Range of Motion Exercises for Patients: Principles & Types

Instructor: Adrianne Baron

Adrianne has a master's degree in cancer biology and has taught high school and college biology.

This lesson is going to cover the exercises that are used in order to take each joint through their full range of motion. We will gain an understanding of doing them alone and with assistance.

Range of Motion

You wake up in the morning and realize that you feel a little stiffness in your neck. What do you do about it? Most likely, you begin to move your head from side-to-side and then rotate it around in order to loosen your neck muscles and relieve the feeling of stiffness. What you did was essentially take your neck joint through its range of motion, or ROM for short, which is the full extent of movement for a joint.

Every joint in your body has a range of motion. Our joints work best when they go through their full range of motion on a regular basis. Certain conditions and diseases may lead to immobility which can cause the joints to become stiff due to lack of use.

Nurses and other healthcare professionals may help those who are completely or partially immobile or paralyzed by using range of motion exercises. These are exercises that take the joints through their range of motion. These can be done alone, which we call active, under the direction of the nurse with minimal assistance, which we call assisted-active, or the nurse may have to manually do the exercises on a person, which we call passive. We are going to discuss how nurse, Alex, helps Will, an arthritis patient beginning to experience limitations in movement, through his range of motion exercises.

Types of Exercises

Lower Body ROM

Will has a little more strength in the upper portion of his body, so Alex likes to begin with the lower part where Will needs the most assistance. The joints that are exercised in the lower part of the body include the knee, hip, lower back, ankle, and toes. All of these exercises are done with Will lying flat on his back, and they are repeated about 10 times on each side of the body. Alex knows that the key is to make sure he exercises Will's joints without pushing them so far that he damages them. It is important for him to exercise the joints to the point of feeling resistance from the joint but not push so far that Will experiences pain.

Alex starts with hip abduction and adduction exercises. This involves Alex placing one hand under Will's heel and cradling his knee. Alex is going to pull the leg out toward himself and then back in toward the rest of Will's body.

With his hands in the same place, Alex now takes Will through hip and knee flexion exercises. He bends Will's knee toward Will's chest. During this exercise, Alex is careful to keep the leg in line with the hip and make sure it does not move from side to side. Alex lowers the leg back to the straight position.

Hip range of motion moves the hip sideways and rotates the joint
Diagram showing hip range of motion

Now Alex will do the hip rotation exercises that help to take the hip joint through its circular range of motion. Alex moves his hands so that one is on the top of the thigh and the other is right below the knee. He lifts the leg so that it is at a right angle with the hip. The foot is then pulled toward Alex to the point when he feels resistance or Will says it hurts and then returns the foot straight and lowers the leg back down.

The ankle is a joint that also has a circular range of motion, so ankle rotation exercises take it through the range of motion. Alex makes sure that Will is back to the starting position of lying on his back with his legs straight. He wraps one hand around Will's ankle and the other around the foot. Alex moves the foot inward and outward.

Alex goes right into the heel stretch next. The hand that is still above Will's ankle stays in place, and his other hand grabs the heel while resting the foot on his same forearm. Alex uses his forearm to push the upper part of the foot forward while easily pulling on the heel. After repeating that portion 10 times, he moves the hand from above the ankle toward the toes to wrap the toes. Alex slowly pushes the toes forward similar to how we do when we point our toes. Ten of these are done with the leg straight, and then 10 more are done with the leg bent at the knee.

Will is lying flat again on his back. Alex bends Will's knees together toward Will's chest and then lowers them to one side of Will's body. After briefly holding this, Alex lifts the legs back to the center and then lowers them to the opposite side of Will's body. This lumbar stretch helps to take the lower back through its range of motion.

Upper Body ROM

Will likes to begin with his hands for his upper body range of motion exercises. He prefers to do them from a seated position. If he were not able to do the first part of the exercises on his own, then he would have remained in the same lying-down position. Will holds his hands open, then bends his thumbs across his palms toward the other end of his hands and returns his thumbs back so his hand is open again. This thumb flexion and extension helps to exercise the joint connecting the thumb to the hand.

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