Mobility, Exercise, and

Patient Care

Presented By:
Inara Ishrat (RN, RM, POST-RN)
Nursing Instructor ACON
 Objectives
1.Define terms mobility, joint mobility, body alignments and body
mechanics.
2.Discuss the benefits of activity and exercise.
3.Identify the principles of gravity that affect balance.
4.Discuss factors affecting mobility.
5.Discuss the effects of immobility on the human body.
6.Describe the impact of immobility on Physiologic and Psychological
functioning.
7.Apply the nursing process while planning for the client with an altered
musculoskeletal system.
Activity Exercise Pattern
Activity Exercise Pattern means a person's daily routine that includes
exercise, physical activities, fun, and relaxation time. It covers two main
parts:

(a) Activities of Daily Living (ADLs): (b) Exercise and Leisure Activities:
These are daily tasks that need energy, This includes activities done for fitness
like: and fun, such as:
● Keeping yourself clean (hygiene)
● Exercise (like walking, jogging,
● Getting dressed (dressing)
● Cooking food going to the gym)
● Playing sports (like cricket,
● Shopping for things
● Eating meals football, badminton)
● Dancing, yoga, swimming, etc.
● Going to work
● Cleaning and maintaining the Here we look at the type of exercise
home (what kind), the quality (how well it is
These are regular activities that we all done), and the quantity (how much
do every day. time is spent).
 Mobility
Refers to the ability to engage in activity and free movement. Which
includes walking, running, sitting, standing, lifting, pushing,
pulling and performing ADLs (Activities of daily life)

The ability to move freely, easily, rhythmically and purposefully in

the environment.
Anatomy And
Physiology
The musculoskeletal system
consist of:
•Framework of bone
•Joints
•Skeletal muscles
•Cartilage, tendons and
ligaments

5
 Ligaments & Tendons
• Ligaments are Tough fibrous bands that bind joints together and connect
bones and cartilages.
• Tendons are strong, flexible, fibrous band that attach muscles to bone
• Cartilages are non vascular connective tissues found in the joints as well
as in the nose, ear, trachea and larynx.
Normal Body Movement
• Normal body movement are the result of an intact
musculoskeletal system, an intact nervous system and intact
inner ear structures responsible for equilibrium.
• Body movement requires coordinated muscles activity and
neurological integration.
• The four basic elements of normal body movement are body
alignment (posture), joint mobility, balance and coordinated
movement.
 Body Alignment /Posture
It promotes optimal balance and maximal body function whether the
client is standing, sitting or lying down.

Body is well aligned when strain on the joints, muscles, tendons, or

ligaments is minimized and internal structures and organs are
supported.
 Joint Mobility
• Movement of joints
• Joints: Two bones articulate to form joint
• Range of Motion (ROM): it is the maximum movement of a
joint

9
 Balance
• Stability produced by even distribution of weight
on each side of the vertical axis.

Principle of Gravity That Affect Balance :-

- Line of gravity
- Centre of gravity Maintain balance
- Base of support

• Physical equilibrium

10
 Types of Joint Movement
❖Extension: Increasing the angle of the joint
“straightening the arm at the elbow”.

❖Flexion: Decreases the angle of the joint

“bending the elbow”.

❖Hyperextension: Further extension or

straightening of a joint “bending the head
backward”.
 Types of Joint Movement
❖Abduction: Movement of the bone away
from the midline of the body.

❖Adduction: Movement of the bone toward

the midline of the body.

❖Rotation: Movement of the bone around

its central axis.

ASSIGNMENT
What is difference b/w rotation and
circumduction?
 Types of Joint Movement
❖Pronation: Pronation is when your palms
face downward.

❖Supination: Supination is when your palms

face upward.

❖Everson: Turning the sole of the foot

outward by moving the ankle joint.

❖Inversion: Turning the sole of the foot

inward by moving the ankle joint.
 Types of Exercises

Aerobic Exercise Anaerobic

exercise

15
 Types of Exercises
• Aerobic exercise: is activity during which the amount of oxygen
taken in the body is greater than that used to perform the activity.
An example walking, jogging.
• Anaerobic exercise: Involves activity in which the muscles cannot
draw out enough oxygen from the bloodstream e.g. sprinting,
push-ups.

