Mobilization And Exercise Flashcards
What does an effective mobilization/exercise program consist of?
A program of graduated mobility following the basic principles of overload, specificity, and reversibility
Any bodily movement produced by the contraction of skeletal muscles that result in a substantial increase over resting energy expenditure … for health benefits
Physical Activity
A type of PA consisting of planned, structured, and repetitive bodily movement done to improve, maintain one or more components of physical fitness…. fitness benefits
Exercise
The therapeutic and prescriptive application of low intensity exercise in the management of acute CP dysfunction
Mobilization
When do you NOT mobilize the pt?
Hemodynamic instability
What is the goal of mobilization?
To use the acute effects of mobilization to optimize O2 transport
What position should mobilization be performed in?
Upright
Acute CP and CV pathology have the additional problem of compromising function capacity in these two ways:
1) Recumbency
2) Immobilization
What 5 things should prescription include?
Types or type of mobilization Specific intensity Duration Frequency Means of progression
Hospitalized patients are _______ secondary to increased ______, _____, _______, ______, _______
Hypermetabolic
Body temp Healing Repair Work of breathing Response to routine interventions
These type of exercises are a central component of CPPT as these interventions can minimize O2 demand
Relaxation exercises
Factors that can contribute to increased metabolic demand and oxygen consumption in patient population?
Pathophysiological factors (fever)
Thermoregulatory challenges (too hot or too cold)
Healing and repair (secondary to illness, trauma, surgery)
Combating infection
Interventions
Physically being handled
Body positioning
Enterally
By mouth
Parenterally
Through IV
What is the a-VO2 diff?
The safety margin that permits the immediate availability of O2 when the body is perturbed
It is how much O2 is available for the body to extract
In disease states, _____ occurs when the patients O2 transport system can NOT meet the metabolic demand required (sepsis or multi-organ failure)
Anaerobiosis
Rhythmic inflation and deflation increases ___ by increasing ___
VA
TV
What facilitates lymphatic flow and drainage?
Rhythmic inflation and deflation
Rhythmic inflation and deflation does what to surfactant?
Stimulates surfactant production distribution
Surfactant increases compliance (eases)
The O2 transport system needs to be stressed to optimize the capacity of the various steps in two ways…
Gravitational stress- body position
Exercise stress- what you are having the pt do
Patients should combine ______ and ______ with exercises
Ventilatory strategies and coughing
Duration and frequency depends on what?
RESPONSE, not time
Step 1 includes…
ID all factors contributing to deficits in O2 transport
For step 1, what do the factors consist of?
Underlying pathophysiology of the disease or condition
Immobility and recumbency
Extrinsic factors related to the patient’s care
Intrinsic factors related to the individual patient
What is step 2?
Determine if mobilization and exercise are indicated
What is step 3?
Match the appropriate mobilization or exercise stimulus to patient’s oxygen transport capacity
What is step 4?
Set the INTENSITY within therapeutic and safe limits of the patients oxygen transport capacity
THR=?
20 BAR
What is step 5?
COMBINE the various body positions especially in the erect position with the following maneuvers... Have pt standing or sitting upright - Thoracic mobility exercises - AROM, AAROM, PROM - Breathing control exercises - Coughing
What is step 6?
Set the duration of the mobilization sessions based on the patient’s responses rather than time
What is step 7?
Repeat the mobilization session as often as possible based on its beneficial effect an don it being safely tolerated by the pt
What is step 8?
Increase the intensity of the mobilization stimulus, duration of the session, or both commensurate with the patient’s capacity to maintain optimal O2 transport when confronted with an increased mobilization stressor, and in the absence of distress monitored variables to remain with predetermined threshold range
