Subject - Nursing Foundation Topic - Range of Motions Notes for ANM, GNM, B.Sc.Nursing,P.B.B.Sc.Nursing

1. RANGE OF MOTION

2. INTRODUCTION
• Clients with restricted mobility are unable to perform some or all range of joint
exercise3 independently.
• the easiest intervention to maintain or improve joint mobility for client is the use
of ROM exercise.
• If joints are not moved periodically, joint may become fixed in one position &
client loses normal use of the joint so, ROM exercise are very important.

3. DEFINITION
“ Range of motion is the range, measured in degrees of a circle,
through which the bones of a joint can be moved.”

4. PURPOSE
• To promote health by improving functioning of the circulatory system and lungs.
• To prevent stiffness of joint
• To delay degenerative changes
• To restore the muscles function in diseases, injuries and deformities.
• To promote physical mobility and improve gait
• To prevent deformity
• To improve the blood supply in vascular disorders.
• To reduce stress
• To rehabilitate the patient.

5. TYPES
1. Active ROM Exercise : Used for the client who are able to move his /her joints
independently.
2. Passive ROM Exercise : Used for the client who does not have voluntary motor
control, passive ROM exercise are of choice.

6. CAUSES OF ALTERED MOBILITY
• Congenital problems
• Neuromuscular deficit
• Musculoskeletal deficit
• Chronica health problems
• Trauma
• Affective disorder
• Therapeutic modalities+

7. CONTRAINDICATIONS
• ROM requires energy & increased circulation, any illness/disorder where increased
use of energy or increased circulation is hazardous is contraindicated; puts
strain/stress in soft tissues of the joint & bony structures, eg; swollen, inflamed joints.

8. TYPES OF MOVEMENTS
• Flexion
• Extension
• Hyperextension
• Abduction
• Adduction
• Circumduction
• Rotation - Internal & External
• Supination
• Pronation
• Inversion
• Eversion
• Dorsi flexion
• Palmer flexion
• Opposition
• Lateral flexion

9. Flexion
Decrease in the angle between circulating bones.
e.g.-
• Bending of head towards chest.
• Movements of palm toward inner aspect of forearm.
• Making a fist.
• Curling toes downward.

10. Extension
Straightening a joint. There is increase in angle between circulating
bones often to restore a part of the body to the anatomical position
after it has been flexed.
e.g.-
• Head in erect position.
• Arm to position at side of the body.
• Straighten toes.

11. Hyperextension
Moving a joint part normal, extension or continuation of extension beyond the
anatomical position is called hyperextension.
e.g.-
• Bend head back as far as possible.
• Move arm behind body, keeping elbow straight.
• Bend fingers back as far as possible.
• Move leg behind body.

12. Abduction
Moving a joint or extremity away from midline of the body.
e.g.-
• Moving of the palm laterally at wrist joint.
• Move leg laterally away from body.

13. Adduction
Moving a joint or extremity toward the midline of the body.
e.g.-
• Bringing fingers together.
• Move leg back toward medial position.

14. Circumduction
Moving a body part in widening circles. It occurs as a result of continuous sequence
of flexion, abduction and adduction.
e.g.-
• Move arm in full circle.
• Move leg in circle

15. Rotation
In rotation, a bone revolve around its own longitudinal axis.
e.g.-
• Turn head as far as possible in circular movement.

16. a)Internal rotation
Turning a joint or an extremity on its axis towards body’s midline.
e.g.-
• With elbow flexed, rotate shoulder by moving arm until thumb is turned inward and
toward back.
• Turning foot and leg toward other leg.

17. b)External rotation
Turning a joint or an extremity on its axis away from body’s midline.
e.g.-
• With elbow flexed, move arm until thumb is upward and lateral to head.
• Turn foot and leg away from other leg.

18. Supination
Turning the body or a body part to face upward.
e.g.-
• Turn lower arm and hand so that palm is up.

19. Pronation
Turning the body or a body part to face downward.
e.g.-
• Turn lower arm so that palm is down.

20. Inversion
Turning the feet inward,so toes are pointing toward the midline.
e.g.-
• Turn sole of foot medially.

21. Eversion
Turning the feet outward, so toes are pointing away from the midline or movement of
soles laterally at the intertarsal joints so that the soles face away from each other.
e.g.-
• Turn sole of foot laterally.

22. Dorsi flexion
Bending of the foot at the ankle in the direction of the dorsum(superior space).
e.g.-
• Standing on heels.

23. Plantar flexion
Bending of the foot at the ankle joint in the direction of the plantar(inferior
surface).
e.g.-
• Standing on toes.

24. Opposition
It is movement of thumb across the palm to touch finger tips on the same hand as touch
thumb to each finger.
e.g.-
• Touch thumb to each finger of same hand.

25. Lateral flexion
It occurs in frontal plane.
Movement of trunk is front plane.
It involves Intervertebral joints.
e.g.-
• Tilting of head as far as possible toward each shoulder.

26. Points to be remembered while performing ROM exercises :
• While assessing ROM, nurse should physically examine the client for stiffness, swelling, pain,
limited movements and unequal movements.
• Nurse should schedule them at specific times perhaps along with another nursing activity.
• With a weak client, the nurse merely provides support while the client performs most of the
movement.
• Movements are carried out slowly and smoothly and should not cause pain.
• Never force a joint beyond its capacity.
• Each movements should be repeated 5 times during the exercises.
• While performing passive range of motion exercises, the nurse stands at the side of the bed closest
to the joint being exercised.