RANGE OF MOTION
General Information
Passive range of motion exercises are done to preserve flexibility and mobility of the joints on which they are performed. It is important to perform these exercises to prevent deformities. All the exercises should be done several times a day. A good time to do them is after the baby's bath or at each diaper change. Your physical therapist will tell you how many times to do each one. These exercises should be done slowly and steadily. Never force a joint. Damage to-the joint space can occur if too much force is applied. Joint range of motion is done on one joint at a time. Stabilize with one hand just above the joint and place your other hand below the joint to move the part through its full range of motion.
12 Shoulder
SHOULDER FLEXION
Starting Position
Place child lying on back.
Hand Placement
Stabilize with one hand at the shoulder so that it doesn't come up. Hold wrist with the other hand (see Figure 1).
Motion
Bend the arm up so hand is over the head, thumb leading. Keep the elbow straight (see Figure 2).
13 SHOULDER HORIZONTAL ADDUCTION
Starting Position
Lay child on back, arm away from body.
Hand Placement
Stabilize with one hand at the shoulder. Hold the wrist with the other hand (see Figure 1).
Movement
Bend the arm across the body toward the other arm (see Figure 2).
14 SHOULDER ROTATION
Starling Position
Lay child on back, elbow bent and arm straight out to the side.
Hand Placement
Hold arm straight out to the side. Hold the forearm with the other hand (see Figure 1).
Movement
Roll the forearm up (see Figure 2), then roll the forearm down (see Figure 3).
15 SHOULDER ABDUCTION
Starting Position
Place child lying on back.
Head Placement
Stabilize with one hand at the shoulder so it doesn't come up. Hold forearm with the other hand (see Figure 1).
Motion
Bend the arm sideways away from the body; bring the arm straight out to the side (see Figure 2).
16 ELBOW FLEXION AND EXTENSION
Starting Position
Lay child on back, elbow straight, arm away from body.
Hand Placement
Stabilize the elbow, hold wrist with other hand (see Figure 1).
Motion
Bend the elbow gently, then straighten the elbow (see Figure 2).
17FOREARM SUPINATION AND PRONATION
Starting Position
Lay child on back, elbow bent, arm close to body.
Hand Placement
Stabilize the upper arm with one hand, hold the wrist with the other hand.
Movement
Roll the forearm and hand up (see Figure 1), then roll the forearm and hand down (see Figure 2).
Wrist
18 WRIST FLEXION AND EXTENSION Starting Position
Place child lying on back.
Hand Placement
Stabilize the forearm with one hand. Hold child's hand with your other hand (see Figure 1).
Movement
Bend the wrist forward and back (see Figures 2 and 3).
19 WRIST ABDUCTION AND ADDUCTION (radial and ulnar deviation)
Starting Position
Place child lying on back.
Hand Placement
Stabilize the forearm with one hand. Hold the child's hand with your other hand (see Figure 1;
Movement
Bend the wrist from side to side (see Figures 2 and 3).
20 FINGER FLEXION AND EXTENSION
Starting Position
Optional
Hand Placement
Stabilize the forearm and wrist with one hand. Hold the child's fingers with your other hand.
Movement
Bend the fingers (see Figure 1), then straighten the fingers (see Figure 2).
21 FINGER ABDUCTION AND ADDUCTION
Starting Position
Hold the child's hand and wrist open and straight.
Hand Placement
Hold the fingers straight (see Figure 1).
Movement
Spread the fingers apart gently, bring them back together (Figures 2, 3, and 4).
22 MP FLEXION AND IP EXTENSION (knuckle bent, fingers straight)
Starting Position
Optional
Hand Placement
Stabilize the child's wrist with one hand. Hold the fingers with your other hand.
Motion
Bend the knuckle while keeping the fingers straight.
Thumb
23 THUMB OPPOSITION
Starting Position
Hold the child's hand open with palm up.
Hand Placement
Stabilize with one hand at the base of the little finger. Hold the end of the thumb with your other hand (see Figure 1).
Movement
Bend the thumb up and over toward the base of the little finger (see Figure 2).
24 THUMB EXTENSION
Starting Position
Hold hand open with palm up.
Hand Placement
Stabilize with one hand in the palm of the child's hand. Hold the end of the thumb with your other hand (see Figure 1).
Movement
Straighten the thumb upward, away from the palm (see Figure 2).
25 THUMB ABDUCTION-ADDUCTION
Starting Position
Hold hand open with palm up.
Hand Placement
Stabilize with one hand in the palm of the child's hand. Hold the end of the thumb with the other hand (see Figure 1).
Movement
Bend the thumb away from the side of the hand (see Figure 2).
