Exercises for Children with Neurological Conditions: Upper Limb Active Movement Exercises

Safety precautions when exercising

Upper limb active exercises

Exercising the upper limb joints helps to maintain flexibility of the arms and range of movement.

Active movement of the upper limb joints is important to maintain flexibility and range of movement. It also helps to improve strength and coordination of the upper limb and may reduce onset of pain in joints. Movement of the arms and hands can be encouraged through joint-specific active range of motion (AROM) exercises and participation in functional activities.

This handout serves as a guide to possible active movement exercises/activities for the upper limb. Do ensure that you have been taught the recommended exercises and exercise regime by your child’s Occupational Therapist before carrying them out.

Safety precautions when exercising

Ensure your child is positioned comfortably in standing, sitting or lying
Perform the movements slowly
Focus on getting your child to achieve the correct movement pattern – pace your child during exercises to encourage better control / coordination
Do not force the movement if the muscle or joint is stiff – move the arm within the safe range as recommended by your therapist
Maintain a sustained stretch at end range
Observe for signs of pain or discomfort – stop if pain occurs, and check in with your therapist before continuing further

Upper limb active exercises

Shoulder Flexion-Extension Keep elbow straight with thumb pointing out Raise arm up towards the head Lower the arm and straighten it behind the back
Shoulder Abduction-Adduction Keep elbow straight with palm facing down Raise arm to the side, away from the body and over the head Lower the arm back to side of body
Elbow Flexion-Extension Move hand towards shoulder, bending at the elbow To extend, slowly straighten the elbow
Forearm Pronation-Supination Position arm at the side with elbow bent Pronation: Turn forearm and wrist so that the palm is facing down Supination: Turn your forearm and wrist in the opposite direction so the palm is facing up
Wrist Flexion-Extension Position forearm on a stable, flat surface and with the wrist resting at the edge of the surface Flexion: Bend wrist downwards Extension: Bend wrist upwards
Thumb Flexion-Extension Flexion: Bend both thumb joints, bring tip of thumb towards palm Extension: Gently straighten out thumb
Fingers Flexion-Extension Flexion: Bend all fingers to form a full fist Extension: Gently straighten fingers out