Overview
This lecture covers the procedures and principles for performing passive range of motion (ROM) exercises on the hip, knee, and ankle, with an emphasis on following individualized care plans in clinical settings.
Types of Range of Motion
- There are two types of ROM: active (patient moves joint) and passive (caregiver moves joint).
- Active ROM involves prompting the patient to perform exercises while you supervise and guide.
- Passive ROM requires the caregiver to support and move the patient's joint without their assistance, which is common for CNAs.
Preparing for ROM Exercises
- Always review the patient's care plan to determine which joints, movements, and repetitions are required.
- Each patient's care plan may differ (e.g., which joints, movement types like flexion/extension, abduction/adduction, and repetitions needed).
- Support joints with flat palms underneath (not fingertips) to avoid bruising, typically supporting below the joint (e.g., knee and ankle).
Performing ROM for Hip, Knee, and Ankle
- For hip and knee flexion/extension, support under the knee and ankle, then bend the knee up toward the chest and return it to the extended (straight) position.
- Repeat hip/knee flexion and extension three times or as specified in the care plan.
- For ankle flexion/extension, lift the heel off the bed and bend the foot forward and back (like pressing and releasing a gas pedal), avoiding friction with the bed.
- Complete three repetitions for the ankle unless otherwise instructed.
Key Steps and Safety
- Move joints slowly and check for pain or discomfort during exercises.
- Communicate with the patient before and during ROM exercises, explaining each step.
- After completing exercises, provide the call light and ensure patient comfort.
Key Terms & Definitions
- Range of Motion (ROM) — The movement of a joint to its full potential, either actively or passively.
- Flexion — Bending a joint to decrease the angle between bones.
- Extension — Straightening a joint to increase the angle between bones.
- Active ROM — Exercises done by the patient under supervision.
- Passive ROM — Exercises done by the caregiver without patient assistance.
- Care Plan — Document detailing personalized instructions for patient care, including ROM exercises.
Action Items / Next Steps
- Review page 57 of the white book for step-by-step ROM instructions.
- Practice reviewing the "gray box" summary before performing the skill.
- Memorize ROM procedures, movements, and required support points.
- Ensure strict adherence to individual care plans during clinical practice.