CNA Skill: Performing range of motion exercises on a patient

You will sometimes be asked to help patients with range-of-motion exercises.  These are typically done during the patient’s bath time.  The patient can be lying in bed or can even be sitting up.  You should do each exercise ten times for the most benefits to your patient.  Before starting range-of-motion exercises, you will want to wash your hands.  Say hello to your patient and let them know what you are going to be doing at that point.

You should raise the bed to a level that will be comfortable for you to work with the patient.  The patient should start their range-of-motion exercises by rotating their head from side to side.  Patients with neck or spinal cord injuries will not perform this exercise.

After the head, you can move to the arms.  The arms should be flexed and then extended at the elbow.  You will also help the patient to abduct as well as adduct their arm during the exercise.  Patients must also flex and extend their fingers and wrist.  Move on the the legs after the arm exercises are completed.  The legs will need to be flexed and extended at the knee.  The leg also needs to be abducted and adducted as well for full range of motion exercise.  Of course, the toes and angles will also need to be flexed and extended.

You should report to the patient’s nurse or doctor if there are any abnormal findings during the exercise.  Once or twice per day, you should help patient’s with these exercises.  If you find that a patient has difficult moving the joint or stiffness, you should talk to the nurse or doctor right away.

Pay careful attention when performing range of motion exercises.  Make note if you see that a patient has inflammation or swelling in their joints.  Contact the nurse for your patient right away if the patient has extreme pain.  You should also get help right away if they are having respiratory distress.

Various Positions:

• The supine position is when the patient is lying on their back.  They will be laying flat with their arms extended at their sides.
• A Sim’s Position is when the patient is laying on their side with their legs straight out.
• The prone position is one in which the patient is laying on their stomach.  Their head is turned to one side and it is their legs that are extended out to the side.
• The Lateral position is one in which the patient lays on their side with their topmost leg flexed.  The leg that is flexed and the topmost arm should be placed on a pillow.
• The Semi-Fowler Position is one in which the patient is positioned on their back.  The head of the bed is moved to an angle of 45 degrees.
• The High Fowler is much like the above accept that the head of the bed is at a 90 degree angle.