Download - 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 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 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.
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.