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.