January 7, 2015

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Range of Motion Exercises for Children with Disabilities

All children need exercise to keep their bodies healthy, strong and flexible.

However, children with disabilities are not always able to participate in activities that assist with fine/gross motor development.

For this reason, children with disabilities can use range of motion (ROM) exercises to strengthen their muscles and prevent muscle weakness.

All ROM exercises must be approved by your child’s doctor. ROM exercises are usually done twice daily and can be done more frequently, as tolerated, if joint motion has been lost. Starting these exercises early can prevent or reduce disability and pain.

If your child’s doctor recommends ROM exercises for your child, you should gently move the joint slowly with steady pressure. Never use force and stop the stretch when it starts to hurt the patient. The stretching may cause discomfort, but should not cause pain. Care must be taken for patients who cannot speak or feel. It’s important to be aware and stop when the cords feel too tight.

It’s important to remember that every child’s needs are different and not all of the same exercises apply for each child.

The greatest danger for children with paralysis or spasticity is when the joint is continuously bent or straight due to muscles that pull a joint in one direction that are much stronger than muscles that pull it the other way.

For painful or stiff joints, or tight muscles and cords, applying heat to the joint and muscles 10-15 minutes prior to ROM may help to reduce pain and relax tight muscles. At all times, protect the joint you’re working on. Weak joints are easily damaged by stretching.

Important reminders about ROM exercises:

  • Only perform ROM exercises if advised and approved by your child’s doctor.
  • Moving spastic joints rapidly causes them to stiffen.
  • ROM exercises should not be done on patients with joints that are floppy or already bend or straighten more than they should.
  • Perform exercises in the opposite direction of the deformity or contracture to help put the joint into a more normal position.
  • Do not move the limb rapidly back and forth like a pump handle. This is a common mistake which is not productive and can cause harm.

Make the exercise fun. ROM exercises can become very boring and the child may not want to perform them after sometime. Be creative and turn exercise time into games whenever possible.