Re: Second request.... ROM: Rena and others please respond

[carol maher]

Title: Second request.... ROM: Rena and others please respond

I agree that this is one of the very confusing parts of the manual that needs further clarification.  I do not include passive range of motion in my assessment of Functional range of motion.  Looking at the example on page 3-111, it discusses a resident with flaccid hemiparesis and shows that the resident has a limitationin functional range of motion on one side.  Since we are measuring the function and not the actual range of the joints, I do not code that a hemiplegic resident has full range on both sides if I can range their joints passively.  I am looking for limitations that interfere with daily functioning or places a resident at risk of injury.  I think that a hemiplegic resident shows a limitation that interferes with daily functioning.  I wish the instructions for G4 a and b were more clear. 


-----Original Message-----
From: [EMAIL PROTECTED]
Sent: Nov 3, 2003 6:57 AM
To: [EMAIL PROTECTED]
Subject: Second request.... ROM: Rena and others please respond

How is everyone coding ROM.  I was always under the impression that Passive ROM could be used when coding G4 after reading the section below I'm not so sure???

On page 3-108 of the RAI Manual it states "For Item G4a, a resident who is unable to follow your verbal instructions or a demonstration of movements can be actively assisted in range of motion exercises to assess for limitations.  Move the resident's joints through low, active assisted ROM by providing support and direction with each activity."  It also states " If resident is still unable to perform the activity after your demonstration, move the resident's joints through slow, active assisted range of motion to assess for limitations.  In active/assistive range of motion exercises, the health professional provides support and direction with the resident performing some of the activity." 

Given this information I am assuming that passive ROM can not be used when coding G4.

However.... on page 3-109 of the RAI manual it states:
" For each body part, code the appropriate response for the resident's active (or assistive/passive)range of motion function during the past seven days." 

Given this information I am thinking that Passive ROM can be used in coding this section. 

What is your take on this section?  What are others doing? The information appears to be conflicting.  I just want to know what is correct.

Thanks in Advance
Diane R. Wierenga RN BSN RAC-C

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