Group 8 :

Agus Maulana (1140970120003)

Aliyas (1140970120006)

Nurharwati (1140970120029)

Panji Sugiarto (1140970120030)

Rina Savita (1140970120034)

RANGE OF MOTION (ROM)

ROM is a joint movement exercise performed by nurses to patients.

OBJECTIVES • Improve the level of functional mobility of the client's extremities,

• prevent contractures and muscle and tendon wasting, and

• improve blood circulation in the extremities,

• reduce immobilization vascular complications, and

• increase client comfort

POLICY • Patients with mobility problems

• Patients with joint stiffness problems

3. Set a comfortable position: lying down with the hands relaxed, the body is usually supine (lateral)

4. Wear gloves

5. Position the nurse on the right side of the patient

Active and Passive ROM Execution

a. Neck

o Place the nurse's left hand under the patient's head and the right hand on the patient's cheek/face.

o Perform the movement:

• Rotation: lower your head, turn left and right.

• Flexion and extension: move the head to touch the chest then slightly tilted head.
• Lateral flexion: move the head to the right and left until the ears and shoulders are almost
touching.

o Observation of changes that occur.

b. Shoulder

o Flexion/Extension

• Place one nurse's hand on the patient's elbow and hold the patient's hand with the other.
• Raise the patient's arm to the starting position.
• Make a movement closer to the body.
• Observe changes that occur. For example: shoulder range of motion and stiffness.

o Abduction and adduction

• Place one nurse's hand on the patient's elbow and hold the patient's hand with the other.
• Move the patient's arm away from the body toward the nurse (to the side).
• Return to original position.
• Record changes that occur. For example: the range of motion of the shoulder, the presence
of stiffness, and the presence of pain.

o Shoulder Rotation

• Position the patient's arm away from the body (to the side) with bent elbows.
• Place one nurse's hand on the patient's upper arm near the patient's elbow and hold the
patient's hand with the other.
• Rotate your shoulders with your arms down until they touch the bed.
• Return the arm to the starting position.
• Move your forearms back until they touch the bed, palms facing up.
• Return to starting position.
• Record changes that occur. For example, the range of motion of the shoulder, the presence
of stiffness, and the presence of pain.

o Flexion and Extension

• Position the patient's arm away from the side of the body and the palm facing the patient's
body.
• Place the nurse's hand on the patient's elbow and hold the patient's hand with the other hand
• Bend the patient's elbow so that the patient's hand is close to the shoulder.
• Perform and return to the previous position.
• Observe the changes that occur. For example, the range of motion in the elbow, joint stiffness,
and the presence of pain.

c. Forearm

o Pronation and Supination

• Adjust the patient's arm position with the elbow bent / straight.
• Place one nurse's hand on the patient's wrist and hold the patient's hand with the other.
• Rotate the patient's forearm to the right or left.
• Return to starting position before pronation and supination.
• Observe the changes that occur. For example, forearm range of motion and stiffness.

d. Wrist
o Flexion and Extension

• Position the patient's arm away from the side of the body and elbow bent.
• Hold the patient's hand with one hand and the other hand holding the patient's wrist.
• Bend the patient's arm forward as far as possible.
• Observe the changes that occur. For example, wrist range of motion and joint stiffness.

o Flexion and Extension

• Grasp the patient's fingers with one hand while the other holds the wrist.
• Bend (bend/flex) the fingers down.
• Straighten the fingers (extend) then push back (hyperextension).
• Move left and right (Abduction-adduction).
• Return to starting position.
• Record changes that occur. For example, range of motion, and the presence of joint stiffness.

c. Thigh

o Rotation

Place the nurse's hand on the patient's ankle and the other on the patient's knee.

• Turn the leg toward the patient.

• Turn the foot towards the implementer.
• Return to original position.
• Observe changes that occur.

o Abduction and adduction

Place one nurse's hand under the patient's knee and one hand on the heel.

• Lift the patient's legs about 8 cm from the bed and keep the position straight. Movement of
the feet away from the patient's body or sideways toward the nurse.
• Move feet toward and away from the patient's body.

d. Knee

• Return to original position.

• Wash hands after the procedure.
• Observe changes that occur. For example, range of motion and the presence of joint stiffness.

o Flexion and Extension

Place one hand under the patient's knee and grasp the patient's heel with the other hand.

• Lift the leg, bend at the knee and groin.

• Continue to bend the knee toward the patient's chest as far as the patient can.
• Lower and straighten your knees while keeping your feet up.
• Return to original position.
• Wash hands after the procedure
• Observe changes that occur. For example, range of motion and the presence of joint stiffness.

e. Ankle
o Flexion and Extension

• Place one hand on the sole of the patient's foot and the other on the ankle, keeping the leg
straight and relaxed.
• Bend the ankles, pointing the toes toward the chest or the patient's upper body.
• Return to starting position.
• Bend the ankle away from the patient's chest. The fingers and soles of the feet are directed
downwards.
• Observe changes that occur. For example, range of motion and stiffness.
• Infersion and Effervescence
• Hold the upper half of the patient's leg with our hand (executive) and grasp the patient's ankle
with the other hand.
• Rotate the foot in an inward direction so that the sole of the foot

facing the other leg.

• Return to original position.

• Turn the foot out so that the sole of the foot is away from the other foot.
• Return to starting position
• Observe changes that occur. For example, range of motion, and the presence of joint stiffness.

f. Fingers

o Flexion and Extension of the fingers

• Grasp the patient's toes with one hand while the other holds the foot.
• Bend (bend) your toes down.
• Straighten your fingers and then push them back.
• Movement to the left and right (Abduction-adduction).
• Return to starting position.
• Observe changes that occur. For example, range of motion, and the presence of joint stiffness.
• Wash hands after the procedure.
• Record changes that occur. For example: range of motion, and the presence of joint stiffness.