Passive Range of Motion (PROM) Exercises

Introduction

• Purpose: Performed by caregivers to help maintain patient independence and mobility.
• Preparation: Verify healthcare provider's orders, perform hand hygiene, ensure privacy, introduce yourself, and identify the patient using two identifiers.
• Patient Example: Name: Vickie Beals, DOB: 12/11/54.

General Guidelines

• Expose only the limb being exercised.
• Move joints slowly and gently; support the joint and extremity.
• Work from head to toe.
• Avoid exercising beyond resistance, fatigue, or pain.
• Repeat movements 5 times (demonstrated as 2-3 repetitions in video).
• Measure joint motion as needed.

Types of Joints

• Pivotal Joints: Rotation - neck, forearms.
• Ball and Socket Joints: Multiple directions - shoulders, hips.
• Hinge Joints: Similar to door hinge - knees, ankles, elbows, fingers.
• Condyloid Joints: Multi-directional - wrists, fingers, toes.
• Saddle Joints: Multi-directional - thumbs.
• Gliding Joints: Spine, hands, toes.

Precautions

• Wear gloves if necessary (e.g., draining wounds, open skin lesions, isolation precautions).
• Stand on the side closest to the joint being exercised.
• Cover patient with a bath blanket; ensure comfort and proper positioning.

Specific Exercises

Neck

• Flexion: Chin toward chest.
• Extension: Head erect.
• Hyperextension: Head back as tolerated.
• Lateral Flexion: Tilt head toward shoulders.
• Rotation: Circle head.

Shoulder

• Flexion: Arm forward above head.
• Extension: Return arm to side.
• Hyperextension: Arm behind body.
• Abduction: Arm side and overhead.
• Adduction: Arm across body.
• Internal Rotation: Elbow flexed, thumb down.
• External Rotation: Elbow flexed, thumb up.
• Circumduction: Full circle.

Elbow

• Flexion: Hand to shoulder.
• Extension: Straighten elbow.
• Supination: Palm up.
• Pronation: Palm down.

Wrist

• Flexion: Palm toward forearm.
• Extension: Fingers aligned with hand.
• Hyperextension: Move hand back.
• Radial Deviation: Bend medially.
• Ulnar Deviation: Bend laterally.

Fingers

• Flexion: Make a fist.
• Extension: Straighten fingers.
• Hyperextension: Bend back.
• Abduction: Spread fingers.
• Adduction: Bring together.

Thumb

• Flexion: Across palm.
• Extension: Away from hand.
• Abduction: Extend laterally.
• Adduction: Move back to hand.
• Opposition: Touch to each finger.

Hip

• Flexion: Lift leg forward and up.
• Extension: Return leg.
• Hyperextension: Leg back.
• Abduction: Leg laterally.
• Adduction: Leg back to and beyond midline.
• Internal/External Rotation: Rotate foot/leg.
• Circumduction: Full circle.

Knee

• Flexion: Heel to back of thigh.
• Extension: Straighten leg.

Ankle

• Dorsiflexion: Toes up.
• Plantar Flexion: Toes down.

Feet

• Inversion: Sole medially.
• Eversion: Sole laterally.
• Circumduction: Full circle.

Toes

• Flexion: Curl toes.
• Extension: Straighten toes.
• Abduction: Spread toes.
• Adduction: Bring together.

Conclusion

• Recognize and respect patient's physical limits.
• Ensure patient comfort post-exercise.
• Perform hand hygiene and document outcomes.

These exercises aim to maintain mobility, flexibility, and provide assistance with daily activities, ensuring a better quality of life for the patient.