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

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Tympanic Membrane Temperature with Electronic Thermometer

A tympanic membrane thermometer uses an infrared sensor to measure the temperature of the tympanic membrane (ear drum). This type of thermometer is considered an accurate and reliable predictor of a patient’s core temperature because the tympanic membrane’s blood supply is sourced from the carotid artery, which is the same artery that carries blood to the hypothalamus in the brain.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Perineal Care of the Male Resident

Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

Orthopneic Position

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.