Performing Passive Range of Motion Exercises
Summary
TLDRThis video script outlines a caregiver's guide to performing passive range of motion exercises for patients. It emphasizes the importance of verifying healthcare provider's orders, maintaining hygiene, and respecting patient privacy. The script details how to move each joint gently and supports the extremity being exercised. It covers various joints, including pivotal, ball and socket, hinge, condyloid, saddle, and gliding, and explains how to perform exercises for each. The script also mentions the use of a goniometer to measure joint flexibility and concludes with reminders to respect the patient's physical limits and document the outcomes.
Takeaways
- 🧼 Always perform hand hygiene and ensure privacy before starting the exercises.
- 🏥 Verify healthcare provider's orders and introduce yourself to the patient, using correct identification.
- 🤝 Support the joint being exercised properly to prevent injury.
- 🚶♀️ Work through the body from head to toe, exposing only the necessary limb.
- 🔁 Repeat each movement five times, but demonstrate 2-3 in the video for brevity.
- 📏 Use a goniometer to measure and track improvements in joint flexibility.
- 🤲 Understand the different types of joints: pivotal, ball and socket, hinge, condyloid, saddle, and gliding.
- 🧤 Wear clean gloves if necessary, especially for patients with wounds or on isolation.
- 🛌 Position the patient comfortably, preferably sitting or lying down.
- 🚫 Do not exercise joints beyond the point of resistance, fatigue, or pain.
- 📝 Document the patient's comfort and any expected or unexpected outcomes after the exercises.
Q & A
What is the purpose of passive range of motion exercises?
-Passive range of motion exercises are performed by a caregiver to help maintain a patient's independence and mobility.
What should a caregiver do before starting passive range of motion exercises?
-Before starting, the caregiver should verify the healthcare provider's orders, perform hand hygiene, ensure privacy, and introduce themselves to the patient.
How should the patient be identified during the exercise session?
-The patient should be identified using their full name and date of birth, for example, 'Your name is Vickie Beals, your date of birth is 12/11/54.'
What are some guidelines to follow when performing passive range of motion exercises?
-Guidelines include exposing only the limb being exercised, moving each joint slowly and gently, supporting the joint, working from head to toe, not exercising beyond resistance or to the point of pain, repeating each movement 5 times, and measuring joint motion as needed.
What are the major types of joints mentioned in the script?
-The major types of joints are pivotal, ball and socket, hinge, condyloid, saddle, and gliding joints.
Why is it important to wear clean gloves during the exercises?
-Clean gloves should be worn if necessary, such as when the patient has a draining wound, an open skin lesion, or if the patient is on isolation precautions.
How should the patient be positioned for the exercises?
-The patient should be positioned comfortably, preferably sitting or lying down in bed.
What is the significance of measuring joint motion with a goniometer?
-A goniometer is used to measure joint range of motion and track improvements in flexibility as rehabilitation progresses.
Can you describe the steps for performing passive range of motion exercises for the shoulder?
-For the shoulder, perform flexion by raising the arm forward, extension by returning the arm to the side, abduction by raising the arm to the side and overhead, and internal and external rotation by moving the arm with the elbow flexed.
What is the goal of performing range of motion exercises for the patient?
-The goal is to increase the angle or range of motion for the joint, which aids in rehabilitation and improving the patient's flexibility.
How should the patient be made comfortable after the exercises are completed?
-After the exercises, the caregiver should ensure the patient is comfortable, perform hand hygiene, and document the outcomes of the session.
Outlines
🧘♀️ Passive Range of Motion Exercises
This paragraph outlines the procedure for performing passive range of motion exercises. It emphasizes the importance of verifying healthcare provider's orders, maintaining hygiene, and ensuring patient privacy before starting. The caregiver is instructed to expose only the limb being exercised, move each joint slowly and gently, and support the joint properly. The exercises should be performed from head to toe, without causing pain or fatigue, and each movement should be repeated five times. The paragraph also explains the types of joints, including pivotal, ball and socket, hinge, condyloid, saddle, and gliding joints, and their locations. It provides examples of daily activities that involve these exercises, such as washing hair, getting dressed, and putting on a coat. The paragraph concludes with instructions for positioning the patient and starting with neck exercises.
🤸♀️ Upper Extremity Exercises
The second paragraph focuses on upper extremity exercises, starting with the shoulder and moving through the elbow, forearm, wrist, fingers, and thumb. Each joint is taken through a series of movements such as flexion, extension, abduction, adduction, rotation, and circumduction. The paragraph provides practical examples of how these exercises relate to daily activities, like brushing teeth or opening a door. It also introduces the use of a goniometer for measuring joint flexibility and emphasizes the goal of increasing the range of motion. The exercises are described in detail, with attention to the patient's comfort and the importance of recognizing physical limits.
