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Benefits of Passive range of Movement Exercises and Stretches Information for the Carer In normal life people constantly change positions to achieve maximum comfort. This need still exists for the person with disabilities or degenerative conditions like Motor Neurone Disease regardless of the level of disability especially since sensation is intact. It is important to try to maintain range of movement in all joints. This assists with hygiene, dressing and comfort and can help to prevent contractures and pain. The following exercises help to stretch muscles and minimize shortening of other soft tissues surrounding the joint. Changing position regularly increases overall comfort. General Precautions
The exercise needs vary between individuals. To be sure that the exercise is appropriate for any one individual, assessment by a physiotherapist is advised. These exercises are a guide only and should only be used in consultation with your physiotherapist.  Passive Range of Movement Exercises Trunk Lumbar spine rotation. Lie on back with knees bent and feet flat on bed. Gently rock knees from side to side allowing rotation at lumbar spine. Aim to keep shoulders flat on bed. Lumbar spine flexion. Lie on back with knees bent and feet flat on bed. Carer assists both legs off bed, knees onto chest. Hold for 10 seconds. Do not force movement.  Shoulder Movements Shoulder flexion – patient lies on back, or sits, arm by side palm facing inwards gently lift arm into air and above head, thumb to ceiling (Hold for 5 seconds at end of range). Carer holds arm above elbow and at wrist, keep elbow straight. Repeat five times. Once per day. Shoulder abduction – lie on back or sit arm by side palm facing to ceiling. Hold arm above elbow and at wrist. Gently take arm out to the side as far as possible. Keep elbow straight Shoulder rotation – lie on back or sit, with elbow bent to 90° place one hand under elbow, the other at the wrist. Move wrist from side to side, causing rotation at shoulder. Hold at end of range 5 seconds. Repeat five times.   Flexion – bend elbow, bringing palm of hand to shoulder. Extension -straighten elbow Pronation/Supination – bend elbow to 90°. Twist forearm so that palm of hand moves from facing shoulder to facing feet  Wrist and finger movements Flexion – lie on back or sit arm by side bend elbow to 90° palm facing towards body. Keep forearm still. Gently move hand forwards and down towards body. Movement may be limited by tightness at back of hand. Hold at limit of movement for 5 – 10 seconds. Patient should feel slight stretch over back of wrist. This should not be painful. Repeat two to three times.  Lower Limb Hip and knee flexion – lie on back, carer holds leg at heel and at a thigh behind knee. Carer kneels on bed or stands beside bed near knees. Bend knee up toward chest, then straighten hip and knee. Repeat three times Hip abduction - lie on back, knees straight. Carer holds leg at heel and at thigh behind knee. Stand in same position as above. Slowly and gently move leg out to side, keeping knee straight. Continue to move leg until resistance is felt. Do not force movement. Hold 10 – 15 seconds. Repeat three times, once per day. Hip internal/external rotation – lie on back, bend up one knee as for hip flexion. Hold hip in bent position 90°. Rotate hip by moving heel from side to side. Do not force movement Hamstring Stretch - lie on back knees straight. Carer holds leg at heel and on top of leg just above knee. Straighten leg slowly until stretch is felt behind knee. Hip extension/quads stretch - Lie on stomach, bend knee to 90°. Without moving leg sideways at all, lift thigh up off bed. This is only a small movement – about 20°. Calf stretch - Lie on back, knees straight. Carer cradles foot with heel in palm of hand. Lean towards patient. Stretch should be felt in calf and behind knees. As above with knee slightly bent. Maintain bent knee with rolled up towel behind knee.  Ref: Bethlehem Neurological Outreach service.
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AuthorShonagh O'Hagan Archives
July 2025
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