Range of Motion — Lower Extremities (Hip, Knee, Ankle) — Practice Checklist

Step-by-Step Procedure (16 steps)

1. 1.

   Wash hands.

2. 2.

   Identify the resident and explain the procedure.

3. 3.

   Raise the bed to a comfortable working height; lower the side rail on the working side.

4. 4.

   Position the resident supine with legs straight.

5. 5.

   Expose only the leg being exercised; keep the resident otherwise draped.

6. 6.

   Hip flexion/extension: support the leg at the knee and ankle; lift the leg, bending the knee and bringing it toward the chest (hip flexion), then return to flat (extension). Perform 3–5 repetitions.

7. 7.

   Hip abduction/adduction: keeping the leg straight, move it out to the side (abduction), then return it to the midline (adduction). Perform 3–5 repetitions.

8. 8.

   Hip internal/external rotation: with the leg straight, roll the leg inward (internal rotation) then outward (external rotation). Perform 3–5 repetitions.

9. 9.

   Knee flexion/extension: support the thigh and ankle; bend the knee, bringing the heel toward the buttocks (flexion), then straighten (extension). Perform 3–5 repetitions.

10. 10.

    Ankle dorsiflexion/plantar flexion: support the lower leg; gently push the foot upward toward the shin (dorsiflexion), then point the foot downward (plantar flexion). Perform 3–5 repetitions.

11. 11.

    Ankle eversion/inversion: turn the sole of the foot outward (eversion), then inward (inversion). Perform 3–5 repetitions.

12. 12.

    Toe flexion/extension: gently curl the toes (flexion) then straighten them (extension). Perform 3–5 repetitions.

13. 13.

    Never force any joint; stop at the point of resistance or if the resident reports pain.

14. 14.

    Reposition the resident comfortably after completing all lower extremity exercises.

15. 15.

    Lower the bed; raise the side rail.

16. 16.

    Wash hands and document.

Evaluator Pass Criteria (5 checkpoints)

All of these must be observed for you to pass this skill.

• Leg is supported at the knee and ankle for all movements.

• All joints are exercised: hip, knee, ankle, and toes.

• Movements are slow, smooth, and controlled.

• Candidate stops if the resident reports discomfort.

• Each motion is repeated 3–5 times.

Critical Mistakes — Avoid These

• ⚠

  Supporting only the ankle without supporting the knee — this strains the joint.

• ⚠

  Forcing the leg past natural resistance.

• ⚠

  Forgetting the ankle inversion/eversion movements.

• ⚠

  Moving too fast and losing control of the heavy lower extremity.

• ⚠

  Not covering the resident adequately during the exercise, compromising privacy.