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

Ref: K21