View source for Disabled Village Children:Range-of-Motion (Rom) Exercises

{{bctrail|segments=3|chaptitle=Chapter 42: Range-of-Motion and Other Exercises}}
{{DISPLAYTITLE:Range-of-Motion (ROM) Exercises}}
{{SideSupplement|bookabbreviation=dvc|pagealt=is from pages 370 to 371 of|chapterpdf=http://hesperian.org/wp-content/uploads/pdf/en_dvc_2023/en_dvc_2023_42.pdf|bookurl=Disabled Village Children|booktitle=Disabled Village Children}}
{{chaptertoc|In this chapter:|
 <ul class{{=}}"noprint">
<li>[[Disabled Village Children:Chapter 42: Range-of-Motion and Other Exercises|Chapter 42: Range-of-Motion and Other Exercises]]</li>
    <li>[[Disabled Village Children:Different Exercises for Different Needs|Different Exercises for Different Needs]]</li>
    <li>[[Disabled Village Children:Range-of-Motion (Rom) Exercises|Range-of-Motion (ROM) Exercises]]</li>
    <li>[[Disabled Village Children:Guidelines for Doing Stretching and Range-of-Motion Exercises|Guidelines for Doing Stretching and Range-of-Motion Exercises]]</li>
    <li>[[Disabled Village Children:There Are 3 Main Ways of Doing Range-of-Motion Exercises|There Are 3 Main Ways of Doing Range-of-Motion Exercises]]</li>
    <li>[[Disabled Village Children:Common Sense Precautions When Doing Exercises|Common Sense Precautions When Doing Exercises]]</li>
    <li>[[Disabled Village Children:Ideas for Making Exercises Fun|Ideas for Making Exercises Fun]]</li>
    <li>[[Disabled Village Children:Complete Range-of-Motion Exercises—Upper Limbs|Complete Range-of-Motion Exercises—Upper Limbs]]</li>
    <li>[[Disabled Village Children:Range-of-Motion Exercises —Lower Limbs|Range-of-Motion Exercises —Lower Limbs]]</li>
    <li>[[Disabled Village Children:Range-of-Motion Exercises—Neck and Trunk|Range-of-Motion Exercises—Neck and Trunk]]</li>
    <li>[[Disabled Village Children:Exercise Instruction Sheets—for Giving to Parents|Exercise Instruction Sheets—for Giving to Parents]]</li>
    <li>[[Disabled Village Children:Stretching Exercise to Help Your Child Put Her Foot Down Flat|Stretching Exercise to Help Your Child Put Her Foot Down Flat]]</li>
    <li>[[Disabled Village Children:Stretching Exercise to Straighten a Stiff Knee|Stretching Exercise to Straighten a Stiff Knee]]</li>
    <li>[[Disabled Village Children:Stretching Exercises for a Bent-Hip Contracture|Stretching Exercises for a Bent-Hip Contracture]]</li>
    <li>[[Disabled Village Children:Exercises and Positions to Help Avoid Pressure Sores and Contractures|Exercises and Positions to Help Avoid Pressure Sores and Contractures]]</li>
    <li>[[Disabled Village Children:Exercise for a Straighter Back|Exercise for a Straighter Back]]</li>
   <li>[[Disabled Village Children:Strengthening Exercises to Get Arms Ready to Walk with Crutches|Strengthening Exercises to Get Arms Ready to Walk with Crutches]]</li>
   <li>[[Disabled Village Children:Strengthening Exercises to Help Your Child Have Stronger Thighs|Strengthening Exercises to Help Your Child Have Stronger Thighs]]</li>
  <li>[[Disabled Village Children:Strengthening Exercise for the Muscles on the Side of the Hip|Strengthening Exercise for the Muscles on the Side of the Hip]]</li>
<li>[[Disabled Village Children:Range-of-Motion and Strengthening Exercises for the Hand and Wrist|Range-of-Motion and Strengthening Exercises for the Hand and Wrist]]</li>
 </ul>
}}
===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. 
[[Image:DVC_Ch42_Page_370-1.png|250px|center|alt=A boy lying down and an adult exercising his hand]]

====Why?====

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

{{spannote2|||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. 
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====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 [http://hesperian.org/books-and-resources/ ''Where There Is No Doctor''], p.&nbsp;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).

