404 Unit 4 Healthcare Skills Copyright Goodheart-Willcox Co., Inc. through as full a range as possible without causing pain. The goal is for patients to do these exercises themselves however, patients who experience pain and have diseases or conditions in which they are immobile or injured will need healthcare workers to provide support and assistance. Types of ROM Exercises There are three types of range-of-motion exercises. Depending on the patient’s abilities, one type or a combination of exercises may be used. The patient’s doctor determines which range-of-motion exercises are appropriate. 1. Active range of motion: used when there is a full range of motion of one or more parts of the body and the patient does not require physical help to perform exercises. Healthcare workers may need to remind or observe the patient to make sure exercises are being done correctly. 2. Active-assistive range of motion: used when the patient needs help with a full range of motion for one or more body parts because the muscles are too weak or stiff. Healthcare workers help with range of motion by encouraging normal muscle function. 3. Passive range of motion: used when a patient cannot move one or more body parts. Healthcare workers perform the full range of motion without any help from the patient. Passive exercises will not preserve muscle mass, but they will keep joints fl exible. Active-assistive and passive range-of-motion exercises are done in a slow, gentle manner to avoid hurting the patient or harming joints and bones. If there is pain, the exercises must be stopped and the appropriate provider notifi ed. Sometimes weights are used with active range of motion and active-assistive range of motion. Some patients may also need to wear a splint or brace to support their limbs during their exercises. Parallel bars and gait belts hel p to provide stability and balance and also assist movement. Range-of-motion exercises require people to use a variety of body move- ments. Some of these body movements are described in Figure 13.45. Contraindications for ROM Exercises It is important to remember that there may be contraindications for range-of-motion exercises. Range-of-motion exercises may be contraindi- cated for people with heart and respiratory diseases and conditions, as they may make the heart beat too fast and cause shortness of breath, chest pain, and fatigue. Range-of-motion exercises can also put stress on the soft tis- sues of joints and on bony structures. Therefore, range-of-motion exercises should not be performed if joints are swollen or infl amed, or if t here has been injury to the muscles or bones near the joint. General Guidelines for ROM Exercises Before you conduct range-of-motion exercises with a patient, it is impor- tant to familiarize yourself with the following general guidelines as well as your facility’s policies.