Range of Motion Checklist

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ROM EXERCISES U

S N
A S
Definition:
T A
I F T
S A I
F I S
A R F
Purpose:
C A
T C
O T
R O
Y R
Y

Procedure:
Range of Motion

1. Wash hands.

2. Explain the procedure to the patient.


3. Determine the type of exercise to be done.
4. Perform/assist in doing ROM on the following joints.

4.1 Neck
- Flexion
- Lateral Flexion
- Rotation

4.2 Shoulder
-Flexion
- Extension
-Abduction
-Adduction
-Internal Rotation
-External Rotation
-Circumduction

4.3 Elbow
-Flexion
-Extension
4.4 Forearm
-Supination
- Pronation
4.5 Wrist
- Flexion
- Extension
- Abduction
- Adduction
4.6 Fingers
- Flexion
- Extension
- Abduction
- Adduction
4.7 Thumb
- Flexion
- Extension
- Abduction
- Adduction
-Opposition

4.8 Hip
- Flexion
- Extension
- Hyperextension
- Abduction
- Adduction
-Internal Rotation
-External Rotation
-Circumduction
4.9 Knee
- Flexion
- Extension

4.10 Ankle
- Dorsal Flexion
- Plantar Flexion
4.11 Foot
- Inversion
- Eversion
4.12 Toes
- Flexion
- Extension
- Abduction
- Adduction

5. When finished, make sure the patient is comfortable, with the side rails
up and the bed in the lowest position.
6. Wash hands.

7. Document and report pertinent assessment data.

PCI CI Date

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