Cebu Doctors’ University
College of Nursing
1 Dr. P. V. Larrazabal Jr. Avenue, North Reclamation, 6014 Mandaue City, Cebu, Philippines
Tel. No. +63 (32) 2388746 local 8191-8192 Web: www.cebudoctorsuniversity.edu E-mail: [email protected]
NCM 103
Fundamentals in Nursing Practice RLE
Range of Motion
CLO#7: define the following terms related to range of motion.
1.1 Abduction -moving an extremity away from the body
1.2 Adduction -bringing an extremity towards the body
1.3 Ankylosis -stiffness of a joint due to abnormal adhesion and rigidity of
the bones of the joint, which may result of injury or disease
1.4 Atony -muscle that has lost its strength. It is frequently associated
with the conditions: Atonic seizure, atonic colon, uterine atony,
gastrointestinal atony and choreaticatonia.
1.5 Contracture -an abnormal, usually permanent condition of a joint,
characterized by flexion and fixation. It may be caused by
atrophy and shortening of muscle fibers resulting from
immobilization or by loss of the normal elasticity of connective
tissues or the skin, as from the formation of extensive scar
tissue over a joint.
1.6 Circumduction -movement of the distal part of the bone in a circle while the
proximal end remained fixed.
1.7 Depression -state of low mood and adversion to activity
1.8 Dorsal Flexion -movement of the foot toward the shin; movement with
decreases the angle between the dorsum (superior surface) of
the foot and the leg so that the toes are brought closer to the
shin.
1.9 Elevation -movement in superior direction
1.10 Eversion -a body part turning away from the midline of the body
1.11 Extension -opposite of flexion; straightening movement that increases the
angle between body parts
1.12 External Rotation -motion that occurs when a part turn on its axis. The head
rotates on the neck, as in shaking the head “no”
1.13 Internal Rotation -rotation towards the center of the body
1.14 Flexion -movement decreasing between two adjoining bones, binding
of limb.
1.15 Gait -manner or style of walking including rhythm, speed
1.16 Hyperextension -movement of body part beyond its normal resting extended
position
1.17 Immobility -inability to move around freely
1.18 Inversion -turning of body part toward midline
1.19 Lateral Flexion -lateral movement away from the midline of the body
1.20 Muscle Atrophy -decreased muscle size
1.21 Plantar Flexion -movement which increased the approximate 90 degree angle
between the frontal part of the foot and the shin, as when
depressing an automobile pedal.
Cebu Doctors’ University
College of Nursing
1 Dr. P. V. Larrazabal Jr. Avenue, North Reclamation, 6014 Mandaue City, Cebu, Philippines
Tel. No. +63 (32) 2388746 local 8191-8192 Web: www.cebudoctorsuniversity.edu E-mail: [email protected]
1.22 Pronation -rational movement of the forearm at the radioulnar joint or the
foot at the subtalar and talocalcaneonavicular joints.
1.24 Radial Flexion -hand abduction
1.25 Retraction -act or instance of retracting; backward or inward movement
of an organ or part.
1.26 ROM Exercise -movement of each joint through its typical range of activity.
1.27 Rotation -circular motion
1.28 Supination -position of either the forearm or foot; in the forearm, when
the palm faces anteriorly or faces up.
1.29 Tonus -body or muscular tone
1.30 Ulnar Flexion -hand adduction
CLO#8: discuss the importance of ROM exercises
• lowers the risk of heart diseases; lowers blood pressure and improves lipid profile;
controls blood glucose level, helps fight obesity
• improves immune function, concentration and task performance, as well as the
quality of sleep.
• improves physical and psychological health; reduces stress, regulates mood,
enhances self-esteem, and increases optimism and confidence.
• increases self-awareness and control over ones choices in life.
• promote socialization.
CLO#9: identify the effects of ROM exercise on the Major Body System.
• Musculoskeletal System: increase and maintain the size, shape, tone and strength of
muscles, muscle hypertrophy; commonly seen in the arm, leg and hand muscles, and
efficiency of muscular contraction increases. Exercise increases joint flexibility and range
of motion. Bone density is maintained through weight-bearing.
