Range of motion exercises (ROM) are those that are performed to help keep a person's circulation going, joints moving smoothly and prevent muscles from becoming atrophied. When a person is bedridden, unresponsive or cannot perform exercises, passive range of motion exercises (PROM) are performed by a caregiver. Passive range of motion exercises for the upper extremities of the body include gentle movement of the shoulders, elbows, forearms and wrists.
Shoulder
Passive range of motion exercises for the shoulder include flexing, rotating and adducting the shoulder joint, according to the Children's Hospital and Clinics of Minnesota. Adduction means bringing the patient's arm toward the center of her body. Shoulder exercises should be the beginning of the daily routine for upper extremity work. Performing exercises in the same order every day helps the caregiver remember the steps.
Shoulder flexing, or flexion, is an exercise that brings the patient's arm over her head, thus flexing the muscles and the joint. The patient should be positioned on her back with her arms at her side. The caregiver supports the arm at the elbow and wrist, and slowly extends the arm as fully as possible, creating no pain or sudden movements. The arm is slowly brought down to the side again.
Horizontal adduction of the shoulder is performed by starting with each arm out at the patient's sides. The caregiver holds the arm at the elbow and wrist, and gently brings each arm across the body--one at a time-- so that the hand approximately reaches the other shoulder.
Shoulder rotation begins by placing the patient's arm at a 90-degree angle so that the elbow is on the bed and the hand faces the ceiling. The shoulder joint gently rotates as the caregiver brings the forearm up toward the patient's head, and back down toward her feet, while holding on to her elbow with one hand and her hand with the other hand.
The number of repetitions for all passive range of motion exercises for the arms will be prescribed by the patient's physician.
Elbow
The Ohio State University Medical Center depicts passive range of motion exercises for the elbow as a two-step process. The recipient of the exercise lies in his back during this exercise.
The caregiver gently grasps the arm at the elbow and at the wrist. He bends the elbow completely so that the patient's hand is approximately at shoulder level. Straighten the arm slowly until the elbow is unbent. The second step begins when the caregiver bends the elbow to a 90-degree angle with the fingers of the patient pointing toward the ceiling. Rotate the arm so that the patient's hand faces him, and then away from him. The second half of the elbow exercise works on the muscles in the forearm as well as the elbow joint.
Drugs.com stresses the importance of working slowly and fluidly to avoid causing pain to the recipient. The recipient may or may not be able to talk, but even if he cannot talk, his face may express pain during the exercises.
Wrist
Passive exercises for the wrist can be done in any position. The caregiver holds the person's forearm firmly with one hand, and gently bends the wrist back and forth in and up and down movement. This is called flexion and extension. Moving the wrist from side to side while holding on to the forearm is called wrist adduction.
Fingers
The fingers are the last of the upper extremities to be worked on during a set of passive range of motion exercises. Stretching the knuckle joints in the fingers is an important part of range of motion exercises, especially if the person affected is working toward regaining fine-motor skills.
The caregiver grasps the wrist in one hand and the fingers in the other, closing the hand into a fist. Unclench the first so that the fingers are straight once again. This causes the fingers to flex and extend as they would normally during a day's activities.
Finger adduction can also be done, gently stretching each finger individually toward the body and away.
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