16
 Benefits of Activity and
Exercise on Major Body Parts
1. Musculoskeletal system
• Increased muscle efficiency strength and flexibility.
• Increased coordination, stability, gait & posture.
• Increased efficiency of nerve impulses transmission.
• Maintained bone density and strength.

2. Cardiovascular system
• Meet the demands for oxygen
• Increased blood flow to all body parts
• Improved heart rate, improved circulation
• Decreased cholesterol level
Benefits of Activity and Exercise
on Major Body Parts
3. Respiratory system
• Increase oxygen available to the muscles.
• Increase depth, rate of gas exchange, rate of CO2 excretion.
• Improved pulmonary functioning.
• Decreasing breathing efforts and risk of infection.
4. Gastrointestinal system
Exercise leads to:
• Increased intestinal tone, facilitating peristalsis.
• Improve digestion and elimination.
• Improve the appetite.
5. Metabolic system
Exercise leads to:
• It elevated the metabolic rate, thus increasing the production of body heat
and waste products and calorie use.
• Reduce level of serum triglycerides and cholesterol.
 Benefits of Activity and
Exercise on Major Body Parts
6. Urinary system
• Regular exercise increase blood circulation including improved blood
flow to the kidneys which allows the kidneys to maintain the body’s
fluid balance and acid-base balance more efficiency and to excrete
body waste.
7. Skin and Psychosocial
• Regular exercise increase circulation which lead to promote good
health and skin.
• Psychosocial outlook: regular exercise have psychological effects such
as increased energy, improve sleep, body image, improve self-
concepts and increased positive health behaviors, improve general
well being.
Factors Affecting Body Alignment
and Activity
• Growth and Development Age and body growth affect how we
move. (Children, adults, and older people move differently.)

• Physical Health If someone is sick or injured, they can’t move

properly. (Healthy people are more active.)

• Mental Health Stress or depression can make people feel tired

or lazy. (This reduces movement and affects posture.)

• Life style Active people move more and have better posture.
(Sitting too much makes muscles weak.)
 Effects of Immobility on major
body systems
• Osteoporosis (the bones become spongy and may gradually deform
and fracture easily).
• Muscles losing most of their strength and normal function.
• Contractures (limiting joint mobility
• Dependent edema
• Thrombus formation
• Constipation
• Urinary retention
• Urinary infection
• Skin breakdown
 Safe Practice for Positioning,
Moving, Lifting, Ambulating Clients
• Correct body mechanics required for nurse to prevent injury.
• Correct body alignment for the client also so that undue stress is not placed on
the musculoskeletal system.

22
 General Guidelines for Moving and
Lifting
• Before moving, assess.

• If indicated, use pain relief modalities.

• Prepare any needed assistive devices.

• Be alert to the effects of any medications.

• Obtain required assistance.

• Explain the procedure to the client.

23
 General Guidelines for
Transferring a Client
• Plan what to do and how to do it
• Obtain essential equipment before
starting
• Remove obstacles
• Explain transfer to client and assistive
personnel
• Support or hold client rather than
equipment
• Explain what client should do
• Make written plan, including client’s
tolerance

24
 General Guidelines for
Ambulating
• Assess the amount of assistance the client will require
• Assess for signs and symptoms of orthostatic hypotension
• Prepare client for ambulation
• Apply transfer or walking belt
• Physically support client
• Obtain assistance to follow with wheelchair or assist with physical support
• Teach client to correctly use mechanical aids

25
Let’s Recall Nursing
Process
 References
• Cox,c.c,hinz,MD,et.al(2002)clincal application of nursing
diagnosis:adult,child,women & psychiatric consideration.philadelphia:FA
Davis.

• Carpienito.L.j.(2003).nursing diagnosis: Application to clinical

practice.philedelhia:Lipinocott.

• Gulanik,M.,&myers,j.L.et.al.(2003).nursing care plans nursing diagnosis

and intervension.USA:Mosby.

• Marilynn E.D. (2006).nursing care plan, Guideline for individualizing

Client care across the life span.philadelphia:F.A.DAVIS