BODY MECHANICS, ALIGNMENT,

AND MOBILITY

Basic Principles When the center of the gravity is

maintained directly above the base of support, weight is balanced and stability can be maintained with the least amount of effort.

Basic Principles Enlarging the base of support

increases the stability of the body.

Basic Principles A person or an object is more

stable when the center of gravity is close to the base of support.

Basic Principles Enlarging the base of support in the

direction of the force to be applied increases the amount of effort that can be applied.

Basic Principles Forming an “internal girdle”, by

tightening the abdominal muscles upward and the gluteal muscles downward, decreases the chance of experiencing a muscle or ligament strain or injury when lifting.

Basic Principles Turning an entire body on a plane

in the direction of the task to be performed reduces spinal torsion.

Basic Principles Objects can be moved more easily

on a flat surface than on a surface that is slanted or inclined against the pull of gravity.

Basic Principles Lifting is easier and less tiring when

the larger leg muscles rather than smaller back muscles are used.

Basic Principles Friction between an object and the

surface on which it rests should be minimized to facilitate motion.

Basic Principles Less energy is expended when

holding an object close to the body than at a distance; in this way an object is also easier to move.

Basic Principles The body’s weight should be used

to assist in lifting and moving objects.

Basic Principles Moderate speed using smooth,

rhythmical movements, requires less energy than rapid, jerky, uncoordinated movements.

Basic Principles When an object is pushed, soft

objects (like body parts) absorb part of the force being exerted, thereby reducing the force applied and increasing the energy expended. However, when an object is pulled, all the force exerted is employed in moving the object.

Normal Mobility Nursing activities such as lifting,

transferring, positioning, ambulating, bending, standing, lying, sitting, and performing activities of daily living all require an understanding of proper body mechanics.

Normal Mobility Body mechanics is the coordinated

effort of the musculoskeletal and nervous systems to perform critical functions. It is related to body alignment, balance and coordinated movement when moving, lifting and bending.

Normal Mobility Understanding proper body

mechanics requires knowledge regarding:The regulation of movementCoordination of body movement

involving the skeletal system, skeletal muscles, and nervous system function

Normal Mobility The musculoskeletal system and

nervous system function to maintain proper body alignment, posture, balance, and coordinated movement.

Normal Mobility Body alignment and mobility are

influenced by developmental stages.

Assessing Mobility Assessing mobility provides an

opportunity to determine the patient’s coordination and balance while walking and performing daily activities, and can indicate his or her ability to participate in an exercise program.

Assessing Mobility Assessment of mobility has three

components:Range of motion in jointsGait used to ambulateExercise performance and tolerance

Body Alignment Assessment of the patient’s body

alignment can be performed with the patient sitting, lying, or standing.

Body Alignment The four objectives to the assessment

of body alignment are: Determining normal physiological change

associated with growth and development. Identifying alignment difficulties

associated with poor posture. Assessing patient knowledge regarding

posture, identifying knowledge deficits, and determining learning needs.

Identifying the presence of factors affecting alignment.

Body Alignment Proper alignment when standing:

The head is erect and midline. The shoulder and hips are straight and parallel The vertebral column is straight. When observed laterally, the spine curves forming a

reversed “S”. The abdomen is tucked in and the knees and ankles

are slightly flexed. The arms hang comfortably at the person’s sides. The feet are slightly apart to form a wide base of

support, with the toes pointed forward. The center of gravity is midline from the middle of the

forehead to a midpoint between the feet.

Body Alignment Proper alignment when sitting in a chair,

wheelchair, or rehabilitation chair: The head is erect and the neck and vertebral column are

straight. Body weight is evenly distributed on the buttocks and

thighs. The feet are supported on the floor or a footstool. There is a 2 to 4 cm space between the edge of the

chair and the popliteal space on the posterior surface of the knee.

The forearms are supported on the armrests, in the lap, or on a table in front of the chair.

Avoid using pillows at the back since they might interfere with proper alignment.