🚶♀️ Lower Extremity and Ankle Exercises
The third paragraph covers lower extremity exercises, including the hip, knee, ankle, foot, and toes. It describes the movements for flexion, extension, abduction, adduction, rotation, and circumduction of the hip and knee. The exercises are linked to common activities like going upstairs or walking. The ankle exercises include dorsiflexion and plantar flexion, while the foot exercises involve inversion, eversion, and circumduction. Toe exercises include flexion, extension, abduction, and adduction. The paragraph concludes with a reminder to respect the patient's physical limits and to ensure their comfort after the exercises. It also highlights the importance of documenting the outcomes of the exercises.
Mindmap
Keywords
💡Passive Range of Motion Exercises
💡Healthcare Provider's Orders
💡Hand Hygiene
💡Privacy
💡Joint
💡Resistance
💡Pivotal Joints
💡Ball and Socket Joints
💡Hinge Joints
💡Circumduction
💡Goniometer
Highlights
Passive range of motion exercises are performed by a caregiver to maintain the patient's independence and mobility.
Verify healthcare provider's orders before starting exercises.
Hand hygiene and privacy are essential before starting the exercises.
Introduce yourself and identify the patient before beginning.
Only expose the limb being exercised.
Move each joint slowly and gently, supporting with the distal portion or cupped hand.
Work from head to toe when performing exercises.
Do not exercise joints beyond the point of resistance or to the point of pain.
Repeat each movement 5 times, demonstrated in the video with 2 or 3 repetitions.
Measure joint motion as needed.
Recall major types of joints: pivotal, ball and socket, hinge, condyloid, saddle, gliding.
Wear clean gloves if necessary, such as for draining wounds or isolation precautions.
Stand on the side of the bed closest to the joint to be exercised.
Help the patient into a comfortable position for exercises.
Exercise the neck through flexion, extension, lateral flexion, and rotation.
Shoulder exercises include flexion, extension, abduction, and rotation.
Elbow exercises involve flexion, extension, supination, and pronation.
Wrist exercises include flexion, extension, radial deviation, and ulnar deviation.
Finger exercises consist of flexion, extension, abduction, and adduction.
Thumb exercises include flexion, extension, abduction, adduction, and opposition.
Hip exercises involve flexion, extension, abduction, adduction, and circumduction.
Knee exercises include flexion and extension.
Ankle exercises involve dorsiflexion and plantar flexion.
Foot exercises include inversion, eversion, and circumduction.
Toe exercises consist of flexion, extension, abduction, and adduction.
Recognize the patient's physical limits during exercises.
Ensure the patient is comfortable and perform hand hygiene after exercises.
Document expected or unexpected outcomes after completing exercises.
Transcripts
passive range of motion exercises are
performed by the caregiver for the
patient to help maintain independence
and mobility verify the health care
providers orders before you get started
after performing hand hygiene and
ensuring privacy introduce yourself to
the patient then identify the patient
using to identify errs your name Vickie
Beals your date of birth 12:11 54 ok
it's helpful to keep a few guidelines in
mind expose only the limb being
exercised move each joint slowly and
gently support the joint in the
extremity being exercised by holding the
distal portion of the extremity or by
using your cupped hand to support it
work from head to toe don't exercise any
joint beyond the point of resistance or
to the point of fatigue or pain repeat
each movement 5 times in this video
we'll demonstrate using just 2 or 3
repetitions and finally measure the
joint motion as needed it's also useful
to recall the major types of joints
pivotal joints allow for rotation and
are located in the neck and forearms
ball and socket joints are formed when
the ball shaped end of one bone fits
into the cup-shaped socket of another
they are located in the shoulders and
hips hinge joints allow movement like
the hinge on a door they are located in
the knees ankles elbows and fingers
condyloid joints allow for flexion
extension adduction abduction and
circumduction they are located in the
wrists fingers and toes saddle joints
permit flexion extension adduction and
abduction they are located in
thumbs gliding joints permit only
gliding movements and are located in the
spine hands and toes remember to wear
clean gloves if necessary
for example if the patient has a
draining wound or an open skin lesion or
if the patient is on isolation
precautions stand on the side of the bed
closest to the joint to be exercised
cover her with a bath blanket and fold
down the top linens to the foot of the
bed help her into a comfortable position
preferably sitting or lying down in bed
for the first exercise move the
patient's neck and deflection by tipping
her chin toward her chest then move her
neck into extension by positioning her
head erect and finally hyperextend her
neck by tipping her head back as far as
she can comfortably tolerate move the
neck through lateral flexion by tilting
her head toward each shoulder as far as
possible then rotate her head as far as
possible in a circle you'll be doing
these kind of activities at home when
you wash your hair answer questions next
exercise the shoulder begin with the
patient's arm at her side and perform
flexion by raising the arm forward and
above her head reaching up into the
cabinet to get a clasp down extension is
