Overview
This lecture covers passive range of motion (ROM) exercises for the hip, knee, and ankle, focusing on following individualized care plans and proper technique for safe patient handling.
Types of Range of Motion
- Active ROM: Patient performs exercises with your prompts and corrections.
- Passive ROM: Caregiver performs all movement; most common for CNAs in clinical settings.
Care Plans and Preparation
- Always check the care plan for which limb, which joints, which movements, and how many repetitions.
- Care plans can vary by patient and may require different ROM motions (flexion/extension, abduction/adduction, rotation).
- Passive ROM should be performed when the patient cannot help; the caregiver supports and moves the limb.
ROM Exercises: Hip, Knee, and Ankle
- Support the limb with flat palms under the joints (knee and ankle) to avoid injury.
- For hip and knee: Flexion is bending the knee up to the chest; extension is straightening the leg back down.
- Perform three repetitions unless specified otherwise in the care plan.
- For the ankle: Support the heel off the bed, move the foot up (toward the head) and down (like pressing a gas pedal).
- Ensure movement returns to the full start position each time and check for patient pain or discomfort.
- Do not drag the heel on the bed to prevent skin injury.
Test and Technique Reminders
- Skills are tested on live students lying in bed, typically with three repetitions per exercise.
- No charting is required for the ROM skill test.
- Flashcards or index cards can help memorize step-by-step procedures and supply lists.
- Review "gray box" summary steps before and during skills practice to ensure completeness.
Key Terms & Definitions
- Range of Motion (ROM) — Exercises that move joints through their full arc of movement.
- Flexion — Bending a joint, decreasing the angle between bones.
- Extension — Straightening a joint, increasing the angle between bones.
- Active ROM — Patient performs the movement independently.
- Passive ROM — Caregiver moves the joint for the patient.
Action Items / Next Steps
- Read page 57 of the white book for step-by-step ROM procedures.
- Practice memorizing skill steps using flashcards or self-made index cards.
- Always consult the care plan before performing any ROM exercises.
- Practice supporting joints with flat palms and using slow, controlled motions.