Body Alignment Proper alignment when lying:

The vertebrae are in straight alignment, without curves.

The joint are slightly flexed and supported.There should be support at the feet to

prevent plantar flexion, commonly referred to as footdrop.

Supports are provided along the thigh and ankles to prevent external hip rotation.

A low pillow is placed under the head to prevent neck extension.

Body Alignment Proper alignment for the side-lying

position:Support the head with a small pillow.Undertuck a pillow along the back to

support the back and hold the patient in position.

Bring the underlying arm forward, flex it, and rest it on a pillow in front of the body.

The top leg should be flexed and brought slightly forward for balance.

Support feet to prevent plantar flexion.

Body Alignment When positioning patients in any

position, a handroll should be placed in the patient’s hand with the fingers and thumb flexed around the handroll, keeping the hands in a functional position.

Body Alignment Many patients can automatically

position themselves; however, they might not position themselves in the manner that promotes proper body alignment.

Alterations in Alignment and Mobility Damage to any part of the

musculoskeletal system or nervous system increases the risk to body alignment: joint mobility may become impaired as well.

Alterations in Alignment and Mobility A variety of factors influence body

alignment and mobility.Congenital and acquired postural

abnormalities affecting efficiency of the musculoskeletal system, as well as affecting alignment, balance and appearance.

Mechanics affecting bone formation:○ Modeling○ Remodeling○ Repairing

Alterations in Alignment and Mobility

Alterations in joint mobility resulting from inflammation, degeneration, or articular disrupt

Impaired muscle development affecting body alignment, balance and mobility.

Alterations in Alignment and Mobility

CNS damage affecting the regulation of voluntary movement.

Musculoskeletal system trauma resulting in bruises, contusions, sprains and fractures.

General Goals for Patients with Alteration in Body Alignment Maintaining proper body alignment. Restoring proper body alignment, or

optimal degree, of body alignment. Reducing injuries resulting from

impaired alignment.

General Goals for Patients with Alteration in Body Alignment Decreasing muscle strain. Preventing deformities or

complication of the musculoskeletal system or altered skin integrity.

Preventing contractures and footdrop.

General Goals for Patients with Altered Mobility Maintaining full range of motion in

all joints. Preventing contractures in

extremities, head and neck. Maintaining the patient’s ability to

perform daily activities.

Moving and Positioning Patients: Nursing Guidelines Position the bed at a height that

reduces back strain. Move the patient closer to one side

of the bed.

Moving and Positioning Patients: Nursing Guidelines Assess the amount of assistance

necessary to safely move the patient.

Encourage the patient to assist in moving and positioning to their greatest potential.

Moving and Positioning Patients: Nursing Guidelines Use aids in moving patients:

Pull sheets or turn sheetsOverhead trapezeslings

Moving and Positioning Patients: Nursing Guidelines Use large muscle groups. When moving patients with the

assistance of others, coordinate your movements and effort.

Moving and Positioning Patients: Nursing Guidelines When providing patient care or

performing treatments, position the patient close to the side of the bed on which you are working.

Use proper body mechanics when moving beds and other heavy equipment.

Quiz1. Give the two methods in lifting.2. Cite one reason why we need to learn proper body mechanics?3. ___________ The point at which the mass of a body or object is

centered; when weight on all sides is equal.4. __________________Area on which an object rests and that

provides support for the object.5. What are these two forces that add resistance to many

activities like lifting, reaching, pushing, pulling, and carrying an object.

6. Cite at least two principles of body mechanics.7. Which is easier to push or to pull?8. ____________ is commonly referred to as footdrop.9. What should be placed in the patient’s hand with the fingers

and thumb flexed around keeping the hands in a functional position.

10. Cite at least two nursing guidelines in moving and positioning patients.

11. TRUE OR FALSE. Damage to any part of the musculoskeletal system or nervous system increases the risk to body alignment: joint mobility may become impaired as well.