Performing Passive Range of Motion Exercises

Summary

This 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

00:00

🧘‍♀️ 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.

05:02

🤸‍♀️ 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.

10:02

🚶‍♀️ 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.

Keywords

💡Passive Range of Motion Exercises

Passive Range of Motion Exercises are movements performed by a caregiver on a patient's limbs to maintain or improve flexibility and mobility. These exercises are crucial for patients who cannot move their limbs actively due to illness or injury. In the script, these exercises are demonstrated for various joints, emphasizing their importance in maintaining independence and mobility.

💡Healthcare Provider's Orders

Healthcare Provider's Orders refer to the instructions given by a medical professional, such as a doctor or a physical therapist, regarding the type and extent of exercises to be performed. It is essential to verify these orders before starting any exercise regimen to ensure safety and effectiveness. The script mentions verifying these orders before beginning passive range of motion exercises.

💡Hand Hygiene

Hand Hygiene is the practice of cleaning one's hands to remove dirt, germs, and other contaminants. It is a critical step in preventing the spread of infections, especially in healthcare settings. The script emphasizes the importance of performing hand hygiene before starting any patient care activities.

💡Privacy

Privacy in healthcare refers to the right of patients to have their personal and medical information kept confidential. It also includes ensuring that patients are comfortable during procedures. The script mentions ensuring privacy before introducing oneself to the patient, which is a part of respecting their rights.

💡Joint

A Joint is a point where two bones meet, allowing for movement in various parts of the body. The script describes different types of joints and how they are exercised, highlighting their importance in overall body movement and the necessity of maintaining their flexibility.

💡Resistance

Resistance in the context of physical therapy refers to the point at which a patient feels tension or difficulty in moving a joint or muscle further. The script advises not to exercise any joint beyond the point of resistance to avoid injury, indicating the importance of gradual and safe progression in therapy.

💡Pivotal Joints

Pivotal Joints are a type of joint that allows for rotational movement, such as those found in the neck and forearms. The script describes pivotal joints and their role in exercises, emphasizing the variety of movements these joints facilitate.

💡Ball and Socket Joints

Ball and Socket Joints are characterized by the ball-shaped end of one bone fitting into the cup-shaped socket of another bone, allowing for a wide range of movement. The script mentions that these joints are located in the shoulders and hips, which are critical for various upper and lower body movements.

💡Hinge Joints

Hinge Joints permit movement similar to the hinge of a door, with a back-and-forth motion. They are found in the knees, ankles, elbows, and fingers. The script explains how hinge joints are exercised, which is essential for activities like walking and grasping objects.

💡Circumduction

Circumduction is a complex movement where a limb describes a cone-shaped path in the air, involving a combination of flexion, extension, abduction, and adduction. The script demonstrates circumduction for the shoulder and hip, illustrating how it helps in improving the overall range of motion.

💡Goniometer

A Goniometer is a tool used to measure the range of motion of a joint. It is a crucial tool in physical therapy to track progress and adjust treatment plans accordingly. The script mentions using a goniometer to measure joint motion, indicating its importance in assessing patient improvement.

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