The Electronic Directory for People with Spinal Cord Injury
"Because no one should cope with a Spinal Cord Injury (SCI) alone"
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The Electronic Directory for People with Spinal Cord Injury "Because no one should cope with a Spinal Cord Injury (SCI) alone" |
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Range of motion (ROM)
Range of motion (ROM) is the term that is used to describe the amount of movement you have at each joint, such as your knee. Every joint in the body has a "normal" range of motion. Joints maintain their normal range of motion by being moved. It is therefore very important to move all your joints every day. Stiff joints can cause pain and permanent deformities and can make it hard for you to do your normal daily activities. In SCI, you may have
difficulty moving your arms and legs, and your joints can easily become stiff
and hard to bend. If your knees and hips become stiff, e.g., it will be hard for
you to dress yourself and sit in a wheelchair. To prevent joint stiffness and
enable you to achieve your highest level of independence, your therapists will
teach you range of motion (ROM) exercises. Some patients may need splints to
keep the muscles around their joints stretched. Self-Stretching Important points to remember:
Self ROM Exercises for Quadriplegics Do these exercises while you are leaning against the headboard of the bed, leaning against a piece of furniture that will not move, or sitting in your wheelchair.
Lower Extremity Passive ROM Exercises Lower extremity passive exercises are for someone else to stretch your hips, legs, and knees if you are unable to do this yourself. These exercises should be done slowly and gently while you are lying on your back. Each exercise should be done ten times on each leg each day.
Hip and Knee Flexion and Extension Cradle the leg by placing one hand under the bent knee. With the other hand, grasp the hip (or place it under the heel) for stabilization. Lift the knee and bend it toward the chest, with the kneecap pointed toward the ceiling. Do not allow the hip to twist during this movement. The foot should stay in a straight line with the hip and not swing in or out. The leg is then lowered to the starting position.
Hamstring Stretching (Straight Leg Raises) Method # 1 - Kneel between the legs and support the ankle with your arm or shoulder. The knee will be straight. Place one or both hands just above your knee, stabilizing the hip joint. If one hand is used, the other hand will be placed on the thigh of the other leg to keep it on the bed. If both hands are used, the person's knee may rest lightly on your other thigh. Raise the leg straight up to approximately 90 degrees.
Method #2 - Place one hand under the knee and the other hand under the heel. With the knee straight and the kneecap pointed toward the ceiling, raise the whole leg toward the ceiling. When the raised knee begins to bend slightly, the hand under your knee should be moved to the top of your knee.
Hip Internal and External Rotation Place one hand on top of the knee and the other hand under the heel. Bend the knee halfway to the chest so that there is a 90 degree angle at the hip and knee. Pull the foot toward you and then push it away. OR: Place one hand on the thigh and other hand below the knee. Roll the leg inward until the kneecap faces the other leg. Then roll the leg outward in the opposite direction. The leg always stays straight in alignment and rolls like a log.
Hip Abduction and Adduction Cradle the leg by placing your hand under your knee and holding it. Place the other hand under the heel, or on the hip, to stabilize the hip joint. Keeping your knee straight, move the leg along the surface of the bed, toward you and away from the other leg, to approximately 45 degrees. Then bring the leg back to the other leg.
Heel-Cord Stretching Place one hand on the knee to prevent it from bending. Your other hand cups or cradles the heel and your forearm is placed against the ball of the foot. Push the ball of the foot forward, bending the foot toward the knee and stretching the muscles in the back of the leg.
Ankle Dorsification Place one hand under the heel, with the foot against the forearm, and push the heel downward with this hand. To stretch one muscle (the gastrocnemius), extend the knee, place the other hand on top of the ankle, and push in the opposite direction
To stretch the second muscle (the soleus), flex the knee, place the other hand under the calf, and push in the opposite direction.
Foot Inversion and Eversion With one hand, hold the foot near the heel. With the other hand, hold the lower leg near the ankle. The foot is moved from side to side or in a circle (up, in, down, out).
Toe Flexion and Extension With one hand, stabilize the foot just below the toes. With the other hand, gently move each or all of the toes forward and backward.
Hip Extension Place the person on his or her side and stand behind them. Place one hand under the knee with the lower leg resting on your forearm. With the other hand, hold your pelvis in place. Pull the leg backward and toward you. Upper Extremity Passive ROM Exercises Upper extremity, passive ROM exercises teach someone else how to stretch your arms if you are unable to move your arms by yourself. These exercises should be done slowly and gently, and can be done with the person sitting in a chair or lying down. Do each exercise ten times.
Shoulder Flexion and Extension Hold the forearm with one hand. With the other hand, grasp the top of the shoulder joint to stabilize it. Turn the palm inward, facing the body, and keep the elbow relatively straight. Move the arm from the side of the body over the head.
Shoulder Abduction and Adduction Place one hand on the shoulder, stabilizing the shoulder joint. With the other hand holding the elbow, support the forearm and turn the palm outward. Bring the arm out to the side, away from the body, as far as it will go.
Shoulder Internal and External Rotation Place one hand on the shoulder. With your other hand, hold the forearm. Bring arm out to the side to shoulder level. Turn arm so that the hand points to the ceiling. Then turn arm back down so that hand points to floor and the upper arm is twisting in the shoulder joint.
Elbow Flexion and Extension Hold the upper arm with one hand and forearm with the other hand. Bend the arm at the elbow so that the hand touches the shoulder. Then straighten the arm all the way out.
Forearm Supination and Pronation Hold under the elbow with one hand and the wrist with the other hand. Turn the palm of the hand so it faces up to the ceiling, and then down to the floor, twisting the forearm.
Wrist Flexion and Extension Hold the forearm above the wrist with one hand. Place the thumb and fingers of your other hand on opposite sides of the palm. Holding the hand in this way, bend it up at the wrist, then down at the wrist, about 90 degrees. The fingers will straighten naturally.
Finger Flexion and Extension Place the hand palm down. While raising the wrist, bend the fingers up. Then straighten out the fingers as you bend the wrist down.
Thumb Bend and straighten the thumb. Stretch the thumb out to the side to stretch the "web space"
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