Restorative Care and Range of Motion
Restorative care is about function - helping residents keep or regain what they can do instead of having it done for them.
Core concepts
- Restorative philosophy: encourage independence in eating, dressing, grooming, and walking; follow the care plan; use adaptive equipment consistently; and document what the resident actually did.
- Types of ROM: active (resident moves the joint), active-assistive (resident moves with your help), and passive (you move the joint). Perform exercises as written in the care plan - typically three to five repetitions - gently, slowly, and within the pain-free range.
- Movements: flexion, extension, abduction (away from midline), adduction (toward midline), rotation, and circumduction.
- Devices: gait belt for transfers and ambulation; cane on the unaffected side; walker lifted and placed forward, then the resident steps into it; wheelchair brakes locked, footrests up, and the chair backed down a ramp.
- Contracture and injury prevention: proper body mechanics, supporting joints, splints and hand rolls as ordered, and correct pillow positioning.
Traps
"Cane on the weak side" is the most common wrong answer. So is "push the joint just past resistance to improve range." Never force a joint, never continue when a resident reports pain, and never place a gait belt around the ribs or under the arms.
Rule of thumb
Cane on the good side. Stop at pain, report it, and try again next time.
Worked example
A resident had a stroke affecting the right side. The cane goes in the left hand. Going up a step, the strong leg moves first; going down, the weak leg moves first together with the cane.