Exercises for Children with Neurological Conditions: Upper Limb Stretching Exercises

Your exercise guide

Upper limb stretching exercises help to maintain flexibility and range of movement in upper limbs.

Stretching exercises or passive range of motion (ROM) exercises are important to maintain flexibility or range of movement in the upper limb joints for children with long-term neurological conditions. It also assists with overall circulation and creates awareness of the arms.

The exercises below serve as a guide to the various stretches of the upper limb. Do ensure that you have been taught the recommended exercises and exercise regime (i.e. number of repetitions/sets and exercise frequency) by your child’s Occupational Therapist before carrying them out.

Safety precautions when exercising

Ensure your child is positioned comfortably in either sitting or lying position
Support your child’s arm as per exercise guide (above and below the joint you are moving) – hold firmly but do not squeeze the arm tightly

Keep your movements slow to allow muscles to relax; moving quickly may increase stiffness
Do not force the movement if the muscle or joint is stiff – move the arm within the safe range as recommended by your therapist
Observe for signs of pain or discomfort – stop if pain occurs, and check in with your therapist before continuing further

Your exercise guide

Shoulder Flexion-Extension Support your child’s arm by holding: Above the elbow, and At the wrist or hand Lift your child’s arm up and stop Lower the arm back down
Shoulder Abduction-Adduction Support your child’s arm and wrist Move the arm out to the side, towards the head Reposition the arm to the side of the body
Shoulder Horizontal Abduction-Adduction Support your child’s elbow and wrist Move your child’s arm across the chest towards the opposite shoulder Bring the arm back down to the side
Shoulder Internal-External Rotation Support your child’s elbow and hand/wrist with the arm positioned to the side, ensure elbow is bent at 90 degrees and fingers are pointing up Gently move the hand/wrist down so that palm is facing down Bring the hand/wrist back up, towards the head, so that palm is facing up	Internal rotation External rotation
Elbow Flexion-Extension Support your child’s arm by holding: Above the elbow, and At the wrist or hand Move your child’s hand towards the shoulder, bending at the elbow To extend, slowly straighten the elbow
Forearm Pronation-Supination Support your child’s elbow with one hand, and wrist with your other hand Gently turn forearm and wrist together so that palm is facing down Gently turn forearm and wrist in the opposite direction so that palm is facing up
Wrist Flexion-Extension Support your child’s forearm near his/her wrist With your other hand, move your child’s hand up to extend his/her wrist Then move his/her hand down to bend the wrist
Wrist Radial-Ulnar Deviation Support your child’s forearm near his/her wrist With your other hand, move your child’s hand to the right Then move his/her hand in the opposite direction, to the left
Thumb Abduction Support your child’s hand and fingers with one hand With your other hand, stabilise the base of your child’s thumb Gently move the thumb outwards, away from the palm
Fingers Flexion-Extension Support your child’s wrist with one hand With your other hand, gently bend your child’s fingers towards the palm Gently straighten fingers out