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====How often?====
ROM exercises should usually be done at least 2&nbsp;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.</td>
<td align=center>at least twice a day</td></tr>

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<td style="padding-left:25px;">[[Image:DVC_Ch42_Page_370-2.png|260px|center|alt=a rising and setting sun]]</td></tr>
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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 [[Disabled_Village_Children:Common_Sense_Precautions_When_Doing_Exercises|"Common Sense Precautions When Doing Exercises"]]. '''Starting range-of-motion exercises EARLY can reduce or prevent disability'''.
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<td>[[Image:DVC_Ch42_Page_371-1.png|160px|right|alt=A baby lying down and looking up]]</td>
<td style{{=}}"font-size:larger;">'''KOFI AND MEDA'''</td>
<td>[[Image:DVC_Ch42_Page_371-2.png|160px|alt=a baby lying down and looking up]]</td></table>

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<td colspan{{=}}4>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.</td></tr>

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<td style{{=}}"border-right:1px solid;">From the time his fever dropped, Kofi’s mother did exercises with him — 2 times every day.</td>
<td >Meda’s mother cared for her child as best she could, but no one told her about exercises.</td></tr>

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<td style{{=}}"width:25%;border-right:1px solid;">[[Image:DVC_Ch42_Page_371-3.png|200px|center|alt=baby lying on his back while his mother is exercing his leg]]</td>
<td style{{=}}"width:25%;">[[Image:DVC_Ch42_Page_371-4.png|200px|center|alt=A mother crying and fanning her stiff baby]]</td></tr>

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<td style{{=}}"line-height:110%;border-right:1px solid;">''Little by little Kofi's body began to loosen up''</td>
<td align{{=}}center style{{=}}"line-height:110%;padding-right:40px;">''Meda’s body became more and more tight and bent.</td></tr>

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<td  style{{=}}"border-right:1px solid;">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.</td>


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<td colspan{{=}}2 style{{=}}"padding-top:25px; padding-bottom:25px;">In both children the muscle spasms gradually went away. By 6 months both had improved control of their body movements.</td></tr>

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<td  style{{=}}"border-right:1px solid;">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.</td>
<td>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.</td></tr>
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<table width{{=}}100%  style{{=}}line-height:110%;">
<td style{{=}}width:33%;">[[Image:DVC_Ch42_Page_371-5.png|220px|center|alt=A boy running and playing]]</td>
<td align{{=}}center style{{=}}width:33%;">RESULTS WITH AND WITHOUT RANGE-OF-MOTION EXERCISES</td>
<td style{{=}}width:33%;">[[Image:DVC_Ch42_Page_371-6.png|220px|center|alt=A weak child struggling to crawl]]</td>
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<td  align{{=}}center style{{=}}"padding-right:60px; padding-left:60px;">'''It is much easier to prevent these problems than to correct them.'''</td>
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<div class{{=}}speechbub style{{=}}"position:relative; width:300px; height:120px;">
[[Image:DVC_Ch42_Page_371-7.png|330px|left|alt=A mother crying ]]
<div style{{=}}"position:absolute; width:120px; top:33px; left:180px;">Why didn't someone tell me sooner?</div></div></td></tr>
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====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. 



{{Previous and next sections|Different Exercises for Different Needs|Guidelines for Doing Stretching and Range-of-Motion Exercises}}
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[[es:Disabled_Village_Children:Ejercicios_para_mantener_el_movimiento_de_las_coyunturas_(MMC)]]

[[en:Disabled_Village_Children:Range-of-Motion_(Rom)_Exercises]]