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

​

Ref: K21

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