MOBILITY AND EXERCISE

Group 4
 MOBILITY

• It refers to the ability to move joints and use

muscles easily and comfortably.
• It involves not only physical movement but
also the independence and freedom to
perform everyday activities without
assistance.
• It includes physical stamina, strength,
balance, coordination, and range of motion.
Mobility is often broken down into two
categories: functional mobility and joint
mobility.

Functional Mobility
• It is described as any basic movement a
person makes to perform the activities of
daily living.

Joint Mobility
• It is the ability for a specifi c joint to perform
a certain motion.
 FACTORS AFFECTING MOBILITY
1. PHYSICAL HEALTH

Musculoskeletal Health
• Conditions like arthritis, osteoporosis, and injuries can
limit movement.

Neurological Health
• Diseases such as Parkinson's, multiple sclerosis, and
stroke can impair coordination and balance.

Cardiovascular Health
• Heart conditions and poor circulation can reduce stamina
 FACTORS AFFECTING MOBILITY

2. MENTAL HEALTH

Cognitive Impairments
• Dementia and other cognitive disorders can affect the
ability to navigate environments.

Psychological Factors
• Depression, anxiety and fear of falling can reduce the
willingness to move.
 FACTORS AFFECTING MOBILITY

3. LIFESTYLE FACTORS

Physical Activity
• Regular exercise helps maintain strength, flexibility,
and balance.

Nutrition
• Proper diet supports overall health and physical
functioning.

Habits
• Smoking and alcohol consumption can negatively
 EXERCISE

• A type of physical activity that enhance or

maintains fitness and overall health.
• It is performed for various reasons,
including weight loss or maintenance, to aid
growth and improve strength, develop
muscles and the cardiovascular system,
hone athletic skills, improve health, or
simply for enjoyment.
 The purpose of exercise for the immobile
patient
• To increase and/or maintain movement in each joint.

• To prevent contracture, atony ( insufficient muscular

tone ), and atrophy of muscles.

• To stimulate circulation, preventing thrombus and

embolus formation.

• To improve coordination.

• To increase tolerance for more activity.

 Types of Exercises
Active
• Active exercises are performed by the patient, without
assistance, to increase muscle strength.

Resistive
• These are active exercises performed by the patient by
pulling or pushing against an opposing force.

Active Assistive
• These exercises are performed by the patient with
assistance from the nurse.
• Active assistive exercises encourage normal muscle
function while the nurse supports the distal joint.
 Types of Exercises
Passive
• These exercises are carried out by the nurse, without
assistance from the patient.
• Passive exercises will not preserve muscle mass or bone
mineralization because there is no voluntary
contraction, lengthening of muscle, or tension on bones.

Isometric
• These exercises are performed by the patient by
contracting and relaxing muscles while keeping the part
in a fixed position.
• Isometric exercises are done to maintain muscle
strength when a joint is immobilized.
 Types of Body Movement

Flexion
• The state of being bent.
Extension
• The state of being in a straight line.
Hyperextension
• The state of exaggerated extension.
Abduction
• Lateral movement of a body part away from the midline
of the body.
Adduction
• Lateral movement of a body part toward the midline of
the body.
 Types of Body Movement
Rotation
• Turning of a body part around an axis.

Circumduction
• Rotating an extremity in a complete circle.
• It is a combination of abduction, adduction, extension,
and flexion.

Supination
• The palm or sole is rotated in an upward position.

Pronation
• The palm or sole is rotated in a downward position.
 AMBULATION

• It is the ability to walk without the need for

any kind of assistance.
• It is most often used when describing the
goals of a patient after a surgery or physical
therapy.
• In order to reach a patient’s goal of
ambulation, they may require assistance
before they are able to walk around on their
own.
 The Importance of Ambulation
After a surgery, it is extremely important to get a patient
moving as soon as able. The technique of early
ambulation involves getting a patient up and out of bed as
soon as it is medically safe to do so after a procedure. The
activity will most likely be very light and may include:
• Sitting
• Standing
• Walking

It is important to get a patient to move around as soon as

able because body systems slow down after surgery.
Ambulating improves blood flow, which in turn can speed
 Assistive devices for ambulation

Walkers
• These are movable, lightweight
devices that consist of a metal
frame, two hand grips, and four
legs.
• Walkers provide great stability
due to their wide base, so they
are great for people who can
bear weight on their feet but
have trouble walking due to
weakness of the legs or balance
issues.
 Assistive devices for ambulation
Canes
• These are also movable, lightweight
devices made of a strong material
like wood or metal.
• Canes consist of a handle, a shaft,
and legs.
• There are single leg, triple leg or
quad leg canes, and the ones with
multiple legs provide more stability
but are also more cumbersome.
• Canes are used by clients who could
bear weight but have weakness in
one of their legs, like a stroke
 Assistive devices for ambulation
Crutches
• They are either single or paired and are used by people
who cannot bear weight on one or both legs.
• There are two common types of crutches: underarm or
axillary, and forearm crutches.
Axillary crutches
• It stretch from the armpits, or axilla,
to the ground.
• They provide better balance but
require more upper body strength to
use.
• They are often used temporarily, like
 Assistive devices for ambulation

Gutter crutches
• also known as platform crutches
• It is designed with a wide, flat
surface on the top of the crutch
that allows the user to place their
arm through the crutch rather
than gripping it with their hand.
• These crutches are often used by
people with limited hand function
or those who have had hand
surgery, as they do not require
gripping.
 GAIT

• Gait is defined as the walking pattern.

