Passive range of motion (PROM) exercises to improve joint movement
What are passive range of motion exercises?
Passive range of motion exercises are done for a person by a helper. The helper does the range of motion exercises because the person cannot do them by himself.
Do not do passive range of motion 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 range of motion exercises?
Range of motion exercises are very important if you have to stay in bed or in a wheelchair. range of motion 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 range of motion exercises.
How do I get started?
Learn passive range of motion exercises from the person's caregiver.
Practice the exercises with the caregiver first. The caregiver can make sure you are doing the exercises right. Caregivers can also show you the easiest way to do the exercises so you do not get hurt or tired.
Raise the person's bed to a height that is comfortable for you.
This will help keep you from hurting your back or other muscles.
Make sure the wheels of the bed or wheelchair are locked before you start the exercises.
Do all range of motion exercises smoothly and gently.
Never force, jerk, or over-stretch a muscle. This can hurt the muscle or joint instead of helping.
Move the joint slowly.
This is especially important if the person has muscle spasms (tightening). Move the joint only to the point of resistance. This is the point where you cannot bend the joint any further. Put slow, steady pressure on the joint until the muscle relaxes.
Stop range of motion exercises if the person feels pain.
Ask the person to tell you right away if he feels any pain. Watch for signs of pain if the person is unable to talk. The exercises should never cause pain or go beyond the normal movement of that joint.
Make range of motion exercises a part of the person's daily routine.
Do range of motion exercises at the same time every day. Do them while bathing the person or while the person watches TV. This will make the time go faster and help the person relax more. You may want to break the exercise program into 2 or 3 sessions. You can then do the sessions at different times of the day instead of doing them all at once.
Follow the caregiver's orders.
The person's caregiver will tell you how many times per day you should do range of motion exercises. The caregiver will tell you how many repetitions (number of times) you should do exercises on each joint.
How are passive range of motion 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 range of motion 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 range of motion exercises for a person.
Head and Neck exercises: Do each exercise 10 to 15 times.
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.
Raise the back of the person's head up frange of motion the bed. Gently tip his chin toward his chest. Try to rest the person's chin on his chest if possible.
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.
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: Do each exercise 10 to 15 times.
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: Do each exercise 10 to 15 times.
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.
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:Do each exercise 10 to 15 times. 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.
Gently straighten out his fingers. Spread the fingers wide apart, one at a time. Then bring the fingers back together.
One at a time, bring each fingertip to touch the thumb.
Move the person's thumb across his palm. Bring it back out again.
Use the thumb to make wide circles.
Repeat the above exercises with the left thumb and fingers.
Hip and Knee exercises: Do each exercise 10 to 15 times.
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: Do each exercise 10 to 15 times. 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.
Hold the ankle with one hand. Hold the person's upper foot with your other hand. Gently turn the foot and ankle in circles.
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.
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. Call the person's caregiver if: After range of motion exercises, the person has pain in a joint area that does not go away. Also call if the joint area begins to swell.