• Cardiovascular System: increase heart rate, strengthen heart muscle contraction,
promote adequate blood supply to the heart muscles and increase cardiac output to as
much as 30 L/min.
• Respiratory System: ventilation increases; intake of oxygen increases to as much as 20
times normal intake; prevents pooling of secretions in the bronchi and bronchioles,
decreases breathing effort, and improves diaphragmatic excursion.
• Gastrointestinal System: improves the appetite and increases GIT tone facilitating
peristalsis.
• Metabolic System: elevates metabolic rate; increases the use of triglycerides and
fatty acids, resulting in a reduced level of serum triglycerides and cholesterol. It also
enhances the effectiveness of insulin.
Cebu Doctors’ University
College of Nursing
1 Dr. P. V. Larrazabal Jr. Avenue, North Reclamation, 6014 Mandaue City, Cebu, Philippines
Tel. No. +63 (32) 2388746 local 8191-8192 Web: www.cebudoctorsuniversity.edu E-mail: [email protected]
• Urinary System: promotes efficient blood flow; stasis of urine in the bladder is
prevented.
• Psychoneurologic System: produces a sense of well-being and improves tolerance to
stress.
CLO#10 explain the factors affecting the ROM exercise
• Age and sex
• Individual energy
• Nutrition and Lifestyle
• Health diagnosis, Illness or Disability
• Emotions and Self-Concept
• Joint Structure
CLO#11: enumerate the types of ROM.
1. Isotonic exercise
1.1 Active exercise – client moves each joint in the body through complete ROM,
maxillary stretching all muscle group with each plane over each joints (clients only)
moving all muscle joints in the body.
1.2 Passive exercise – another person moves the clients joints through complete ROM;
maxillary stretching the muscle group within each plane over a joint.
1.3 Active-assistive exercise – carried out with both patient and a professional; need
in physical conditioning.
2. Isometric exercise – static setting; no movement; change in muscle tension and strength.
3. Isokinetic exercise – increase muscle strength and endurance.
CLO#12: discuss the indications and contraindications in performing ROM exercises.
• Indications
-weak musculature
-segment of body is immobilized for a period of time
-comatose patient
-clients experiencing muscle atrophy
-bedridden clients
-clients with rheumatoid arthritis
-ambulatory clients who can move freely without pain or discomfort
• Contraindications
-immediately following acute tears, fractures, and surgery
-when client is prescribed for complete bed rest
-fractured areas of the body
-joints with pathological conditions
Cebu Doctors’ University
College of Nursing
1 Dr. P. V. Larrazabal Jr. Avenue, North Reclamation, 6014 Mandaue City, Cebu, Philippines
Tel. No. +63 (32) 2388746 local 8191-8192 Web: www.cebudoctorsuniversity.edu E-mail: [email protected]
CLO#13: state the scientific principles involved in the performance of ROM exercise.
• Anatomy and Physiology – muscles are chiefly involved in rest and exercise.
• Chemistry – facilitate in the distribution of nutrients especially calcium and potassium
• Physics – movement of the body may raise place by means on the function of the muscles
and bones.
• Psychology – sense of well-being; development of trust and confidence.
• Safety and security – being able to perform the exercises in a safe environment wearing
the proper outfit and use of correct equipment.
• Microbiology – observing medical handwashing prior to performing the procedure.
• Time and Energy – beginning to perform the exercises slowly and gradually build up to
more. Rest time will vary due to the amount of energy used during the exercise.
CLO#14: cite the guidelines in performing evidence-based practice ROM exercise.
✓ be aware of any medical limitations (e.g. weight-bearing status, untreated fracture,
cardio-vascular disease)
✓ teach client breathing exercises to help reduce anxiety.
✓ do not force a muscle or joint during exercise.
✓ let client move at his or her own pace.
✓ monitor vital signs before, during, and after exercises.
✓ stop the exercise if the client manifest pain, shortness of breath, or any changes in vital
signs and sensorium.
CLO#15: document client responses and outcomes after performing ROM exercises.
✓ know the client’s baseline mobility prior to hospitalization.
✓ keep a record of the client’s progress and provide feedback.
