Passive range of motion (PROM) are exercises designed to increase the movement possible in a joint or limb by carefully stretching the muscles and tendons. PROM exercises are done 2 – 3 times a day and for short periods of time. The motion of each joint should be isolated from all other joints as much as possible. For instance, to perform PROM of the toes, you would hold the leg still just above the toes so it can not bend. Then gently bend and extend each toe back and forth several times. Each time you perform the PROM exercises, try to move the joint slighly more than before. However, it is important that you do not cause pain. Pain can cause your pet to resist the exercises and cause swelling. Since these exercises can sometimes cause swelling applying ice packs afterwards is important.
METHOD OF PERFORMING PASSIVE RANGE OF MOTION EXERCISES
- Legs, gently supporting entire limb, slowly begin to move and flex each joint, beginning with the toes and moving upwards towards the body. Only flex and extend one joint at a time.
- Hips and shoulders – while supporting the body with your arm under the belly or while the pet is lying on its side, slowly stretch the leg backwards, then forwards, then up (or out) the in (or towards the body). Hold the leg as chose to the hip or shoulder as possible so you are moving only this joint. Remember the shoulders and the hips are ball joints and can pretty much move in any direction. We just need to move the limb through these movements.
- Head – while gently supporting the muzzle (nose) and with one had on the neck to keep it from moving also, slowly push the dog or cat’s head upwards towards the ceiling, then downwards toward the floor. Next move it to the left and then the right.
- Neck – Same as with head but moving the head and neck together.
- Spine – While pet is standing, slowly turn pet in a tight circle in one direction, then the other direction several times. While pet is on its side slowly stretch the body out so the spine is curved in a slight C-shape or curve the body in like the pet is curled up and sleeping. This the same movement you make when you stretch your body backwards and then touch your toes.
With any PROM, a complete range of motion should occur. If the joint or spine is painful, flex or extend only as much as is comfortable for the animal. Each day try to flex and extend the joint or spine slightly further until a complete range of motion can be done. Signs that the patient is in discomfort include tensing the limb, moving, vocalizing, turning the head toward the therapist, or trying to pull away. Do not cause undue discomfort.
Once you complete the PROM exercises you should use ice packs to reduce pain and swelling. If ice packs are not possible, warm packs can be used to reduce pain but this will not reduce swelling. Ice packs can be made with ice in a zip lock bag and covered with a towel. Warm packs can be made with a aromatherapy pack that is slightly warm to touch. Hot pads should NEVER be use as these can cause painful and serious burns.