Mobility and Immobility

Mobility and Immobility

Definition

Mobility refers to a person’s ability to move about freely.
"Mobility is defined as the ability of the human body and its parts to move easily, freely, rhythmically and purposefully in the environment"
Mobility-Ability to engage in activity and free movement.

Walking, running, sitting, standing, lifting, pushing, pulling
Activities of daily living (ADLs)

Immobility

Immobility refers to the inability to move about freely (physical restriction of movement to body or a body segment).
Immobility refers to a reduction in the amount and control of movement a person has.

Elements of Normal Movement

Body alignment (posture)
Joint mobility
Balance
Coordinated movement

1. Body alignment (posture)-

Posture is defined as the maintenance of a particular body position against gravity. Posture is a body alignment, which is referred to relative positions of the body, when lying down, standing, sitting or any other activity.
Brings body parts into position that promotes optimal balance and body function.
Person maintains balance as long as line of gravity passes through center of gravity and base of support.

2. Joint mobility-

Joint mobility or range of motion is defined as the maximum movement possible for a joint. Joint mobility varies from person to person and usually determined by genetic factors, developmental patterns, presence or absence of any disease and physical activity.

3. Balance-

Balance is referred as smooth and purposeful body movement. Balance results from the proper functioning of cerebral cortex (initiates voluntary movement), cerebellum (coordinates motor activity) and basal ganglia (maintains posture).

4. Coordinated movement-

Coordinated body movement is defined as the ability of muscles to work together for purposeful movement. Coordinated movements are the complex mechanisms, it includes proprioception, physical activity, exercise and activity tolerance. This is further explained under maintenance of normal body alignment and mobility.

Body Mechanics

Some of the most common injuries sustained by members of the health care team are severe musculoskeletal strains. Many injuries can be avoided by the conscious use of proper body mechanics when performing physical work.

Definition

Body mechanics the term used to describe the efficient, coordinated, and safe use of the body to move objects and carry out the Activities of Daily Living (ADL’s).

Factors Affecting Movement and Alignment

Growth and Development
Physical Health
Nutrition
Personal Values and Attitudes
Certain External Factors
Prescribed Limitations
Mental Health
Lifestyle
Fatigue and Stress

1. Growth and Development

A person’s age and musculoskeletal and nervous system development affect posture, body proportions, body mass and body movements.
Newborn movements are random. All extremities are generally flexed .
As the neurologic system matures, control over movement progresses during the first year.
As age advances, muscle tone and bone density decrease , joints lose flexibility, and bone mass decreases, particularly in women who have osteoporosis.
All of these changes affect older adults’ posture, gait, and balance.

2. Physical Health

Health—Chronic or Acute Disease
Musculoskeletal: Congenital or acquired abnormalities
Nervous System: Stroke
Cardiovascular: Orthostatic Hypotension
Metabolic: Affects Normal Metabolic Functioning.

3. Nutrition

Both under nutrition and over nutrition can influence body alignment and mobility.
Poorly nourished people may have muscle weakness and fatigue.
Vitamin D deficiency causes bone deformity during growth.
Inadequate calcium intake and vitamin D synthesis and intake increase the risk of osteoporosis.
Obesity can distort movement and stress joints, adversely affecting mobility.

4. Personal Values And Attitudes

Whether people value regular exercise is often the result of family influences. In families that incorporate regular exercise in their daily routine or spend time together in activities, children learn to value physical activity.
Values about physical appearance also influence some people’s participation in regular exercise. People who value a muscular build or physical attractiveness may participate in regular exercise programs to produce the appearance they desire.

5. External Factors

Many external factors affect a person’s mobility.
Excessively high/ low temperatures
High humidity
Availability of recreational facilities
Unsafe environment

6. Prescribed Limitations

Limitations to movement may be Medically prescribed for some health problems. Eg: patient with plaster of Paris
Bed rest is the choice for certain clients, for example to reduce metabolic and oxygen needs, to decrease pain.
Clients who are short of breath may be advised not to walkup stairs.

7. Mental Health

A person's mental health influences body appearance and movement as much as the person's physical health. Body processes tend to slow down in depression, and there is a lack of visible energy and enthusiasm. Body posture also may be affected.

8. Lifestyle

Whether a person chooses an active or sedentary lifestyle depends on many variables, including occupation, leisure activity preferences, and cultural influences. Many occupations are sedentary (e.g., bank manager or computer programmer). Therefore, people in sedentary Occupations wishing to exercise regularly need to plan ahead for these leisure activities by preparing to exercise before or after working hours or during a lunch break.

9. Fatigue and Stress

Chronic stress may deplete body energy to the point that fatigue occurs even with thought of exercise. Ironically, regular exercise is energizing and can better equip a person to deal with daily stresses.

Principles of Body Mechanics

It is important to select and apply techniques that reduce the adverse effects of gravity or friction, enhance the positive effects of these two forces to reduce expenditure of energy, avoid undue stress or strain to body systems, and maintain control of body.

1. Erect posture/ correct alignment-

Develop a habit of erect posture/correct alignment. Slouching can strain neck and back muscles.
When sitting, use the chair back to support the whole spine, keeping the shoulders back but relaxed.
Balance the head over the shoulders, avoid leaning forward, and hold in the stomach muscles.

2. Use the longest and the strongest muscles

Use the longest and the strongest muscles. of the arms and the legs to help and provide the strength needed in strenuous activities.
The muscles of the back are less strong and more easily injured when used improperly.

3. Use the internal girdle and a long midriff.

It helps to stabilize the pelvis and to protect the abdominal viscera when reaching, stooping, lifting, or pulling.
The internal girdle is made by contracting the gluteal muscles in the buttocks downward and the abdominal muscles upward. It is helped further by making a long midriff by stretching the muscles in the waist.

4. Work as closely as possible to the object to be lifted.

This brings the body's center of gravity close to that of the object being moved, permitting most of the burden to be borne by the arm muscles, rather than the back.
Flex the knees, put on the internal girdle, and come down close to an object that is to be lifted.

5. Avoid twisting of body.

Face the direction of your movement.

6. Use the body weight as a force.

For pulling or pushing, shift body weight by rocking on the feet or leaning forward or backward.
This reduces the amount of strain placed on the arms and the back.

7. Slide, roll, push, or pull an object, rather than lifting it.

Helps to reduce the energy needed to lift the weight against the pull of gravity.

8. Push rather than pull

Push rather than pull the object when possible. Keep arms close to the body and push with the whole body, not just by arms.

9. Broadening base-

Begin activities by broadening base of support. Spread the feet to shoulder width.

10. Keep surface dry-

Make sure that the surface is dry and smooth when moving an object to decrease the effects of friction. Rough, wet, or soiled surfaces can contribute to increased friction, increasing the amount of effort required to move an object.

11. Manageable loads-

Break up heavy loads into smaller loads. Take breaks from lifting or moving to relax and recover.