Mobility and Immobility
Yulian Wiji Utami, SKp.,MKes
Overview of Mobility
Mobility
Ability to engage in activity and free movement Walking, running, sitting, standing, lifting, pushing, pulling Activities of daily living (ADLs)
Overview of Mobility
Mobility
Enhances muscle tone, increases energy levels Mobility refers to a persons ability to move about freely. Immobility refers to a persons inability to move about freely
Overview of Mobility
Body
elements of body alignment, balance, and coordinated movement (stability). Range of motion reflects the extent to which a joint can move.
Mechanics involves the three basic
Physiology of Mobility
Musculoskeletal
System
Bones Joints Tendons Ligaments Bursa Cartilage
Physiology of Mobility
Nervous
Tells
System
Proprioception
us where our body is in space relative to other objects. postural tonus.
Postural Reflexes (righting)
Maintain
Exercise
Any
physical activity involving muscles that elevates the heart rate above resting levels Reduces joint pain and stiffness. Increases flexibility, muscle strength, and endurance. Weight reduction and improved sense of well-being
Exercise
Types
of Exercise
Aerobic, anaerobic Strengthening Isometric Isotonic Isokinetic
Exercise
Range-of-Motion
Exercise (ROM)
Passive Active
Shoulder ROM
Elbow Joint ROM
Wrist ROM
Hip Joint ROM
Knee Joint ROM
Ankle ROM
Factors Affecting Mobility
Health
Status Developmental Stage
Children Adolescents Adults
Environment
Lifestyle Attitude and beliefs
Mobility Problems: Deconditioning
Predisposing risk factors:
Prolonged
Disability
bed rest because of an acute illness
that limits or temporarily eliminates
mobility
Chronic Use
disease that causes a in activity
of certain medications factors
Psychosocial
Physiological Effects of Mobility and Immobility
Cardiovascular
Effects Respiratory Effects Musculoskeletal Effects Digestive Effects Elimination Effects Integumentary Effects
Deep Vein Thrombosis (DVT)
Assessment
Health
History
ADLs Exercise patterns Activity tolerance Medications Alteration in health status
Physical Examination
Musculoskeletal
Assessment
Movement and Gait Alignment Endurance
Musculoskeletal Assessment
Muscle
Impairments (common overuse injuries)
Strain Tendonitis Bursitis Sprain
Pathological Alterations
Postural
Abnormalities
Scoliosis Kyphosis Lordosis
Pathological Alterations
Contractures
Contracture deformities occur when a muscle group is not moved for a period of time or if proper body alignment is not maintained.
Pathological Alterations
Musculoskeletal
Trauma
Fractures Amputation
Pathological Alterations
Central
Nervous System (CNS)
Any disruption in the CNS can impair mobility. Spinal cord injury can lead to partial paralysis or complete loss of mobility.
Neurological Assessment
Cranial
Nerves Motor System Sensory System Reflexes
Functional Assessment
Focuses
on clients ability to perform ADLs.
Clients ability to feed, dress, toilet, move, transfer, and ambulate self independently, or with assistance
Nursing Diagnoses
Activity
Intolerance Impaired Physical Mobility Self-Care Deficits Risks for Falls
Planning and Outcome Identification
Realistic
Outcomes Consider Clients
Understanding of mobility status Health status in general Ability to solve problems
Planning and Outcome Identification
Interventions
Bed Rest Restorative Nursing Care Health Promotion
Implementation
Meeting
Psychosocial Needs Applying Principles of Body Mechanics Maintaining Body Alignment: Positioning
Fowlers Recumbent (supine) Prone Lateral Sims
Implementation
Range-of-Motion
Exercises
Performed several times a day. Each joint is placed through its full functional motion.
Implementation
Transfer
Techniques
Moving clients Logrolling the client Transferring from bed to chair Transferring from bed to stretcher
Implementation
Assisting
with Ambulation
Preparing the client to walk Client education Preambulating exercise
Assisting with Ambulation
Nurse
promotes safety of a client using a quad cane.
Assisting with Ambulation
Assistive
Devices
Canes Walkers Crutches
Evaluation
Transfer
of skills and knowledge from the acute care hospital or rehabilitation facility to home
Mobility status Activities of daily living capacity Use of appropriate adaptive devices Clients ability to function within his or her own environment
Evaluation
Ongoing
assessment in the home setting is important because compliance with home exercise programs may lessen over time after discharge.
