9.10 Skills Checklist: Range of Motion (ROM) for the Hip and Knee

Note: Includes abduction/adduction of the hip and flexion/extension of the hip and knee movements.

1. Gather Supplies: None

2. Routine Pre-Procedure Steps:

• • Knock on the client’s door.
  • Perform hand hygiene.
  • Introduce yourself and identify the resident.
  • Maintain respectful, courteous, and professional communication at all times.
  • Provide for privacy.
  • Explain the procedure to the client.

3. Procedure Steps:

• • Raise the bed height if needed.
  • Position the resident in the supine position (with the bed flat).
  • Place one of your hands under the resident’s knee with your palm facing up.
  • Place your other hand under the resident’s ankle with your palm facing up.
  • Watch for any objective signs of pain during movement.

Abduction/Adduction for Hip:

• • • Keeping the resident’s leg straight, gently move their entire leg away from their body (i.e., abduction).
    • Move their leg gently and stop if there is any resistance.
    • Ask the resident if they are experiencing any pain during movement.
    • Stop the ROM movement if the resident reports pain or displays objective signs of pain.
    • Keeping the resident’s leg straight, move their entire leg toward their body (i.e., adduction).
    • Complete abduction and adduction movements of the hip according to the order in their restorative care plan.
    • Continue to correctly support joints by keeping one of your hands under the resident’s knee and the other hand under the resident’s ankle.

Flexion/Extension of Knee and Hip:

• • • Bend the resident’s knee and hip up toward the resident’s trunk (i.e., flexion of hip and knee at the same time).
    • Move the resident’s leg gently and stop if there is any resistance.
    • Ask the resident if they are experiencing any pain during movement.
    • Stop the ROM movement if the resident reports pain or displays objective signs of pain.
    • Straighten their knee and hip (i.e., extension of knee and hip at the same time).
    • Complete flexion and extension movements of the knee and hip according to the order in the restorative care plan.

4. Post-Procedure Steps:

• • Perform hand hygiene.
  • Check on resident comfort and ask if anything else is needed.
  • Ensure the bed is low and locked. Check the brakes.
  • Place the call light or signaling device within reach of the resident.
  • Open the door and privacy curtain.
  • Perform hand hygiene.
  • Document and report ROM performed and any skin issues, pain with movement, or other changes noted with the resident.