Hesperian Health Guides

Range-of-Motion (ROM) Exercises

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HealthWiki > Disabled Village Children > Chapter 42: Range-of-Motion and Other Exercises > Range-of-Motion (Rom) Exercises

What are they?

Range-of-motion exercises are regularly repeated exercises that straighten or bend one or more joints of the body and move them in all the directions that a joint normally moves.

A boy lying down and an adult exercising his hand


The main purpose of these exercises is to keep the joints flexible. They can help prevent joint stiffness, contractures, and deformities.

Range-of-motion exercises are especially important for prevention of joint contractures. This danger is greatest when paralysis or spasticity causes ‘muscle imbalance’ — which means the muscles that pull a joint one way are much stronger than those that should pull it the other way, so that the joint is continuously kept bent or kept straight.

Who should do them?

Range-of-motion exercises are important for:

  • babies born with cerebral palsy, spina bifida, club feet, or other conditions that may lead to gradually increasing deformities.
  • persons who are so sick, weak, or badly injured that they cannot get out of bed or move their bodies very much.
  • persons who have an illness or injury causing damage to the brain or spinal cord, including:
    • polio (during and following the original illness)
    • meningitis or encephalitis (infections of the brain)
    • spinal cord injury
    • stroke (paralysis from bleeding or blood clot in the brain, mostly in older adults, see Where There Is No Doctor, p. 327)
  • children with parts of their bodies paralyzed from polio, injury, or other causes, especially when there is muscle imbalance, with risk of contractures.
  • children with progressive nerve or muscle disease, including muscular dystrophy and leprosy.
  • children who have lost part of a limb (amputation).

How often?

ROM exercises should usually be done at least 2 times a day. If some joint motion has already been lost and you are trying to get it back, do the exercises more often, and for longer each time.
at least twice a day
a rising and setting sun

When should range-of-motion exercises be started?

Early! Start before any loss in range of motion begins. With gentleness and caution, help a severely ill or recently paralyzed child to do range-of-motion exercises from the first few days. See "Common Sense Precautions When Doing Exercises". Starting range-of-motion exercises EARLY can reduce or prevent disability.

For how long should range-of-motion exercises be continued?

To prevent contractures or deformities, range-of-motion exercises often need to be continued all through life. Therefore it is important that a child learn to move the affected parts of his body through their full range of motion as part of work, play, and daily activity. If the range of motion remains good, and the child seems to be getting enough motion through daily activities, then the exercises can be done less often. Or simply check every few weeks to be sure there is no loss in range of motion.

Which joints?

Exercise all the joints that the child does not move through normal range of motion during her daily activities. For a child who is very ill or newly paralyzed, this may mean exercising all the joints of the body. For a child with one paralyzed limb, range-ofmotion exercises usually only need to be done with that limb (including the hip or shoulder). Children with arthritis may need range-of-motion exercises in all their joints, including the back, neck, and even jaw and ribs.

This page was updated:19 Jan 2018