Range-of-motion Exercises For A Quadriplegic

The effects of gravity and muscle imbalances can lead to tight joints and muscles, making life in a wheelchair difficult and increasing the risk of health complications. They can also lead to dysfunction that may interfere with regaining movement or working toward ambulation. Range-of-motion exercises keep joints mobile and muscles and tendons pliable. You should perform range-of-motion exercises for each direction that the joints are able to move and actively participate in as much of the movement as you can. The Illinois Neurological institute recommends performing each exercise 10 times daily.

Precautions

Spinal cord injury causes loss of nervous system function around joints, causing varying degrees of paralysis. Quadriplegics often have loose joints because the nervous system isn't acting on muscles and tendons to keep the joints stable. Inactivity and lack of load bearing also contribute to joint instability. Range-of-motion exercises can result in muscle tears, joint dislocation and joint subluxation if performed incorrectly. Avoid excessive range of motion; pay attention to feelings of tightness and learn how to perform range-of-motion exercises under the supervision of a professional. According to Craig Hospital in Colorado, a facility exclusively for patients with spinal cord and brain injuries, range-of-motion exercises should only be viewed as stretching if a joint is abnormally tight. Your leg should always be supported to prevent it from falling into a dangerous position. Be mindful of the position of the lower back during all exercises, and limit range of motion if it is arching or flexing excessively.

Lower Body

Your hip, knee and ankle joints are the major joints of your lower body. Your hip joint is able to move in all directions, so do exercises that bring your leg toward your chest, away from your chest, out to the side and back to the middle, and rotate inward and outward. These exercises can be performed with a bent leg and a straight leg and are also called hip flexion, extension, abduction, adduction, internal rotation and external rotation. Your knee joint bends and straightens, also called flexion and extension, so incorporate movements that move your heel toward your butt and then straighten the knee out again. Your ankles point, flex, move inward and move outward. Perform these movements separately and then add them all together by making circles with your ankle. Lower-body range-of-motion exercises can be performed seated or lying on your back, side or stomach.

Upper Body

Movements of the lower body joints are similar to those of the upper body, with the shoulder moving like the hip, the elbow moving like the knee, and the wrist moving like the ankle. Use your muscles through as much of the range of motion as you can. Like the hip, your shoulder is able to move in all directions. Move it up toward your head, down and behind you, out to the side and back to the middle, and rotate in and out. Start with your arm raised at shoulder level in front of you and move it out and in. Your elbow only bends and straightens, or flexes and extends. Your wrist moves up, down and side to side. Like the ankle, perform these movements separately or combine them to make a circle. Your radioulnar joint allows you to rotate your palm up and down.

Considerations

Some range-of-motion exercises may be performed independently, while others require a partner. Both you and your partner should pay attention to the alignment of your limbs throughout each movement. Tight or dysfunctional muscles may cause misalignment or poor tracking of a limb. For example, your leg may naturally rotate outward when you lift it up straight in front of you. You or your partner can correct for that by manually keeping the top of your thigh, knee and ankle pointed up toward the ceiling.