Range of Motion
Terms
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- Range of Motion: Critical Criteria
-
Critical Criteria-ROM
• Supports dependent joints
• Moves body parts smoothly, slowly, and
rhythmically
• Stops at point of pain, resistance, or fatigue
• Identifies and demonstrates exercises
appropriate for specific body joints
– flexion, extension, hyperextension, abduction,
adduction, circumduction, opposition, internal rotation,
external rotation - Define Range of Motion
-
Complete extent of movement
of which the joint is normally capable - ⬢ Active
-
• Active
– Client performs independently.
– Improves/maintains strength,
cardiovascular, respiratory function - ⬢ Active-assisted
-
• Active-assisted
– Nurse provides minimal assist - ⬢Passive
-
•Passive
– Nurse moves joint through ROM -
Joint Movements
⬢Flexion -
•Flexion
– Decreasing the angle of the joint -
Joint Movements
⬢ Extension -
• Extension
– Increasing the angle of the joint -
Joint Movements
⬢ Hyperextension -
• Hyperextension
– Further extension or straightening of a joint
– Not done on the neck for passive ROM -
Joint Movements
⬢ Abduction -
• Abduction
– Movement of the bone away from the midline
of the body -
Joint Movements
⬢ Adduction -
• Adduction
– Movement of the bone toward the midline of
the body -
Joint movements
⬢ Rotation-Internal & External -
• Rotation-Internal & External
– Movement of the bone around its central axis -
Joint movements
⬢ Circumduction -
• Circumduction
– Movement of the distal part of the bone in a circle
while the proximal end remains fixed -
Joint movements
⬢Eversion -
•Eversion
– Turning the sole of the foot outward by moving the
ankle joint -
Joint movements
⬢ Inversion -
• Inversion
– Turning the sole of the foot inward by moving the
ankle joint -
Joint Movement
⬢ Pronation -
• Pronation
– Moving the bones of the forearm so that the palm of
the hand faces downward when held in front of the
body -
Joint Movement
⬢ Supination -
• Supination
– Moving the bones of the forearm so that the palm of
the hand faces downward when held in front of the
body -
Joint Movement
⬢ Opposition -
• Opposition
– Thumb movement to touch other fingers only - Patient Limitations
-
Patient Limitations
⬢ Joint mobility
⬢ Swelling, tenderness at joint, redness
⬢ Deformities
⬢ Pain
⬢ Muscle atrophy, contractures
⬢ Asymmetrical movement - Nursing Procedure
-
Nursing Procedure
• Explain procedure to client. Wash hands
• Raise bed to waist level, lower HOB as
tolerated
• Begin ROM at client head, move down body one
side at a time
• Perform each exercise 2-5 times
• Protect joint
– Use cupped hand to support joint
– Cradle distal portion of extremity
– Support joint by holding distal and proximal areas
next to joint
-Documentation - Goal
-
Keep patient in best possible physical
state when bed rest is necessary - ⬢ Physician Order:
-
⬢ Physician Order: Physical therapy designs
and implements program - ⬢ Document
-
⬢ Document: What was done, how, when,
patient education, limb(s), exercise,
repetitions, patient response -
MOBILITY
GROWTH AND DEVELOPMENT
ADOLSCENTS (12-18yrs.) -
ADOLSCENTS (12-18yrs.)
1 Tremendous uneven growth spurts
2 Awkward
3 Uncoordinated
4 Postural problems -
MOBILITY
GROWTH AND DEVELOPMENT
ADULT (18yrs. >) -
ADOLSCENTS (12-18yrs.)
1 Tremendous uneven growth spurts
2 Awkward
3 Uncoordinated
4 Postural problems -
MOBILITY
GROWTH AND DEVELOPMENT
20-40
Midlife 40-65
- Older 65> -
20-40 – generally have few physical changes
affecting mobility with the exception of pregnant
women
- Midlife 40-65 – coordination and musculoskeletal
development determined upon lifestyle
- Older 65> -decreased ROM, decreased muscle,
bone mass, and strength, slower gait
( not all elderly ) - JOINTS
-
- Functional unit of the Musculoskeletal System
- Bones connect at joints
- Muscles attach to bones at / near joints
- Muscles are classified according to joint
action ( flexors,extensors ) -
TYPES OF JOINTS
Synarthrosis - Synarthrosis – immovable
-
TYPES OF JOINTS
Amphiarthrosis - Amphiarthrosis – slightly movable
-
TYPES OF JOINTS
Diarthrosis / Synovial - Diarthrosis / Synovial – freely movable
- SYNOVIAL JOINTS
-
SYNOVIAL JOINTS
1) Freely movable
2) Characteristically has a cavity enclosed by a
capsule
3) Lubricated with synovial fluid
4) Primary function:
-Bear weight
-Movement - TYPES OF SYNOVIAL JOINTS (6)
-
TYPES OF SYNOVIAL JOINTS (6)
1) Ball and Socket
2) Hinge
3) Pivot
4) Condyloid
5) Saddle
6) Gliding - BALL AND SOCKET
-
BALL AND SOCKET
- Movement
-flexion,
-extension,
-hyperextension
-abduction
-adduction
-circumduction
*Examples – hip, shoulder - HINGE JOINT
-
HINGE JOINT
- Movement
– flexion
-extension
*Examples – finger, toe,
knee, elbow, ankle
joints - PIVOT JOINT
-
- Movement – rotation
* Examples – joints
between the proximal
ends of the radius and
ulna. Some joints of
the vertebral column. - CONDYLOID JOINT
-
CONDYLOID JOINT
-Movement
– flexion
-extension
-abduction
-adduction
* Example – wrist joints - SADDLE JOINT
-
SADDLE JOINT
- Movement
– flexion
-extension
-abduction
-adduction
* Example – base of the thumb only - GLIDING JOINT
-
GLIDING JOINT
- Movement – gliding
* Examples – carpal
bones, tarsal bones,
ribs w/ vertebrae, sacrum
and iliac, fibula w/ tibia - BODY MECHANICS
-
BODY MECHANICS
- The ability to maintain balance, body
alignment, and coordinated body movements
- Correct use of body mechanics is a phase of
illness prevention and health promotion.
- Nurses responsibility is to use ( be an
example) and teach correct body mechanics. -
BODY MECHANICS
- Proper -
- Proper – safe and effective movement
conservation of muscle energy
increased mobility -
BODY MECHANICS
- Improper -
- Improper – unsafe movement
increased energy output
strains, falls, decreased mobility -
FACTORS THAT INFLUENCE BODY
MECHANICS -
- General health status
- Nutrition
- Emotions
- Habits
- Situational factors
- Life style
- Personal values
- Knowledge
- Disease/injury
- Postural abnormalities - THERAPEUTIC BEDREST
-
- Decreased physical activity
- Decreased pain
- Increased rest
- Bed rest vs. bed rest with bathroom
privileges
(Familiarize yourself with the meaning of bed
rest in each practice setting)