Range of Motion Exercises
Range of motion (ROM) exercises are done to preserve
flexibility and mobility of the joints on which they are performed. These
exercises reduce stiffness and will prevent or at least slow down the freezing
of your joints as the disease progresses and you move less often. Range of
motion is the term that is used to describe the amount of movement you have at
each joint. Every joint in the body has a "normal" range of motion.
Joints maintain their normal range of motion by being moved. It is therefore
very important to move all your joints every day. Stiff joints can cause pain
and can make it hard for you to do your normal daily activities. Each person with ALS needs a
program of exercise tailored to his or her individual needs and abilities. With a prescription your
doctor can either send you to an outpatient clinic to see a Physical Therapist
or have one come to your home to help you design a personalized exercise
program. The therapist will see you until you or your caregiver are independent
with a home exercise program that you can follow through with daily. It is
important to remember that as the disease progresses, the type of ROM exercises
you will need will change. It is important to be proactive when this occurs and
ask your doctor to write you another prescription to see a therapist so your
home exercise program can be modified.
There are different kinds of ROM exercises. There are stretching exercises you can do yourself when you still have the muscle strength to move your joints through their complete ranges. These are called Active ROM exercises. There are Self-ROM exercises which involve using a stronger arm to assist a weaker arm to perform the exercises, eliminating the need for caregiver assistance. Then there are Passive ROM exercises which are done for a weaker PALS by a caregiver. Often a combination of the types of ROM exercises above will be used. For instance if a PALS has strong arms but very weak legs, he would use an active ROM program for the arms independently and a passive ROM program for the legs. Even within a limb the type of exercise used can vary depending on the strength of the different muscle groups. PALS with increased muscle tone (spasticity) will also need to learn techniques to decrease the tone before exercising. What type of ROM exercises are most effective for an individual is best determined by a therapist who can evaluate your own muscle strength and tone.
It is important to realize that these exercises will
not strengthen muscles that have been weakened by ALS. Once the supply of motor
neurons that control a particular muscle has degenerated, it cannot be
regenerated by exercise. It is important that all exercise be performed in moderation. Fatigue
will only increase your weakness and rob you of energy that you need for your
daily routines and the activities you enjoy. If you find that your prescribed
set of exercises tires you, talk to your therapist. Changes can be made that
will eliminate the risk of fatigue. Similarly, none of your exercises should
cause you pain. If you do experience pain when exercising, stop that exercise
and talk to your therapist. It may be that you are not doing the exercise
correctly, or perhaps some modification to your exercise program must be made.
If your joints are very painful and swollen, move them
gently through their range of motion. These exercises should be done slowly and
steadily. It is important with ROM exercises not to force movements and to stop
a movement if it causes you pain. Damage to the joint space can occur if too
much force is applied. Joint range of motion is done on one joint at a time.
Stabilize with one hand just above the joint and place your other hand below
the joint to move the part through its full range of motion. Your physical
therapist will tell you how many times to do each one.
General instructions:
·
Ideally,
these exercises should be done once per day.
·
Do
each exercise 10 times or move to the point of resistance and hold for 30
seconds.
·
Begin
exercises slowly, doing each exercise a few times only and gradually build up
to more.
·
Try
to achieve full range of motion by moving until you feel a slight stretch, but
don't force a movement.
·
Move
only to the point of resistance. Do not force the movement.
·
Keep
limbs supported throughout motion.
·
Move
slowly, watching the patient's face for response to ROM.
Lower extremity passive exercises are for someone
else to stretch your hips, legs, and knees if you are unable to do this
yourself. These exercises should be done slowly and gently while you are lying
on your back. Each exercise should be done ten times on each leg each day.
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ROM Exercises
(Lower Extremities) – Page 1 of 4
ROM Exercises
(Lower Extremities) – Page 2 of 4
ROM Exercises
(Upper Extremities) – Page 3 of 4
ROM Exercises
(Upper Extremities) – Page 4 of 4