Hesperian Health Guides
Range-of-Motion (ROM) Exercises
HealthWiki > Disabled Village Children > Chapter 42: Range-of-Motion and Other Exercises > Range-of-Motion (Rom) Exercises
Contents
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 usually moves.
Why?
The main purpose of these exercises is to keep the joints flexible. They can help prevent joint stiffness, contractures, and deformities.
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 trauma causing injury 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 |
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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.
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KOFI AND MEDA |  |
| Kofi and Meda got meningitis on the same day. With quick, good medical treatment both survived. But both had brain injury that left their bodies stiff and bent. | |||
| From the time his fever dropped, Kofi’s mother did exercises with him — 2 times every day. | Meda’s mother cared for her child as best she could, but no one told her about exercises. | ||
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| Little by little Kofi's body began to loosen up | Meda’s body became more and more tight and bent. | ||
| As he got better, she also played with him a lot—in ways that helped him stretch and bend all joints as much as possible. | |||
| In both children the muscle spasms gradually went away. By 6 months both had improved control of their body movements. | |||
| Because Kofi’s joints were kept flexible, as his muscle control came back he learned to use his body nearly as well as any child his age. | When Meda’s muscle control returned, his muscles had shortened so much that he could not straighten his hips or knees enough to walk. He could only crawl, and his contractures became more and more severe. | ||
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RESULTS WITH AND WITHOUT RANGE-OF-MOTION EXERCISES |  |
| It is much easier to prevent these problems than to correct them. |
 Why didn't someone tell me sooner? |
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 full 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-of-motion 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.