Range of motion exercises, or ROM, are stretches that maintain joint function, protect muscles from atrophy in an attempt to minimize pain and stiffness. Passive range of motion exercises are those that are performed by a helper--a spouse, parent, friend, adult child or physical therapist--when the person needing the exercises cannot perform the exercises himself. Passive ROM for the feet include manipulating the ankle, heel and toes, and are usually the last set of stretches to be performed. Drugs.com recommends beginning ROM exercises at the head and working down to the feet.
Ankles
The ALS Association's Greater Philadelphia chapter suggests that lower extremity ROM exercises be done after a warm bath or shower, because the muscles are loosened and ready to be manipulated. The first set of foot exercises involves the ankles. Ankle rotation requires the patient to be lying on her back with her knees straight. The caregiver holds the leg steady just above the ankle. With the other hand, the caregiver grasps the foot, and slowly and gently rotates the ankle in toward the body and back out. Do at least 3 to 5 repetitions, holding each stretch for 20 seconds, unless the patient complains of pain.
Heels
Heel cord stretching loosens the Achilles tendon and lower leg muscles, as well as the plantar fascia on the bottom of the foot. The helper supports the patient's foot on his forearm, holding on to the heel with the same hand. The caregiver's other hand supports the ankle. Push the patient's heel and ball of the foot forward, so that the toes are pushed back toward his body. Hold the position for 20 to 30 seconds, and repeat the entire stretch 3 to 5 times. Drugs.com reminds caregivers to work slowly, and to watch the patient's face or body language for pain, if he is unable to verbalize discomfort.
Toes
The University of Florida's Jackson Memorial Center suggests doing 10 repetitions of toe flexion and extensions on each foot every day as part of a passive range of motion program. The caregiver stabilizes the patient's leg by holding on to the middle of the foot. Move the toes backward and forward, either as a whole or each toe individually.
Member Comments