Range of Motion Exercises

  Begin following exercises in sequence outlined.

   1. Perform hand hygiene.
   2. Fully expose only limb to be exercised.
   3. Raise bed to comfortable position, and stand on side of bed of joints to be exercised.
   4. When performing ROM exercises, support joint by holding distal and proximal areas adjacent to joint, by               cradling distal portion of extremity, or by using cupped hand to support joint. Exercises should be performed           slowly and gently.
   5. Each movement should be repeated 5 times during exercise period. (Discontinue exercise if patient                       complains of discomfort or if there is resistance or muscle spasm.)


    * Flexion: Bring chin to rest on chest (ROM: 45 degrees).
    * Extension: Return head to erect position (ROM: 45 degrees).
    * Hyperextension: Bend head as far back as possible (ROM: 10 degrees).
    * Lateral flexion: Tilt head as far as possible toward each shoulder (ROM: 40 to 45 degrees).
    * Rotation: Have patient look straight ahead and rotate head in a circle (ROM: 360 degrees).


    * Flexion: Raise arm from side position forward to above head (ROM: 180 degrees).
    * Extension: Return arm to position at side of body (ROM: 180 degrees).
    * Hyperextension: Move arm behind body, keeping elbow straight (ROM: 45 to 60 degrees).
    * Abduction: Raise arm to side to position above head with palm turned away from head (ROM: 180 degrees).
    * Adduction: Lower arm sideways and across body as far as possible.
    * Internal rotation: Move arm to side at shoulder level with elbow bent at 45 degrees. Lower arm so palm faces back.
    * External rotation: With elbow flexed, move arm until thumb is upward and lateral to head (ROM: 90 degrees).
    * Circumduction: Move arm in full circle. Circumduction is a combination of all movements of ball-and-socket           joint (ROM: 360 degrees).


    * Flexion: Extend the arm, then bend elbow so that lower arm moves toward the shoulder joint and hand touches       shoulder (ROM: 150 degrees).
    * Extension: Straighten elbow by lowering hand (ROM: 150 degrees).
    * Hyperextension: Bend lower arm back as far as possible beyond normal extension (ROM: 10 to 20 degrees).
    * Forearm
    * Supination: Turn lower arm and hand so that palm is up (ROM: 70 to 90 degrees).
    * Pronation: Turn lower arm so that palm is down (ROM 70 to 90 degrees).
    * Wrist
    * Flexion: Move palm toward inner aspect of forearm (ROM: 80 to 90 degrees).
    * Extension: Move fingers so fingers, hands, and forearm are in same plane (ROM: 80 to 90 degrees).
    * Hyperextension: Bring dorsal surface of hand back as far as possible.
    * Abduction (radial flexion): Bend wrist medially toward thumb (ROM: up to 30 degrees).
    * Adduction (ulnar flexion): Bend wrist laterally toward fifth finger (ROM: 30 to 50 degrees).


    * Flexion: Make fist (ROM: 90 degrees).
    * Extension: Straighten fingers (ROM: 90 degrees).
    * Hyperextension: Bend fingers back as far as possible (ROM: 30 to 60 degrees).
    * Abduction: Spread fingers apart.
    * Adduction: Bring fingers together.


    * Flexion: Move thumb across palmar surface of hand (ROM: 90 degrees).
    * Extension: Move thumb straight away from hand (ROM: 90 degrees).
    * Abduction: Extend thumb laterally (usually done when placing fingers in abduction and adduction) (ROM: 30 degrees).
    * Adduction: Move thumb back toward hand (ROM: 30 degrees).
    * Opposition: Touch thumb to each finger of same hand.


    * Flexion: Move leg forward and up (ROM: 90 to 120 degrees).
    * Extension: Move leg back beside other leg (ROM: 90 to 120 degrees).
    * Hyperextension: Move leg back beyond normal extension (ROM: 30 to 50 degrees).
    * Abduction: Move leg laterally away from body (ROM: 30 to 50 degrees).
    * Adduction: Move leg back toward medial position and beyond if possible (ROM: 30 to 50 degrees).
    * Internal rotation: Turn foot and leg inward 90 degrees.
    * External rotation: Turn foot and leg outward 90 degrees.
    * Circumduction: Move leg in circle (ROM: 360 degrees).


    * Flexion: Bend knee by bringing heel toward back of thigh (ROM: 120 to 130 degrees).
    * Extension: Return leg to floor (ROM: 120 to 130 degrees).
    * Ankle
    * Dorsiflexion: Move foot so toes are pointed upward (ROM: 20 to 30 degrees).
    * Plantar flexion: Move foot so toes are pointed downward (ROM: 45 to 50 degrees).


    * Inversion: Turn sole of foot medially (ROM: 10 degrees or less).
    * Eversion: Turn sole of foot laterally (ROM: 10 degrees or less).
    * Flexion: Curl toes downward (ROM: 30 to 60 degrees).
    * Extension: Straighten toes (ROM: 30 to 60 degrees).
    * Abduction: Spread toes apart (ROM: 15 degrees or less).
    * Adduction: Bring toes together (ROM: 15 degrees or less).
    * Lower bed to safe position (replacing side rails if required), reposition patient to position of comfort, and perform hand hygiene.