TRINITY VALLEY COMMUNITY COLLEGE

ASSOCIATE DEGREE NURSING

RNSG 1216
PROCEDURE GUIDE AND CHECK-OFF SHEET
RANGE OF MOTION EXERCISES

Range of motion (ROM) exercises are performed to maintain joint mobility. These exercises can either be active
(patient performs exercises) or passive (caregiver performs exercises). Perform exercises as appropriate or
prescribed.

Delegation: This procedure can be delegated to unlicensed assistive personnel with proper training. An
assessment of the patient’s joint mobility by a nurse should be completed prior to delegation.

Procedure Scientific Rationale

1. The following equipment is needed for this skill:

a. bath blanket a. Blanket used to provide privacy
b. pillows. b. Pillows used to provide support
2. Clothe patient in a loose gown and cover with Expose only limb being exercised to avoid embarrassment of
bath blanket. patient.
3. Position bed at appropriate height and use proper Prevents muscle strain or injury to yourself and patient.
body mechanics.
4. Procedure:
a. Support patient’s limbs above and below the a. Prevents muscle strain or injury.
joint by cupping joints in palms of your hand
or cradling limb along your forearm.
b. Use a firm, comfortable grip when handling b. Ensures comfort of patient.
the limb.
c. Move body parts smoothly, slowly, and c. Jerky movements can cause discomfort and injury. Fast
rhythmically. movements can spasticity or rigidity.
d. Perform using a systematic approach.
e. Avoid moving or forcing a body part beyond e. Prevents muscle strain, pain and injury.
the existing range of motion. Move joint only
to point of resistance not pain.
f. Finish with joint in proper alignment. f. Prevents injury.
g. Assess for tolerance and fatigue throughout g. Determines if procedure should be discontinued.
procedure.
h. Frequency is determined by policy of facility. h. Ensures full benefit of joint mobility.
(typical procedure: four sets daily with five
repetitions)
5. Exercises: NECK
a. flexion (move head from upright midline
position forward, so chin rests on chest)
b. extension (move head from flexed position to
upright position)
c. hyperextension (move head from upright
position as far back as possible)
d. lateral flexion (move head laterally to right
and left shoulders)
e. rotation (turn face as far as possible to right
and left)
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 Procedure Scientific Rationale

6. Exercises: SHOULDER
a. flexion (raise each arm from position by side
forward and upward to a position beside the
head)
b. extension (move each arm from a vertical
position beside head forward and down to
resting position at side of body)
c. hyperextension (move each arm from resting
position to behind body)
d. abduction (move each arm laterally from
resting position at sides to a side position
above head, palm of hand away from head)
e. adduction (move each arm from position
beside head downward laterally and across
front of body)
f. circumduction (move each arm forward, up,
back, and down in full circle)
g. external rotation (with each arm held out to
side at shoulder level and elbow bent to right
angle, fingers pointing down, move arm
upward so fingers point out)
h. internal rotation (with each arm held out to
side at shoulder level and elbow bent to
right angle, fingers pointing up, bring arm
forward and down so fingers point down)
7. Exercises: ELBOW
a. flexion (bring each lower arm forward and
upward, until hand is at shoulder)
b. extension (bring each lower arm forward
and downward, straighten arm)
c. rotation for supination (turn each hand and
forearm so palm is upward)
d. rotation for pronation
(turn each hand and forearm so palm is
downward)
8. Exercises: WRIST
a. flexion (bring fingers toward inner aspect of
forearm)
b. extension (straighten hand to same plane as
arm)
c. hyperextension (bend fingers back as far as
possible)
d. abduction (bend wrist laterally toward
thumb side with hand supinated)
e. adduction (bend wrist laterally toward fifth
finger with hand supinated)
9. Exercises: HANDS AND FINGERS
a. flexion (make fist)
b. extension (straighten fingers)
c. hyperextension (bend fingers back as far as
possible)
d. abduction (spread fingers apart)
e. adduction (bring fingers together)
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 Procedure Scientific Rationale

f. flexion of thumb (move thumb across palm

toward fifth finger)
g. extension of thumb (move thumb away
from hand)
h. abduction of thumb (move thumb laterally)
i. adduction of thumb (move thumb back to
hand)
j. opposition of thumb (touch thumb to top of
each finger)
10. Exercises: HIP
a. flexion (move each leg forward and upward)
b. extension (move each leg back beside the
other)
c. hyperextension (move each leg back behind
body)
d. abduction (move each leg out to side)
e. adduction (move each leg back to other leg
and beyond)
f. circumduction (move each leg backward, up,
to side, and down in a circle)
g. internal rotation (turn foot and leg inward,
toes pointed toward other leg)
h. external rotation (turn foot and leg
outward, toes pointed away from other leg)
11. Exercises: KNEE
a. flexion (bend each leg, bringing heel toward
back of thigh)
b. extension (straighten each leg, returning
foot to position beside the other foot)
12. Exercises: ANKLE
a. flexion (point toes up- ward)
b. extension (point toes downward)
13. Exercises: FEET AND TOES
a. eversion (turn sole laterally)
b. inversion (turn sole medially)
c. flexion (curl toes downward)
d. extension (straighten toes)
e. abduction (spread toes apart)
f. adduction (bring toes together)
14. Exercises: TRUNK
a. flexion (bend at waist toward toes)
b. extension (straighten trunk at waist)
c. hyperextension (bend trunk backwards)
d. lateral flexion (bend trunk to right and left)
e. rotation (turn upper part of body from side
to side)
15. Document mobility of joints and patient’s All data must be entered into patient’s record.
tolerance of procedure.

N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - ROM

Reviewed 04/16
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