of your post and it has made him feel more positive about the exercise regime.
Thanks again

Magic

teynhambees
16th March 2012, 21:36
Jeannie,
Thank you very much for this, although I have good mobility ive been asking about exercises with my Physio who suggested starting with a mile walk! I'm struggling today with sore thighs so a mile it ain't! But this is really helpful why can't this be standardised nationally so all MND patients are give this from the outset eg put into the mnda information pack? My MND nurse suggested passive exercise and she would mention it to the Physio now need ow you've answered my question.
Scott

Jeannie
11th June 2012, 17:12
Bump for newbies

Terry
11th June 2012, 19:56
Well done Jeannie, could we have photo’s too. It is an excellent idea having a information sheet made out and distributed Scott. I will put it forward.

Smudge
12th June 2012, 10:01
Thank you so much for these, I've printed them off so that my other half can do them.

Things like this are exactly why I joined the forum

Wendy :-)

john
12th June 2012, 11:06
Sorry Jeannie,
you have already done what i was asking today in another thread.

john

Jeannie
12th June 2012, 12:49
You're welcome ;-)

Here is a better description with pictures https://docs.google.com/viewer?a=v&q=cache:VCyuotvOhKsJ:www.alsworldwide.org/pdfs/rom_exercises.pdf+range+of+motion+exercises&hl=en&gl=uk&pid=bl&srcid=ADGEESgRP8VxLZjEGW-jA-aTsGXllkoPpzx3p7d7a009pbSwW4YvGSCZsdeHJeklvZvHbl8o fsmWFAxkE-50xtNw5_gwYxmf2qLbhedUuYfXDyrS-KEVKbWMkj7sAHjjBZqUOvaZNIom&sig=AHIEtbQfiBUzpg2qwX_XhsPeKjcEX0-N-Q - you know it really pisses me off that were not given such simple info at the time of dx grrrrrrrrrrr

Terry
12th June 2012, 21:07
I was half joking about pictures, excellent download link. Have asked about Mnda making an information sheet on exercise, their first opinion was that one size would not fit all, but they will look at it in the future.
Well done, Jeannie

john
3rd December 2012, 10:39
Pete has started a discussion on exercise elsewhere so i thought it might be a good time to do this bump.

john

Chrissy
3rd December 2012, 11:42
Thanks everyone for the bump, I hadn't come across this thread. Think it will be very useful

Chrissy

john
23rd January 2013, 09:06
Just bumping for newcomers.

John

miranda
23rd January 2013, 12:33
John - that is a such weird phrase - took me ages to figure out what it meant when I first saw it. Wonder what our regular forum fun fellas will comment??

Rory
23rd January 2013, 13:45
Well Miranda - I am still not sure what it means !
The only bumps I relate to is when
A) I am rude to the missus
B) when I used to have to walk up the aisles shopping and knocked people out of the way
C) the marks on the car when the missus has driven somewhere
D) the bumps in the road which the missus seems to ignore
And E) unprintable

By the way the exercise routine is very helpful - is it designed for the carers to keep them in trim ?
Keep fit and have fun

Rory

Jeannie
23rd January 2013, 16:41
Rory, i love your sense of humor ;)

For those who don't know :o "Thread bumping" is the act of posting in a thread, with the sole goal of getting it back to the top of the thread list. Some people thread bump because their thread wasn't noticed during a busy time, while others bump threads because they want to make new members aware of the thread.

Rory
23rd January 2013, 18:38
Hi Jeannie
Thanks for all the informative posts !
I have not written to you before as my ex wife was called Jeannie and if my current wife finds I am writing to someone called Jeannie , all hell would be let loose.
Ouch ! She was behind me reading over my shoulder.
You had better add F) to the Bump list above !

Keep laughing

Rory

Jeannie
29th October 2014, 12:05
Bump

Steve
29th October 2014, 12:24
I have a couple of sessions a month with a Sports physio and the difference is amazing afterwards. it feels like torture but there is a real benefit in terms of both movement and comfort.

IThese are really thorough instructions.

Terry
29th October 2014, 15:58
Hi Steve;

I believe that gentilish movements are a great benefit in many ways.

Terry

KayEhm
4th April 2015, 23:40
A good way to implement all these exercises is to use a device like the Vertical Vortex (http://verticalvortextoys.com) , which uses kinetic energy to provide range of motion movement.

fishmate12
5th April 2015, 00:32
Sounds like something that fits up the back passage,...let us know how it feels when you've done it.........

Barry52
5th April 2015, 09:42
Nice one Ray,
Some people have nothing better to do than troll forums looking for a mug. Well there are no mugs in this gang.

Terry
5th April 2015, 11:14
No Ray, it's something from Doctor who???

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