Range of motion exercises

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Chincoteaguer

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246
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Loved one DX
Diagnosis
12/2017
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Us
State
Virginia
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Carrollton
We started range of motion exercises when my PALS became increasingly immobile. About 4 months ago.

We stopped these during a 5 day stay at the hospital and did not fully resume the exercises do to discomfort from recovery and stiffness in the legs.

We are now considering resuming these exercises even though we know they will be uncomfortable or painful.

Our paid caregiver, my daughter, and myself have differing opinions about the exercises and would appreciate any feedback from the forum.
 
I’d recommend restarting them but at a lower intensity than previously, and then gradually increasing as tolerated. E.g., maybe do each exercise half as long as previously and don’t push her as hard.

Flexion contractures with loss of range of motion can occur if someone doesn’t routinely take their joints through their full range of motion. And it’s easy to get out of a routine. People often use pain as a reason not to do range of motion, but this can result in more pain down the road.
 
With ALS, so many things can become uncomfortable and hurt. We both believe that ROM exercises are worth every second spent on them. With Darcey unable to move on her own, moving joints and stretching muscles is something she looks forward to each and every day. We do ours each morning as part of our "get up" routine.


My best...


Jim
 
Agree with above. With patience on both sides it can really help. My sister was able to reverse some contractures after a hospitalization through careful ROM with one off her caregivers. You do not say who is in favor of what. The person doing the ROM needs to be willing to take things slowly and not rush or push. I think you should consider asking for a PT or OT to come and review everything and set up a program for her current abilities and teach everyone how to do it. If it is your paid caregiver who is given the task remember it will take time to do properly and you might have to adjust other tasks - or might not
 
Agree that a PT familiar with ALS should vet the program, but some level of active and/or passive ROM is of value throughout, even if there is not pain and it is for circulation, and even if totally in bed.
 
It’s called workout fun
 
Hi Ernie, we had a similar situation. A PT had already given us the excersises previously which I think is a good way to start. What I tried to think about when I did them was like when I played sports, going to that point when you start to feel it and holding that for a bit but not pushing to pain just discomfort. I would watch my husband's face closely to see where the discomfort point was. Kate
 
Thanks all;

Your comments are appreciated and Chally, the video is awesome.

Sibyl is rarely out of her bed.

To some degree she experience ROM exercises with daily bathing , changing garments , and changing her position. We will be starting limited knee bends, leg spreads, and foot stretches today if discomfort is not too much.

She cannot move her arms above her neck and even with little exercise she has sporadic pain in her right shoulder.
 
Ernie,

I think it's important and productive to warm the muscles before you do range of motion. You can do that with several heating pads placed on the areas you will be moving.

I have a lot of pain in my joints. I notice that I can move them more freely when they are warm. Gently massaging the muscles is also a good way to warm them up, usually after you apply the heat. I wrap my feet with a heating pad, then massage them, then move each toe gently. Then I move on to the ankle, etc.

I agree a PT familiar with ALS would be very helpful in starting a program.
 
Don't try to move her arms above her neck at this stage. They should go no higher than shoulder level, or whatever she tolerates. You want to protect the joint.

Examples of moves that prevent/address contractures include supporting the elbow while you bend it, lifting the full arm at an angle vertically or laterally while supporting the shoulder, same with holding the wrist for wrist and finger exercise, etc. Always support the joints because the muscles that hold them in place are weak.

Second heat -- a low-voltage heated mattress pad can be placed under or on top of the mattress under the fitted sheet.
 
These are some videos I made of doing ROM with Chris - one huge tip - keep eye contact with your PALS and let them guide you on how far you can go. It should never hurt, and never stay in a place of discomfort. During a session you can usually increase movement towards the end as things warm and loosen, which is where that eye contact works. If you know your PALS well they don't need speech to be able to indicate what is good and what is getting uncomfortable :)

https://www.alsforums.com/forum/current-caregivers-cals/26580-massage-rom.html

We just kept adjusting the routine as he progressed.
 
thanks, tillie. really helpful and inspiring.
 
Chally you keep it up Brother!!
 
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