Perform Passive Range of Motion to Elbow and Wrist

Care Plan: Provide the following range of motion exercises to the resident’s right elbow/wrist: flexion/extension of the elbow and flexion/hyperextension of the wrist three times each. The resident is not able to help with the exercises. 


Click on each question below to view the answer…

Why do we only perform one exercise on the elbow?

Because the elbow is a hinge joint, it only moves in one direction (up and down).  Performing exercises other than this one can cause injury because the joint is not designed to move in those directions.

Do we have to describe exactly what we are going to do for each exercise?

Yes.  By explaining the motions clearly to the patient, using terms and motions they understand, the patient will not be as fearful and will cooperate more fully with the exercises.  Not explaining these exercises prior to performing them is a violation of patient rights, because the patient has the right to participate in their care.

How will I know if the patient is experiencing pain?

You must be alert for verbal and non-verbal cues that the patient may be experiencing pain.  Things like grimacing, moaning, wincing, saying “ouch” or stiffening up during the skill are all signs that the patient may be experiencing pain.  It is important to ask the patient frequently about pain when performing each exercise.  If the patient experiences pain, do not go to the level of pain on the next repetition.

Do we have to perform exercises in the order shown?

No.  You may perform these exercises in any order.  However, it is usually best to establish a routine in order to be able to remember all the exercises.

Why are range of motion exercises done?

Range of motion exercises are done on extremities to retain function and prevent muscle atrophy and joint stiffening during illness or recovery.  This can help prevent complications and maintains the overall level of health in a patient.

Why is it important to keep the elbow on the bed during these exercises?

Keeping the elbow supported by the mattress reduces fatigue and provides support.  It is important to provide support when performing these exercises to prevent injury.

Do I have to perform these exercises on all patients?

No.  You will only provide range of motion exercises when a doctor or nurse has ordered them. Range of Motion exercises are only provided when ordered, and only on the extremities ordered.  You must follow the care plan exactly.  If the care plan does not specify that range of motion exercises should be performed, you may not do them on the patient.  If you think the patient might benefit, you may discuss it with the nurse caring for the patient.

Which of these exercises will be assigned for the test?

The elbow will need flexion/extension exercises (an up/down motion) but that is the only exercise that can be done on a hinge joint (like the elbow). The wrist will require flexion/extension exercises (up/down motion) as well. These are the only exercises to be done for the exam. Always follow the care plan.