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Health education number：HC-101
Passive range of motion exercise about joints for the bedridden patient
To deliver intelligent and holistic medicine and to provide the best healthcare Compassion Quality Innovation Accountability
All information above has been reviewed by Hospice specialists Edited and published by the Department of Nursing,
Taichung Veterans General Hospital
Set date:2017.09.08 Review date:2018.08.10 Revised date:2022.11.09
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Have you ever been in bed for two or three days and then felt stiffness in your joints when you got out of bed? The joints of the body are like the wheels of a bicycle, if they are not moved for a while, they will rust and become difficult to move.
Although a bedridden family member may not be able to get out of bed and walk anymore, keeping his joints moving will not only make him feel comfortable, but will also make it easier for us to take care of him!
Encourage and supervise the patient to move some joints to their maximum range of motion on a daily basis when they are still mobile. For those joints that cannot be moved, perform joint exercises twice a day for 10 minutes each time.
A. The principle of range of motion (ROM) exercises:
(a) Apply hot towels or pads to the joint before exercise to relax the muscles.
(b) From the hands and shoulders to the feet, from the proximal to the distal joints, every joint that can be moved should be done.
(c) Don't forcefully bend or straighten the joint to avoid fractures or injuries, but gradually increase the angle of motion.
(d) Regular and consistent joint exercises, once in the morning and once in the evening, 3-5 times per day for each joint.
(e) Be careful of your posture when helping the patient and do not bend too much to avoid soreness.
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B. How to do passive movement? Following are some methods and steps:
(A) Upper limb movement（Picture a-h）
(a) Raise the upper limb (b) forearm flexion
(c) Straighten the arm and stretch (d) Raise hand over the front chest and then bend inward
(e) Internal rotation (f) External Rotation
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(g) Pronation:palm down (h) Supination:palm up
(B) Hand movement（Picture a-b）
(a) Stretch the palm and finger (b) Wrist and fingers flexion
(C)Leg movement（Picture a-d）
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(a)Straight leg raise (b) Bend your knees toward your chest
(c)Toes flexion (d)Toes extension
C. Conclusion
It is very important to perform joint exercises every day in bedridden patients.
By properly guiding and assisting joint activities, joint stiffness and muscle
contracture can be avoided, so as to alleviate the patient's disability and improve the quality of daily life.
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D.References
陳美如、謝心柔、賴珍妙、盧玉華（2020）・以品管圈手法改善腦中風病人病
房復健運動執行率・
醫療品質，
9(1)，9-25。https://www.airitilibrary.com/ Publication/alDetailedMesh?DocID=a0000035-20 2012-20210106002 1-202101060021-9-25
衛生福利部長照專區（2022年 07月13日）‧肢體關節活動操作指引。
https://1966.gov.tw/LTC/cp-4266-45818-201.html
Purton, J., Sim, J., & Hunter, S. M. (2021). The experience of upper-limb dysfunction after stroke: a phenomenological study. Disability and Rehabilitation, 43(23), 3377–3386. https://doi.org/10.1080/09638288.2020.1743775
