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Unit 10 Activity & Exercise
Unit 10 Activity & Exercise
ASHA RUSSEL
ASST. SCIENCE TUTOR ‘A’
Objectives
1. Describe the four basic elements of normal movement.
2. Differentiate isotonic, isometric, isokinetic, aerobic and
anaerobic exercise.
3. Identify factors influencing a person body alignment and
activity.
4. Compare the effects of exercise and immobility on body
system.
5. Discuss the components of mobility assessment.
6. Specify nursing strategies to maintain or promote body
alignment and mobility. (Self -Learning)
7. Describe various positions used to ensure proper
alignment and promote client comfort and safety.
Activity – Exercise Pattern
• It refers to a person’s routine of exercise, activity,
leisure and recreation.
• It includes:
a) ADLs that require energy expenditure
b) The type, quality and quantity of exercise,
including sports.
Objective 1
Describe the four basic elements of normal movement
Four Basic Elements of Normal Movement
• Normal movement & stability are the result of an
intact musculoskeletal system, nervous system and
inner ear structures responsible for equilibrium.
2. Joint mobility
3. Balance
4. Coordinated movement
1. Body Alignment/Posture
• Useful for:
Strengthening abdominal, gluteal and quadriceps muscles used in
ambulation.
Maintaining strength in immobilized muscles in casts or traction.
Endurance training.
Isometric (Static or Setting) Exercises
• No apparent increase in
blood flow to other parts of
the body
Isokinetic (Resistive) Exercises
• Involve muscle contraction or tension against resistance.
2. Nutrition
4. External factors
i.e., Temperature, humidity, availability of recreational facilities,
safety of the neighborhood
5. Prescribed limitations
i.e., Casts, braces, traction, activity restrictions including bed rest
1. Growth and Development
• A person’s (1) age, (2) musculoskeletal and (3) nervous
system development affect:
Posture
Body proportions
Body mass
Body movements
&
Reflexes
2. Nutrition
• Both (1) undernutrition and (2) overnutrition can influence
body alignment & mobility.
2. Nutrition
• Poorly nourished Muscle weakness & Fatigue.
• Nourish joints.
• Contractures.
• Dependent edema
• Thrombus formation
3. Effects on Respiratory System
Exercise Immobility
• Increase ventilation and oxygen • Decreased respiratory
intake improving gas exchange movement
• Atelectasis
• Hypostatic pneumonia
4. Effects on Metabolic System
Exercise Immobility
• Elevates the metabolic rate • Decreased metabolic rate
• Facilitates peristalsis
6. Effects on Urinary System
Exercise Immobility
• Promotes blood flow to the • Urinary stasis
kidneys causing body wastes to
be excreted more effectively
• Renal calculi
• Prevents stasis (stagnation) of
urine in the bladder
• Urinary retention
• Urinary infection
7. Effects on Immune System
Exercise
Advantages
• Pumps lymph fluid from tissues into lymph capillaries and vessels
• Increases circulation through lymph nodes
Disadvantage
• Strenuous exercise may reduce immune function
Leaving window of opportunity for infection during recovery phase
8. Effects on Integumentary System
Immobility
• Reduced skin turgor
• Skin breakdown
9. Effects on Psychoneurologic System
Exercise Immobility
• Elevates mood • Decline in mood elevating
substances
• Relieves stress and anxiety
• Perception of time intervals
deteriorates
• Improves quality of sleep for
most individuals
• Problem-solving and decision-
making abilities may
deteriorate
• Physical Examination:
Body alignment
Gait
Appearance and movement of joints
Capabilities and limitations for movement
Muscle mass and strength
Activity tolerance
Problems related to immobility
Nursing History
• Activity-Exercise history is usually part of the comprehensive
nursing history.
&
Whether these methods have been effective.
Assessment Interview
Assessment Interview
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1. Body Alignment
• It includes an inspection of the client while the client stands.
• The nurse may also assess pace (the number of steps taken per
minute), which often slows with age and disability.
2. Gait
• A normal walking pace is 70 to 100 steps per minute.
• The pace of an older person may slow to about 40 steps per minute.
• The nurse should also note the client’s need for a prosthesis or
assistive device.
3. Appearance & Movement of Joints
• Physical examination of the joints involves:
Inspection
Palpation
Assessment of active ROM
Assessment of passive ROM
3. Appearance & Movement of Joints
• The nurse should assess the following:
Any joint swelling or redness.
Any deformity, such as a bony enlargement or contracture, and
symmetry of involvement.
The muscle development associated with each joint and the
relative size and symmetry of the muscles on each side of the
body.
Any reported or palpable tenderness.
3. Appearance & Movement of Joints
• The nurse should assess the following:
Crepitation (palpable or audible crackling or grating sensation
produced by joint motion)
Increased temperature over the joint.
Degree of joint movement.
3. Appearance & Movement of Joints
• Assessment of ROM performed by moving joints smoothly, slowly,
and rhythmically.
• This activity, then, can serve as a standard for predicting the client’s
tolerance for similar activities.
7. Problems Related to Immobility
• When collecting data pertaining to the problems of immobility, the
nurse uses the assessment methods of:
Inspection
Palpation
Auscultation
Checks results of laboratory tests and
Takes measurements, including:
Body weight,
Fluid intake, and
Fluid output.
Assessing Problems of Immobility
Table 3
7. Problems Related to Immobility
• Clients at risk for developing complications of immobility, include
those who:
a) are poorly nourished
b) have decreased sensitivity to pain, temperature, or pressure
c) have existing cardiovascular, pulmonary, or neuromuscular
problems &
d) have an altered level of consciousness.
Objective 6
Specify Nursing Strategies to Maintain or
Promote Body Alignment and Mobility
(Self -Learning)
Nursing strategies to maintain/promote body alignment and
mobility
• It involves:
2. Orthopneic
3. Dorsal recumbent
4. Lateral
5. Prone
6. Sims
1. Fowler’s/ Semi Sitting Position
• Is a bed position in which the head and trunk are raised 45⁰ to 60⁰.
1. Fowler’s/ Semi Sitting Position
• Semi-fowler’s: Head and trunk are raised 15⁰ to 45⁰.
• Advantages:
Is used to provide comfort.