对一侧肩关节进行被动关节活动度练习怎么做
Passive shoulder range of motion has you move the resident's arm through its motions while they stay relaxed. The idea that makes it click: hold the arm at both the elbow and the wrist so the shoulder is fully supported, move slowly, and stop the moment you feel resistance — you guide the joint, you never force it.
分步操作
- 1
Greet the resident by name, wash your hands, introduce yourself, explain the exercise, and provide for privacy.
- 2
Position the resident comfortably (supine or as ordered) with the shoulder to be exercised accessible.
- 3
Tell the resident to report any pain or discomfort before you begin, and ask again during the movements.关键
- 4
Exercise only the correct joint on the correct side — the assigned shoulder.关键
- 5
Support the arm at the elbow and the wrist throughout every motion.关键
- 6
Shoulder flexion: keeping the arm straight, slowly raise it up alongside the head toward the head of the bed.
- 7
Shoulder extension: slowly lower the arm back down to the mattress at the resident's side.
- 8
Shoulder abduction: move the straight arm out and away from the body.
- 9
Shoulder adduction: bring the arm back in toward the side of the body; repeat each motion the required number of times (commonly 3-5) unless the resident reports pain.
- 10
Keep all movement smooth, slow, and non-forceful, and stop at the point of pain or resistance — never force the joint.关键
- 11
Return the arm to a comfortable position, ensure comfort and safety, place the call light within reach, wash your hands, and report any pain, resistance, or skin changes.
关键步骤(千万别漏)
- Support the arm at both the elbow and the wrist during every motion.
- Move slowly and gently and stop immediately at pain or resistance — never force.
- Instruct the resident to report discomfort before AND during the exercise (NNAAP scores this verbalization).
- Perform the tested motions: shoulder flexion/extension and abduction/adduction, on the correct side.
常见错误
- Holding only the wrist or only the elbow, leaving the shoulder unsupported.
- Bending the arm during flexion or abduction instead of keeping it straight.
- Forgetting to tell the resident to report pain or discomfort before and during.
- Rushing the movements or pushing past resistance.
为什么这样做
The shoulder is the body's most mobile and least stable joint, so supporting the arm at both the elbow and the wrist keeps the whole lever controlled and the motion inside the joint instead of yanking it. Keeping the arm straight makes each named motion (flexion, abduction) true to its range, and moving slowly with a stop at resistance protects a relaxed shoulder from strain — which is exactly why support, straight-arm, and the discomfort cue are the scored points.