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the ability to move freely within the environment and is fundamental to everyday function.
Independence is defined by
the persons ability to perform ADL's, job-related activities, and role-related activities such as parent or spouse.
Movement is significant in diffusing
negative feelings and tension
full mobility occurs when a person has
no physical or psychological factors that limit mobility
immobility occurs when
the person cannot move his or her entire body or a specific body part.
Clients move along this continuum as their abilities change:
- Therapeautic treatments such as traction to repair a fracture may impair mobility.
- some conditions lead to progressive diability
maintaining upright posture requires
proper alignmentof the bones, muscles, and joints and a stable center of gravity
In a balanced center of gravity
the weight of the body is centered and the downward forces of gravity of are balanced, The usual line of gravity starts at the top of the head and bisect the shoulders, trunk, weight bearing joints, and base of support. It runs slightly anterior to the sacrum.
In an older person the center of gravity moves to :
the lumbar spine tends to flatten and the upper spine and head tilt forward causing the head to fall forward from the usual line of gravity.
if a person begins to fall to one side the extensor muscles:
on that side stiffen and the opposite side relax to prevent falling.
the crebellum coordinates
the motor activites of movement
the cerebral cortex initiates
voluntary motor activity
the basal ganglia maintain
body mechanics can be defined as
using alignment, posture, and balance in coordinated effort to perform activities such as bending, lifting, and moving.
some general rules for body mechanics include the following:
- 1: assess the situation carefully before acting.
- 2.use the legs large muscle group whenever possible to provide the force of movement.
- 3. perform work at the appropriate height for body position.
- 4. use a mechanical lift or assistance whenever needed for ease to move.
aerobic exercise requires
oxygen to use the energy provided by the metabolic acivities of skeletal muscles.
anaerobic exercise occurs when
the muscle cannot extract enough oxygen from the blood and anaerobic pathways provide additional energy for a short time.
isotonic exercise is a dynamic form of exercise with
constant muscle tension, muscle contraction, and active movement.
isometric exercise is static exercise by which the client
tenses a muscle, holding stationary while maintaining tension.
range of motion (ROM) is the ability to
move all joints through the full extent of intended function. Each joint must be kept actively moving for the joints to maintain mobility, muscles to maintain strength, and the cardiovascular system to function properly.
The normal walking gait has the following two phases:
- the stance phase is composed of three events: heel strike, midstance, and push-off.
- the swing phase completes the walking gait with another three events: acceleration, swing through, and deceleration.
The maxim "use it or lose it" means
the person must use it regularly to maintain funtion.
Conditining is promoted by
30 minutes of strenuous exercising three times a week.
The following influence muscle strength:
fluid and electrolyte levels, exercise, conditioning, nutrition and condition of tendons, ligaments, or soft tissue.
the following are essential to maintaining bone resiliance and an intact skeletal system:
adequate dietary calcium, phosphorus, and vitamin B.
demineralizaton of bones such as osteoporosis increases
the risk of fractures
rheumatoid arthritis, degenerative joint disease (osteoarthritis), and gout
limit mobility cause it causes pain.
A client must be placed on bedrest for the following reasons:
- to promote healing a tissue repair by decreasing metabolic needs
- to relieve edema (swelling)
- to reduce the body's oxygen requirements
- to decrease pain
- to support a weak, exhausted, or febrile client
- to avoid dislodging a deep vein thrombosis
the client with altered mobility may have the following symptoms:
- decreased muscle strength and tone
- lack of coordination
- altered gait
- decreased joint flexibility
- pain on movement
- decreased ability to tolerate activity
decreased muscle tone
increased muscle tone
impaired muscle coordination
rhythmic repetitive movement that can occur at rest or when movement is initiated.
spontaneous, brief, involuntary muscle twitching in the limbs or face.
movement characterized by slow irregular twisting movements
similar to athetosis but involves larger areas of body.
an ataxic gait is
staggering and unsteadiness
spastic gait is
walking appears stiff and toes appear to catch and drag.
waddling gait is
walking with feet wide apart in a ducklike fashion
hemiplegic gait is when
one leg is paralyzed or neurologically damaged so the leg is dragged or swung forward to propel it forward
festinating gait is
walking on the toes as if being pushed, common in parkinson's disease.
a contracture is
the progressive shortening of a muscle and loss of joint mobility resulting from fibrotic changes in tissues surrounding the joint.