• It is further described as particular manner
of moving on foot which can be a walk, jog
or run.
 Four diff erent types of gait with
crutches
Four-point gait
• The right crutch moves forward, followed by the left leg.
Then the left crutch moves forward, followed by the
right leg.
 Four diff erent types of gait with
crutches
Three-point gait
• In a three-point gait, both crutches move forwards,
followed by the strong leg and then the weak leg.
 Four diff erent types of gait with
crutches
Two-point gait
• In the two-point gait, the left foot and right crutch
moves forward together, followed by the right foot and
left crutch.
 Four diff erent types of gait with
crutches
Swing-to gait
• For the swing-to gait, both crutches move forwards,
then using them as support, both legs are lifted and
swing to the crutches position.
 PATIENT POSITIONING

• Patient positioning involves properly

maintaining a patient’s neutral body
alignment by preventing hyperextension
and extreme lateral rotation to prevent
complications of immobility and injury.
 Common Patient Positions
Supine Position, or Dorsal Recumbent
• Supine position, or dorsal recumbent, is wherein the
patient lies flat on the back with head and shoulders
slightly elevated using a pillow unless contraindicated.
• Supine is frequently used on procedures involving the
anterior surface of the body (e.g., abdominal area,
cardiac, thoracic area).
• Supine position may put patients at risk for pressure
ulcers and nerve damage. Assess for skin breakdown
and pad bony prominences.
 Common Patient Positions
Fowler’s Position
• also known as semi-sitting position
• It is a bed position wherein the head of the bed is
elevated 45 to 60 degrees. Variations of Fowler’s
position include low Fowler’s (15 to 30 degrees),
semi-Fowler’s (30 to 45 degrees), and high
Fowler’s (nearly vertical).
• Fowler’s position is used for patients who have
difficulty breathing because, in this position, gravity
pulls the diaphragm downward, allowing greater chest
and lung expansion.
 Common Patient Positions
Orthopneic or Tripod Position
• This position places the patient in a sitting position or
on the side of the bed with an overbed table in front to
lean on and several pillows on the table to rest on.
• Patients with difficulty of breathing are often placed in
this position because it allows maximum chest
expansion.
• It is particularly helpful to patients who have problems
exhaling because they can press the lower part of the
chest against the edge of the overbed table.
 Common Patient Positions
Prone Position
• In prone position, the patient lies on the abdomen with
their head turned to one side and the hips are not
flexed.
• Prone position is the only bed position that allows full
extension of the hip and knee joints. It also helps to
prevent flexion contractures of the hips and knees.
• Prone position is the only bed position that allows full
extension of the hip and knee joints. It also helps to
prevent flexion contractures of the hips and knees.
 Common Patient Positions
Sims' Position
• This position is when the patient assumes a posture
halfway between the lateral and the prone positions.
The lower arm is positioned behind the client, and the
upper arm is flexed at the shoulder and the elbow. The
upper leg is more acutely flexed at both the hip and
the knee than is the lower one.
• Sims’ may be used for unconscious clients because it
facilitates drainage from the mouth and prevents
aspiration of fluids.
 Common Patient Positions
Lithotomy Position
• It is a patient position in which the patient is on their
back with hips and knees flexed and thighs apart.
• It is commonly used for vaginal examinations and
childbirth
 Common Patient Positions
Reverse Trendelenburg’s Position
• It is a patient position wherein the head of the bed is
elevated with the foot of the bed down. It is the
opposite of Trendelenburg’s position.
• It is often used for patients with gastrointestinal
problems as it helps minimize esophageal reflux.
 Common Patient Positions
Jackknife Position
• also known as Kraske,
• It is wherein the patient’s abdomen lies flat on the bed.
• The bed is scissored, so the hip is lifted, and the legs
and head are low.
• This position is frequently used for surgeries involving
the anus, rectum, coccyx, certain back surgeries, and
adrenal surgery.
 Support Devices for Patient
Positioning
Bed Boards
• are plywood boards placed under the mattress’s entire
surface area and are useful for increasing back support
and body alignment.
Foot Boots
• are rigid plastic or heavy foam shoes that keep the
foot flexed at the proper angle.
• It is recommended that they should be removed 2 to 3
times a day to assess the skin integrity and joint
mobility.
Hand Rolls
• Hand rolls maintain the fingers in a slightly flexed and
 Support Devices for Patient
Positioning
Hand-Wrist Splints
• These splints are individually molded for the client to
maintain proper alignment of the thumb in slight
adduction and the wrist in slight dorsiflexion.
Pillows
• provide support, elevate body parts and splint incision
areas, and reduce postoperative pain during activity,
coughing, or deep breathing. They should be of the
appropriate size for the body to be positioned.
Sandbags
• soft devices filled with substances that can be used to
shape or contour the body’s shape and provide support.
 Support Devices for Patient
Positioning
Side Rails
• Theses are bars along the sides of the length of the bed.
• They ensure client safety and are useful for increased
mobility.
• They also assist in rolling from side to side or sitting in
bed.
Trochanter Rolls
• These rolls prevent the external rotation of the legs when
the client is in the supine position.
• To form a roll, use a cotton bath blanket or a sheet folded
lengthwise to a width extending from the greater
trochanter of the femur to the lowest border of the
popliteal space.