EXERCISE

❖TYPES OF EXERCISES: ◦Expect the patient's heart rate and respiratory rate to
➣Passive increase during exercise.
➥These exercises are carried out by the nurse, without
◦Range-of-motion exercises should be done at least twice
assistance from the patient. Passive exercises will not
a day. During the bath is one appropriate time. The warm
preserve muscle mass or bone mineralization because
bath water relaxes the muscles and decreases spasticity
there is no voluntary contraction, lengthening of muscle,
of the joints. Also, during the bath, areas are exposed so
or tension on bones.
that the joints can be both moved and observed. Another
appropriate time might be before bedtime. The joints of
➣Active Assistive helpless or immobile patients should be exercised once
➥These exercises are performed by the patient with every eight hours to prevent contracture from occurring.
assistance from the nurse. Active assistive exercises
encourage normal muscle function while the nurse ◦Joints are exercised sequentially, starting with the neck
supports the distal joint. and moving down. Put each joint needing exercise
through the range of motion procedure a minimum of three
➣Active times, and preferably five times. Avoid overexerting the
➥Active exercises are performed by the patient, without patient; do not continue the exercises to the point that the
assistance, to increase muscle strength. patient develops fatigue. Some exercises may need to be
delayed until the patient's condition improves.
➣Resistive
➥These are active exercises performed by the patient ◦Start gradually and move slowly using smooth and
by pulling or pushing against an opposing force. rhythmic movements appropriate for the patient's
condition.
➣Isometric
◦Support the extremity when giving passive exercise to
➥These exercises are performed by the patient by the joints of the arm or leg.
contracting and relaxing muscles while keeping the part
in a fixed position. Isometric exercises are done to ◦Stretch the muscles and keep the joint flexible
maintain muscle strength when a joint is immobilized.
Full patient cooperation is required. ◦Move each joint until there is resistance, but never force
a joint to the point of pain.
❑RANGE OF MOTION (ROM)
☞PURPOSES: ◦Keep friction at a minimum to avoid injuring the skin.
✓Prevent joints from becoming stiff and contractures
(deformities) from developing. ◦Return the joint to its neutral position.
✓Prevent the loss of minerals from bones
(osteoporosis) ◦Use passive exercises as required, however, encourage
active exercises when the patient is able to do so.
✓ Improve circulation
✓ Prevent muscles from losing strength and shrinking
❖TYPES OF BODY MOVEMENT:
(atrophy).
▷Flexion ⇢The state of being bent. The cervical spine is
flexed when the chin is moved toward the chest.
☞TYPES OF ROM EXERCISES:
▹Active ROM ⇢means that the client performs the
▷Extension ⇢The state of being in a straight line. The
exercises alone or uses a device such as a pulley or
cervical spine is extended when the head is held straight.
bicycle.
▷Hyperextension ⇢The state of exaggerated extension.
▹Passive ROM ⇢means that the exercise is done for the
The cervical spine is hyperextended when the person
client who is unable to move independently. It involves
looks overhead, toward the ceiling.
moving the client's body parts through a series of
exercises.
▷Abduction ⇢Lateral movement of a body part away from
the midline of the body. The arm is abducted when it is
☑GUIDELINES FOR ROM EXERCISES:
held away from the body.
◦Plan when range of motion exercises should be done.
Plan whether exercises will be passive, active-assistive, or
active. Involve the patient in planning the program of ▷Adduction ⇢Lateral movement of a body part toward the
exercises and other activities because he/she will be more midline of the body. The arm is adducted when it is moved
apt to do the exercises voluntarily. from an outstretched position toward the body.

FUNDAMENTALS OF NURSING REVIEWER 2019 / NV

 EXERCISE
▷Rotation ⇢Turning of a body part around an axis. The ・Abduction
head is rotated when moved from side to side to indicate ・Adduction
‘no’. ・Opposition

▷Circumduction ⇢Rotating an extremity in a complete ▻Hip- Ball & Socket Joint

circle. Circumduction is a combination of abduction, ・Flexion
adduction, extension, and flexion. ・Extension
・Hyperextension
▷Supination ⇢The palm or sole is rotated in an upward
・Abduction
position
・Adduction
▷Pronation ⇢The palm or sole is rotated in a downward ・Circumduction
position. ・External Rotation
・Internal Rotation
▷Eversion ⇢Turning the sole of foot outward by moving
the ankle joint. ▻Knee- Hinge Joint
・Flexion
▷Inversion ⇢Turning the sole of foot inward by moving ・Extension
the ankle joint.
▻Ankle- Hinge Joint
◆Selected Body Part & Joint Movements: ・Flexion (Dorsiflexion)
▻Neck- Pivot Joint ・Extension (Plantar flexion)
・Flexion
・Extension ▻Foot- Gliding Joint
・Hyperextension ・Eversion
・Lateral flexion ・Inversion
・Rotation
▻Toes: Interphalangeal Joints- Hinge
▻Shoulder- Ball and Socket Joint Metatarsophalengeal—Hinge
・Flexion Intertarsal Joints--Gliding
・Extension ・Flexion
・Hyperextension ・Extension
・Abduction
・Adduction ▻Trunk- Gliding Joint
・Circumduction ・Flexion
・External Rotation ・Extension
・Internal Rotation ・Hyperextension
・Lateral Flexion
▻Elbow- Hinge Joint ・Rotation
✖
・Flexion
・Extension CONTRAINDICATIONS TO ROM EXERCISES:
・Rotation (Pronation & Supination) a. Heart and Respiratory Disease
⇢Range of motion exercises require energy and tend
to increase circulation. Increasing the level of energy
▻Hands & Fingers: Metacarpophalangeal expended or increasing the demand for circulation is
Joints- Condyloid potentially hazardous to patients with heart and
Interphalangeal Joints- Hinge Joint respiratory diseases.
・Flexion
・Extension b. Connective Tissue Disorders
・Hyperextension ⇢Range of motion exercises put stress on the soft
・Abduction tissues of the joint and on the bony structures. These
・Adduction exercises should not be performed if the joints are swollen
or inflamed or if there has been injury to the
▻Thumb- Saddle Joint musculoskeletal system in the vicinity of the joint.
・Flexion
・Extension
FUNDAMENTALS OF NURSING REVIEWER 2019 / NV