Practicing passive range of motion exercises can be extremely helpful for individuals with quadriplegia.
They help reduce stiffness in the joints, allow for muscle lengthening, and promote circulation.
This article will explain what passive range of motion exercises are and share some exercises to improve joint flexibility.
What Are Passive Range of Motion Exercises for Quadriplegics?
Passive range of motion exercise requires no exertion of energy from the patient. Instead, a physical therapist, occupational therapist, or caregiver will be facilitating your movements and making sure that your joints move to their full extent.
Everybody has to start somewhere and passive exercise is a great way for individuals with quadriplegia to maintain joint flexibility and promote circulation. Passive range of motion exercises can and should be performed for both the upper and lower body.
Can All Individuals with Quadriplegia Benefit From Passive Range of Motion Exercises?
Without paralysis, you’d be moving your joints to their full range of motion regularly without even thinking about it.
However, with quadriplegia, you have to be mindful of your body movements and make sure that your joints are being moved to their full potential.
Passive range of motion exercises will help improve blood flow, flexibility, and reduce pain after spinal cord injury.
The only time when these exercises may not be a good idea is when you have specific precautions due to your SCI (or even other injuries that happened elsewhere in your body when you were hurt). For example, some individuals will have a neck or back brace and “spinal precautions” after their injury, which are specific ways they should NOT be moving their spine. Or, you may have injured your arm or leg during your accident, and your doctor may tell you not to move this limb in a certain way or direction. These types of precautions are typically necessary for around 12 weeks after injury, but it will be up to your doctor when to lift them. Please be mindful of these precautions when looking through these exercises.
Passive Range of Motion Exercises for Individuals with Quadriplegia
Remember that your therapist or caregiver should be helping you make these movements slowly and gently to avoid injury.
Try to hold the movements so that there is a slight stretch, but do not force anything. If anything is really painful, stop immediately.
Repeat these passive exercises at least 10 times.
- Neck Rotations: Tilt the head to one side so that your ear moves toward your shoulder and then alternate sides. Then, tilt it forward so that the patient’s chin goes toward their chest, then backwards so their chin goes toward the ceiling.
- Side-to-Side Head Shake: Turn the head from side to side as if signaling ‘no’; the eyes should stay level the entire time.
- Fists: Curl the fingers inward towards the palm, creating a fist, and extend them back so that they are straight. Keep the wrists neutral (straight) while doing this.
- O’s: Touch the tip of a finger to the tip of the thumb
- Finger Splits: Separate any two adjacent fingers away from each other and then bring them back together.
- Wrist Flicks: Move the hand forward so that the palm moves towards the inner arm and makes a 90° angle. Then, move the hand back in the opposite direction. If the patient has some hand movement preserved and is working on use of a “tenodesis grasp” in therapy, then be sure to keep their fingers curled in while performing this wrist exercise.
- Flexes: Bend the elbow so that the hand can touch the shoulder. Then extend it so that the arm is straight.
- Hand Flips: Hold the arm out so that it is straight and the back of the hand is facing up. With one hand, hold on to the elbow and with the other, flip the hand so that the palm faces up.
- Hand Raises: Start with the arm neutral so that your fingers are facing your feet. Keeping the arm straight, raise the hand forward and up so that your fingers face up.
- Wing Flaps: Start with the arm straight and neutral again and move the hand outward to the side, away from the center of the body. The arm should be level with the shoulders. Then, bring them back to the starting position. When done quickly, it’ll look like you’re trying to fly.
- Spine Twists: Have the patient lay down on his or her back with knees together and bent. After, tilt the knees towards one side and then the other. Make sure that the shoulders stay and don’t move.
Hip and Knees:
All these hip and knee ROM exercises should have the patient lying down.
- Hip Circles: Bend one knee so that the thigh is perpendicular to the mat/bed and there’s a 90° angle with the knee. Then, rotate the hip in circles by holding and moving the thigh. The bigger the circles, the better the hip movement.
- Foot Claps: The legs should be straight. Pull one to the side, creating separation between the feet until there’s slight resistance. Then, bring your feet back together.
- Knees to Chest: With one hand on the upper leg just above the knee and the other on the foot, bend one knee so that it‘s reaching towards the chest. Then, bring the foot back to the other leg and straighten the knee.
- Ankle Rotations: Put one hand just above the ankle to stabilize the leg and the other hand on the foot. Then move the foot in circular motions.
- Toe Curls: bend the toes in towards the sole and bring them back out to normal.
Here’s a video that quickly demonstrates some of the exercises so you can get a better understanding.
Mentality When Practicing Passive Range of Motion Exercises
If you think that range of motion exercises won’t do anything, we strongly urge you to change your mentality.
Rather than focusing on speed, concentrate on consistent movement and repetition.
You can’t get better without mastering the basics and setting a strong foundation.
Everybody has to start somewhere and developing range of motion will prepare your body for more intense spinal cord injury exercises in the future.