Range of motion therapy refers to a form of physical therapy designed to stretch the muscles, keep the joints flexible, decrease pain, and lessen the development of contractures. This type of physical therapy may be appropriate for many individuals with neuromuscular disease, even those who cannot engage in more strenuous forms of physical therapy or exercise.

The traditional view of physical therapy generally emphasized active exercises that were meant to improve functioning. Range of motion therapy works, however, towards maintaining as much function and quality of life for individuals as possible. This type of physical therapy often requires assisted movement with the help of a physical therapist or caregiver. Unfortunately, some individuals might have difficulty with arranging for third-party payment for range of motion therapy through their insurance carriers.

In some types of degenerative neuromuscular diseases, especially those in which can be worsened by strenuous exercise stretching and range of motion exercises have been recommended as the safest type of exercise. This includes some of the metabolic muscle disorders (including phosphorylase deficiency and McArdle’s disease), periodic paralysis, and some of the muscular dystrophies (including Duchenne muscular dystrophy, and some limb-girdle dystrophies) and at least one of the congenital dystrophies.

Concerns about possible negative effects of over-exercise have also been raised for many of the other neuromuscular diseases. There remains a need for research into the effects of exercise for those with neuromuscular disease.

Range of motion exercises can be provided by a physical therapist, and may often be continued at home by a caregiver in between visits. For individuals in the U.S. searching for a qualified physical therapist, the American Physical Therapy Association (APTA) maintains a searchable database of physical therapist members (see Resources for web address). Individuals worldwide may wish to visit the World Confederation for Physical Therapy for more information about global physical therapy resources.

For examples of range of motion exercises for the arms, shoulders, elbows, wrists, fingers, hips, ankles and toes, see the Muscular Dystrophy Association webpages Passive Range-of-Motion and Range-of Motion Exercises given below in Resources. While these exercises are part of Everyday Life with ALS: A Practical Guide, the descriptions and illustrations will provide examples of what this type of therapy entails. Before starting range of therapy exercises, however, make sure to speak with your physician and/or consult with a physical therapist.

Resources:
APTA, (n.d.). Find a PT. American Physical Therapy Association website. Retrieved on 8/10/15 from http://www.apta.org/apta/findapt/index.aspx?navID=10737422525 .

MDA, (2010). Passive Range-of-Motion. In Everyday Life with ALS: A Practical Guide. Retrieved on 8/10/15 from htp://www.mda.org/publications/everyday-life-als/chapter-9/passive-range-motion . .

MDA, (2010). Range-of-Motion Exercises. In Everyday Life with ALS: A Practical Guide. Retrieved on 8/10/15 from http://www.mda.org/publications/everyday-life-als/chapter-9/range-motion .

Slasky, A.J., and McDonald, C.M., (2012). Prevention and Management of limb contractures in neuromuscular diseases. Physical Medicine Rehabilitation Clinics of North America, 23(3), pp. 675-687. Full article available at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482407/ .

Wahl, M., (2000). Physical Therapy: Flexibility, Fitness and Fun. Quest. Retrieved on 8/10/15 from http://quest.mda.org/article/physical-therapy-flexibility-fitness-and-fun .

Wahl, M., (2009). Recommended Exercises in Muscle Disease. Quest, 16:2. Retrieved on 8/10/15 from http://quest.mda.org/series/exercising-muscle-disease-series/recommended-exercises-muscle-disease .

Wahl, M., (2009). What Kind of Exercise Can be Done By… Quest, 16:2. Retrieved on 8/10/15 from http://quest.mda.org/series/exercising-muscle-disease-series/what-kind-exercise-can-be-done .

wcpt.org, (n.d.). World Confederation for Physical Therapy website. Retrieved on 8/10/15 from http://www.wcpt.org/ .