Passive range of motion (pROM) helps prevent joint contractures and maintain joint flexibility for the paralyzed limb. It is done by passively moving a limb through its available range of motion. The stroke survivor can perform the exercises alone or have a caregiver help. Arm exercises can often be done by the patient without assistance, however leg passive range of motion exercises are best performed by a caregiver. Exercises can be performed for 5-10 repetitions each preferably several times a day.
The following passive range of motion exercises for the arms are ones that an individual can do for him/herself without a caregiver.
Clasp Hands - Lying down, clasp your hands together to prepare for doing exercises.
Shoulder Flexion Forward - Raise hands straight up toward ceiling using your strong arm to help lift the weak or paralyzed arm. Bring hands back down to chest.
Straight Arm Punches - Keeping arms straight, try to lift shoulder blades off of the bed or mat. Do not lift the head.
Elbow Flexion and Extension - Bring hands to forehead, bending elbows, then straighten arms bringing hands back up toward ceiling.
Shoulder Flexion Overhead - Keeping elbows straight raise arms overhead as far as it is comfortable. If your shoulder is subluxed (dropping down from the socket), then only bring arms straight up and not overhead (arms at 90 degree angle with body). Check with your occupational or physical therapist to see how to perform safe range of motion if your shoulder is subluxed. Also, if you feel pain, do not raise arm any higher. Stop at the point where you start to feel any discomfort in the shoulder. Perform in a pain-free range only.
Shoulder External Rotation - If you are able to bring arms overhead comfortably and your physical or occupational therapist gives you the okay, try to place your hands behind your head and relax your elbows to the side(keeping hands clasped). This exercise is difficult for many stroke patients. Do not attempt if you have pain or have been advised not to do this exercise by your therapist.
Wrist Flexion and Extension - Holding your arms straight up, bend your wrist slowly side to side. This exercise may work better in a seated position with the hands in front of you instead of having the arms raised.
Wrist Supination and Pronation - Turn weak hand palm up and then palm down.
Finger Flexion and Extension - Bend fingers of weak hand into palm then straighten. If hands are already fisted then only work on straightening fingers.
Leg passive range of motion exercises are more difficult for stroke patients to perform on their own and will not be demonstrated on this page. However, if you are interested in knowing hot to do self range of motion for the legs, you can visit: https://patienteducation.osumc.edu/Documents/leg-self.pdf
The video below shows how each joint is moved through passive range of motion by a helper. The subject in the video does not have a stroke and has full range of motion. When performing passive range of motion on a stroke patient with limited range of motion, the exercises would only be done in a pain-free range, performed more slowly, and the helper should be aware of the patient's available movement or range of motion. Never force movement if you feel resistance or the patient expresses pain. A licensed occupational or physical therapist can teach caregivers how to do passive range of motion on a stroke patient.
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