Mobility/Activity PDF

Mobility/Activity Dr. Paola Reyes, DNP, PHN, CMSRN, CHEP 1 Copyright 2022 Assessment Technologies Institute, L.L.C.  Mobility...

Mobility/Activity Dr. Paola Reyes, DNP, PHN, CMSRN, CHEP 1 Copyright 2022 Assessment Technologies Institute, L.L.C.  Mobility 2 Copyright 2022 Assessment Technologies Institute, L.L.C.  Mobility Another way to say motion or movement. Our bodies are designed for motion and require the muscles, skeleton, and nerves to function in unison. A nursing goal is to assist in preserving, maintaining, and restoring as much mobility and function as possible. The ability to walk from place to place independently is ambulation. 3 Copyright 2022 Assessment Technologies Institute, L.L.C.  Musculoskeletal The word musculoskeletal is a general term used when referring to the muscles and the skeleton. 4 Copyright 2022 Assessment Technologies Institute, L.L.C.  The Muscular System Comprised of the muscles which provide the motor power or force for movement. More than 600 muscles in the human body. Accounts for half a person’s weight. When contracted across a joint, creates a force to pull against the skeleton. Is always working and has a high demand for oxygen and glucose, making it difficult to build and maintain muscles. 5 Copyright 2022 Assessment Technologies Institute, L.L.C. The Four Properties of a Muscle (CEEE) C: Contractibility: the ability to shorten (contract) and then relax. E: Excitability: muscle fibers can receive and respond to nerve or hormone stimulation. A resting muscle is negatively charged. When stimulated (excited), it becomes positively charged and active. E: Extensibility: the ability to stretch (extend), which occurs simultaneously as other muscles contract. E: Elasticity: the ability to bounce back or recoil to its original state after being contracted or extended. 6 Copyright 2022 Assessment Technologies Institute, L.L.C. Three Main Muscle Types Cardiac: only located in the heart and functions involuntarily. Smooth: located in the blood vessels and the visceral organs and functions involuntarily. Skeletal: attached to the skeleton (bones) by tendons and functions voluntarily. 7 Copyright 2022 Assessment Technologies Institute, L.L.C. Functions of a Muscle: Useful Mnemonic M: muscles C: contract and P: pull to G: generate M: movement 8 Copyright 2022 Assessment Technologies Institute, L.L.C. The Skeletal System Made up of 206 different bones. Bones are hard connective tissue that provide the rigid structure and shape of the human body. Bones are the weight-bearing organ of the body. Bones mechanically protect and support internal organs and muscles and store important minerals. Bones are not solid structures but are, instead, composed of layers. Gives the body shape and structure but cannot move on its own. 9 Copyright 2022 Assessment Technologies Institute, L.L.C.  Classifications of Bones Long: weight-bearing bones of the skeleton that are greater in length than width. Short: small, cube-shaped bones found in the wrists and the ankles. Flat: thin, flat, and slightly curved bones in the skull, ribs, sternum, and shoulder that protect the brain and the internal organs. Irregular: a unique shape unlike the other patterns, found in the face, ears, vertebrae, sacrum, and coccyx. Sesamoid: formed within a tendon and protect the tendon from joint stress and strain. These bones include the patella and the carpals in the hands and feet. 10 Copyright 2022 Assessment Technologies Institute, L.L.C.  Remodeling Once bones have matured, they undergo the process of remodeling where old bone is constantly being replaced with new bone. 11 Copyright 2022 Assessment Technologies Institute, L.L.C.  Cartilage Cartilage is a firm, yet flexible connective tissue found in many areas such as the ears, nose, larynx, ribs, intervertebral discs, knees, and ankles. 12 Copyright 2022 Assessment Technologies Institute, L.L.C.  Types of Movements Flexion: bend; reduces the angle between the bones Extension: straighten the limb Abduction: move away from baseline Adduction: bring closer to baseline Pronation: turning to face backwards Supination: turning to face forward Circumduction: circular motion Rotation: side-to-side Inversion: turn inward Eversion: turn outward Dorsiflexion: draw toes upward toward the body Plantarflexion: point toes downward away from the body 13 Copyright 2022 Assessment Technologies Institute, L.L.C.  Body Mechanics Involves the combined effort from the musculoskeletal and nervous systems to maintain posture, alignment, and balance in daily life. The correct use includes knowledge in the coordination of efficient body movement and the integrated function of the musculoskeletal and nervous systems to maximize strength and minimize strain. Proper body mechanics is good posture in motion. 14 Copyright 2022 Assessment Technologies Institute, L.L.C.  Types of Postural Misalignments Lordosis: lower back significantly curves inward with the pelvis tilting anteriorly. Kyphosis: upper back is abnormally rounded with a forward tilt in the pelvis. Flat back: a loss in the curvature to the spine referred to as straight back. Sway back: the back extends backward while the lower back abnormally curves inward and the pelvis tilts forward, positioning the head in front of the pelvis; results from loss of muscle tone in the abdomen and lower back, which allows the spine to sag. Scoliosis: C- or S-shaping of the spine. 15 Copyright 2022 Assessment Technologies Institute, L.L.C.  Immobility is an inability to move one or more body parts. Prolonged immobility is detrimental to the body, Immobility negatively affecting all major systems in a critical cascade to dependency. The initial impacts of immobility on joints are stiffness, pain, and limited range of motion, especially in the shoulders, elbows, hips, knees, and ankles. Prolonged immobilization causes the formation of fibrofatty connective tissue and abnormal adhesions within and between the joint space, which restricts nourishment to joints. Prolonged bedrest, standing, or sitting causes the blood flow to slow (venous stasis), increasing the risk for blood clots. 16 Copyright 2022 Assessment Technologies Institute, L.L.C.  Assessment of Mobility Activity intolerance is an inadequate amount of physical or physiological energy to undergo or complete a necessary activity. Activity tolerance is the capacity to successfully complete a necessary activity without distress. Activities of daily living (ADL) are basic essential skills that a person does independently every day and are usually related to personal care. 17 Copyright 2022 Assessment Technologies Institute, L.L.C. Proper Positioning The process of intentionally placing the body or a body part in a specific way. Involves aligning the body in a neutral position, supporting the body’s natural curves, and eliminating pressure points, hyperextension, or lateral rotation. Goals for client positioning and alignment consist of the two Ps, promotion and prevention. 18 Copyright 2022 Assessment Technologies Institute, L.L.C.  Proper Body Mechanics Differentiate between proper and improper body mechanics when performing movement/activity with the client. 19 Copyright 2022 Assessment Technologies Institute, L.L.C.  References Holman, H. C., Williams, D., Johnson, J., Sommer, S., Ball, B. S., Morris, C., Leehy, P., Hertel, R., & Assessment Technologies Institute (Contributors). (2019). Fundamentals for nursing: Review module (10th ed.). Assessment Technologies Institute. Taylor, C., Lynn, P. 1., & Bartlett, J. L. (2023). Fundamentals of nursing: the art and science of person-centered nursing care. 10th edition. Philadelphia, Wolters Kluwer. 20 Copyright 2022 Assessment Technologies Institute, L.L.C.