Chapter 13 Assisting with Mobility 405 Copyright Goodheart-Willcox Co., Inc. Create a Schedule Create a schedule for when range-of-motion exercises should be done. Consulting patients as you plan may make them more willing to participate voluntarily. Always explain what you are going to do before beginning any exercise. Remember to maintain proper body mechanics as you carry out these exercises to avoid hurting or straining yourself. Range-of-motion exercises should be performed at least twice daily. Doing these exercises as the patient bathes is benefi cial because the warm water relaxes the muscles and can reduce muscle spasms. Exercising before bedtime may be another option. Immobile patients must have their joints exercised once every eight hours to prevent contractures. Begin each exercise slowly, using smooth and rhythmic movements appropriate for the patient’s condition. Use the Best Approach Begin the exercises with the neck and work your way down the body. Put each joint that requires exercise through the range of motion a minimum of three times (fi ve times is preferable). Do not do the exercises to the point of patient fatigue. When passively exercising the joints of the arm or leg, make sure you support that extremity. Never force a joint to the point of pain. Instead, move each joint until you feel slight resistance. Always return the joint to a neutral position when you have completed the exercise. Pay Attention You can cause serious injury if you do not perform ROM exercises properly. Check with the appropriate provider for specifi c instructions or limitations. For example, some facilities do not allow healthcare workers to exercise the neck. Remember, only exercise the joints that require exercise, and always stop and notify the appropriate provider if the patient complains of pain. Body Movements Movement Description Example Flexion the act of bending a joint bending the arm at the elbow Extension the act of straightening a joint lowering the arm back down at the elbow Hyperextension an exaggerated, or extreme, extension moving the arm from the side so that it extends behind the body Abduction lateral (sideways) movement away from the midline (an invisible line running vertically through the body) moving the leg away from the body Adduction lateral movement toward the midline of the body moving the leg toward the body Rotation turning of a body part around an axis, or fixed point rotating the ankle outward so that the foot moves away from the body Circumduction rotating a body part in a complete circle moving the pointer finger in a circular motion Supination rotating a body part from the body rotating the forearm so that the palm faces upward Pronation rotating a body part toward the body rotating the forearm so that the palm faces downward Goodheart-Willcox Publisher Figure 13.45 Body movements can be described using these directional terms. Think It Through Think It Through Think about your own range of motion. Do your joints get enough exercise? Try to flex and extend your head, arms, wrists, fingers, legs, knees, feet, and toes. Were you able to do this easily? If not, which joints were more difficult to move or caused pain? What can you do to make sure your joints are getting enough exercise?