Activity and Immobility Flashcards
__ is very interconnected with balance
Gait
Expected gait
Steady, smooth, and coordinated
Unexpected gait
Shuffled, uncoordinated, slow, difficult
Who is at risk for gait abnormalities?
Older adults, neurologic conditions, and spinal or lower extremity problems
Unexpected gait indicates…
Risk for falling
Movement that decreases the angle between two joints such as the elbow or knee
Flexion
Movement that increases the angle between two joints such as the elbow or knee
Extension
Movement beyond normal resting extended position such as the head
Hyperextension
Movement so that the ventral surface faces down such as the hand
Pronation
Movement so that the ventral surface faces up such as the hand
Supination
Movement away from the midline
Abduction
Movement towards the midline
Adduction
Rotation of joint inward
internal rotation
Rotation of joint outward
external rotation
Turning foot away from midline
Eversion
Turning foot towards midline
inversion
Flexion of toes and foot upward
dorsiflexion
Bending toes and foot towards the ground
plantar flexion
Cervical spine should be
concave
Thoracic spine should be
convex
Lumbar spine should be
concave
Sacral spring should be
convex
Exaggerated curvature of lumbar spine
Lordosis
Exaggerated curvature of thoracic spine
Kyphosis
Exaggerated lateral curvature
Scoliosis
Muscle strength grade 0
Paralysis
Muscle strength grade 1
Muscle contraction is seen, no joint motion
Muscle strength grade 2
Muscle can move joint only if properly positioned so gravity is eliminated
Muscle strength grade 3
Can move joint against gravity without resistance
Muscle strength grade 4
Muscle can move joint against moderate resistance
Muscle strength grade 5
Full ROM against resistance
Contraindicated for heat and cold compresses
Very old, very young, frail skin, fair skinned, immobile
Don’t use cold therapy on someone with
Vascular insufficiency or an open wound
Assess hot or cold every 5-10 minutes especially if…
Patient is immobile
Center of gravity
the lower the better
Don’t have knees…
locked or straight
When lifting use…
assistive device when necessary
Pushing or pulling use a
wide base of support
Major risk factor for mobility issues
Obesity
Other risk factors for mobility issues
Congenital defects, bone/joint or muscle disorders, arthritis, CNS disorders, trauma, reconditioning
Who determines mobility?
Physical therapy
Bedrest ordered by MD is usually
procedure related and time sensitive
Semi-fowlers position
Bed elevated at 15-45 degrees
Fowlers position
bed elevated at 45-60 degrees
High fowler’s position
bed elevated at 60-90 degrees
Modified trendelenburg position
Patient is flat, legs are elevated above heart
For patient’s with spinal or cervical precautions you must
log roll them
Helpful to aid independence, good for obese patients or those with low extremity issues
Trapeze bar
Patients who have been on bedrest for a long time use a __ __ __
Total lift bed
Mobility foals for most patients are
up within first several hours after surgery or event
Trauma ICU patients up to chair in
next morning if cervical spine cleared
Early mobility helps with…
Respiratory, cardiac, muscle tone, and GI and metabolism
Biggest barrier to mobility is…
Time and lack of staff
Plan ahead for mobile activities by…
Administering pain medication 30 minutes prior if indicated
2 types of canes
Single straight legged and quad canes
Canes are used for
MILD strength and balance impairments
Quad canes used for patients with
Unilateral weakness
Canes go on the
strong side
Then the weaker side
moves with the cane
The patient needs __ points of support on the ground at all times
2
Teach patient to never
Lean over walker and always stay upright
Don’t let walker get too much
ahead of the patient
Don’t use walkers on
multiple stairs
Walk with…
affected leg or weak side first
Cane opposite of
affected leg
Forearm crutch used longer typically for…
Paralysis
Crutch pads should be __-__ finger lengths from the axilla
2-3
Weight bearing should be on __ __ not axilla pads
hand grips
Basic crutch position is the
tripod position
Four point gait is…
Weight bearing on both legs and always 3 points of support
Crutches: 3 point gait: All weight on
unaffected leg
Crutches 2 point gait
Partial weight bearing on both feet
Crutches with 2 point gait mimics
how normal arms and legs move