the opposite movement returning the arm
to her side for extension its reaching
back behind to pull your pants up
good I'm gonna have you sit up for me a
little hyper extension is accomplished
by moving her arm behind her body
keeping the elbow straight and I'm gonna
bring your arm back this is to help you
with getting dressed putting a coat on
okay now move her shoulder into
abduction by raising her arm to the side
and overhead with her palm facing out
and into abduction by lowering the arms
sideways and across the body as far as
possible like putting deodorant on or
getting a coat sleeve on perform
internal rotation by moving the
patient's arm elbow flexed at the
shoulder until her thumb is down and her
elbow is lateral to or parallel to her
side and now we're going to go ahead and
go into some external rotation then
perform external rotation by moving the
arm again with the elbow flexed until
the thumb is up and the elbow is lateral
to the head circumduction circumduction
is performed by moving the patient's
straightened arm in a full circle
watching TV now move to her elbow
performing flexion so that the elbow
bends and the patient's hand touches her
shoulder brushing your teeth perform
extension by straightening her elbow and
lowering her hand move the patient's
forearm to accomplish supination by
turning the lower arm and hand palm up
that's what if you're opening a door
handle and pronation by performing the
opposite movement a goniometer is a
useful tool for measuring joint range of
motion the goniometer measures
improvement in the patient's flexibility
as rehabilitation progresses explain to
the patient that the goal of therapy is
to increase the angle or range of motion
for the joint
next work the patients wrist through
flexion moving her palm toward the
inside of her forearm
then we're going to say an extension
moving her fingers into the same plane
as her hand and forearm then hyper
extend her wrist by moving the dorsal
surface of the hand back as far as
possible we do a lot of these arrest
exercises to help you with playing cards
cutting food move the wrist into radial
deviation by bending it medially toward
the thumb and into ulnar deviation by
bending it laterally toward the fifth
finger good now exercise the fingers
start with flexion by closing the
patient's fingers to make a fist close
your fingers finger flexion like we're
gonna make a fist
[Music]
then practice extension by straightening
the fingers
and hyperextension by gently bending
them back as far as the patient can
tolerate good abduct the fingers by
spreading them apart I'm just gonna open
your fingers good adduct them by
bringing them together again close
together to complete your exercise of
the upper extremities perform range of
motion exercise for the thumb for
flexion move the patient's thumb across
her palm for extension move her thumb
directly away from her hand
for abduction extend her thumb laterally
for adduction move the thumb back toward
the hand and for opposition touch the
patient's thumb to each finger on the
same hand this helps us make our grips
to hold on to the hairbrush toothbrush
and the phone now passively exercise the
patient's hip moving it through flexion
by lifting her leg forward and up hip
flexion then move the hip through
extension by returning that leg to its
original position good with the patient
prone lying on her side or standing
hyper extend her hip by moving her leg
back beyond the normal range of
extension continue exercising the
patient's hip by performing abduction
moving her leg laterally away from her
body adduction requires moving her leg
back toward the midline and beyond good
so you can cross your legs when you're
you can externally rotate the foot and
leg by turning them out internal
rotation is accomplished by turning the
foot and leg in circumduction is
performed by moving the leg in a full
circle your leg all around in circles
okay now exercise the knee with the
patient prone side lying or standing for
flexion bend the knee by bringing her
heel toward the back of her thigh going
upstairs good and some knee extension
for extension return the leg to a
straight position when you're doing your
exercises make sure that you're walking
a lot because that's going to
help get the mobility of your knee with
the patient once again supine perform
range of motion exercises for the ankle
for dorsiflexion move her foot so that
her toes point up toward her head for
plantar flexion move it so the toes
point down away from her head 3 this is
to help you with walking finally do
passive range of motion exercises for
the feet inversion of the foot is
turning the sole medially or toward the
middle eversion is turning the sole
laterally or outward circumduction is
performed by moving the foot in a full
circle and that'll get all those motions
into it passive range of motion
exercises for the toes begin with
flexion by curling the toes down to an
extension by straightening them and what
you're gonna do this one for move the
toes through abduction by spreading them
apart an abduction by bringing them
together again three so you're going to
do these motions at home you want to
curl your toes bring them up open your
toes and close them to help with walking
remember as you exercise your patient
it's important to recognize her physical
limits I'm too tired I can't do anything
now maybe later okay let me go ahead and
make you comfortable okay when you're
finished make sure the patient is
comfortable perform hand hygiene and
document expected or unexpected outcomes
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