CHAPTER 44 - ACTIVITY AND EXERCISE

Activity-exercise pattern - person’s routine of exercise, activity, leisure, and recreation

Mobility - ability to move freely, easily, rhythmically, and purposefully in the environment, is an essential part of living

Line of gravity - imaginary vertical line drawn through the body’s center of gravity

Center of gravity - point at which all of the body’s mass is centered

Base of support - foundation on which the body rests

Extensor muscles (antigravity muscles) - carry the major load as they keep the body upright

Range of motion (ROM) of a joint is the maximum movement that is possible for that joint

Types of joint movements:

Flexion - Decreasing the angle of the joint (e.g. bending, the elbow)

Extension - Increasing the angle of the joint (e.g. straightening the arm at the elbow)

Hyperextension - Further extension or straightening of a joint (e.g., bending the head backward)

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

Circumduction - Movement of the distal part of the bone in a circle while the proximal end remains fixed

Eversion - 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

Pronation - Moving the bones of the forearm so that the palm of the hand faces downward when held in front
of the body
 Supination - Moving the bones of the forearm so that the palm of the hand faces upward when held in front
of the body

Proprioception - describe awareness of posture, movement and changes in equilibrium and the knowledge of position, weight,
resistance of objects in relation to the body

Osteoporosis - condition in which the bones become brittle and fragile due to calcium depletion

Individualized exercise prescriptions - tailor exercise mode and dose and address these varying states with each person will
ensure greater adherence to an exercise program

Bed rest - strict confinement to bed or complete bed rest

Functional strength - another goal of exercise and the ability to perform work

Activity tolerance - type and amount of exercise of ADLs an individual is able to perform without experiencing adverse effects

Types of exercises:

Isotonic (dynamic) exercises - muscle shortens to produce muscle contraction and active movement

Isometric (static or setting) exercises - muscle contraction occurs without moving the joint (muscle length does not
change)

Isokinetic (resistive) exercises - muscle contraction or tension against resistance

Aerobic exercise - activity during which the amount of oxygen taken into the body is greater than that used to perform
the activity

Intensity of exercise can be measured in three ways:

1. Target heart rate

2. Talk test

3. Borg scale of perceived exertion

Anaerobic exercise - activity in which the muscles cannot draw out enough oxygen from the bloodstream and anaerobic
pathways are used to provide additional energy for a short time
Relaxation response (RR) - described by Dr. Herbert Benson; beneficial for counteracting some of the harmful effects of stress
on the body and mind

- healthful physiological relaxation that can be elicited through recitation of a word or a phrase or prayer while sitting
quietly and relaxing your muscles

Paresis - paralyzed

Spastic - with too much muscle tone

Flaccid - without muscle tone

Musculoskeletal system:

- disuse osteoporosis - without the stress of weight-bearing activity, the bones demineralize

- disuse atrophy - unused muscles atrophy (decrease in size), losing most of their strength and normal function

- contractures - when the muscle fibers are not able to shorten and lengthen, eventually a contracture (permanent
shortening if the muscle

- ankylosed - permanently immobile

Valsalva maneuver - refers to holding the breath and straining against a closed glottis

Orthostatic hypotension - common result of immobilization

Thrombophlebitis - a clot that is loosely attached to an inflamed vein wall

Thrombus (clot) - particularly dangerous if it breaks loose from the vein wall to enter the general circulation as an embolus
(object that has moved from its place of origin, causing obstruction to circulation elsewhere)

Vital capacity - maximum amount of air that can be exhaled after a maximum inhalation

Atelectasis - collapse of a lobe or of an entire lung

Metabolism - refers to the sum of all the physical and chemical processes by which the living substance is formed and
maintained and by which energy is made available for use by the body

Basal metabolic rate - minimal energy expended for the maintenance of these processes, expressed in calories per hour per
square meter of body surface

Anabolism - protein synthesis

Catabolism - protein breakdown

Anorexia - loss of appetite

Urinary stasis -stoppage or slowdown of flow

Calculi - calcium salts precipitate as crystals to form renal stones

Urinary retention - accumulation of urine in the bladder

Urinary incontinence - involuntary urination

Urinary reflux - backward flow

Lordosis - exaggerated anterior or inward curvature of the lumbar spine

Gait - walk

Pace - number of steps taken per minute

Crepitation - palpable or audible crackling or grating sensation produced by joint motion and frequently experienced in joints
that have suffered repeated trauma over time

Assessing problems of immobility:

Body mechanics - term used to describe the efficient, coordinated, and safe use of the body to move objects and carry out the
ADLs

Lifting:

- it is important to remember that nurses should not lift more than 35 pounds without assistance from proper equipment
and/or other individuals

Pivoting - technique in which the body is turned in a way that avoids twisting of the spine

Logrolling is a technique used to turn a client whose body must at all times be kept in straight alignment (like a log)

Active ROM exercise - isotonic exercises in which the client moves each joint in the body through its complete range of
movement, maximally stretching all muscle groups within each plane over the joint

Passive ROM exercise - another person moves each of the client’s joints through its complete range of movement, maximally
stretching all muscle groups within each plane over each joint

Ambulation - act of walking

Canes: Three types of canes

 - standard straight-legged cane

- tripod cane

- quad cane

Walkers - mechanical devices for ambulatory clients who need more support than a cane provides and lack the strength and
balance required for crutches

Crutches - temporary need for some clients and a permanent one for others; enable client to ambulate independently

Crutch gait - gait a person assumes on crutches by alternating body weight on one or both legs and the crutches

- four-point gait - slowest

- three-point gait

- two-point gate - fastest

- swing-to gait

- swing-through gait

Tripod (triangle) position - proper standing position with crutches

Four-point alternate gait - most elementary and safest gait, providing at least three points of support at all times but requires
coordination

Three-point gait - able to bear the entire body weight on unaffected leg

Two-point alternate gait - faster than the four-point gait; requires more balance because only two points support the body at
one time

Swing-to gait - used by clients with paralysis of the legs and hips

Swing-through gait - requires considerable skill, strength, and coordination