Exercise and range of motion exercises

MEETING BASIC NEEDS
MOBILITY
FIRST YEAR BSC NURSING

1. E xercise

2. Introduction Physical activity : is bodily movement produced by skeletal muscle contraction that increases energy expenditure. Exercise is type of physical activity defined as a planned , structured , and repetitive bodily movement performed to improve or maintain one or more components of physical fitness Exercise involves the active contraction and relaxation of muscles

3. Isotonic (dynamic) exercises Isotonic exercises are those in which the muscle shortens to produce muscle contraction and active movement Eg : Running , Walking ,Swimming Cycling ,ADL ,Active ROM exercises Increases muscle tone, mass and strength and maintain joint flexibility and circulation Increases blood flow to all parts of body Increases HR and cardiac output

4. Isometric (static or setting) exercises…………. There is muscle contraction without moving the joint ( muscle length does not change) Eg: squeezing a towel or pillow between the knees while at the same time tightening the muscles in the fronts of thighs by pressing the knees backwards and holding for several seconds. Often called “quad sets” Produce mild increase in HR and cardiac output No appreciable increase in blood flow to other parts of the body

5. Isokinetic (resistive) exercises Muscle contraction against resistance They can be either isometric or isotonic The person moves (isotonic) or tenses ( isometric ) against resistance Special machines or devices used Eg : lifting weights Increases blood pressure and blood flow to the muscles

6. Aerobic exercises Is activity during which the amount of oxygen taken in the body is greater than that used to perform the activity Uses large muscle groups that moves repetitively Improve cardiovascular conditioning and physical fitness

7. Anaerobic exercises Involves activity in which the muscles cannot draw out enough oxygen from the blood stream Anaerobic pathways are used to provide additional energy for a short time Used to enhance athletes Eg : weight lifting and sprinting

8. Benefits of exercise Essential for maintaining mental and physical health Musculoskeletal system Size, shape, tone and strength of muscle are maintained with mild exercises & increases with strenuous exercises Increases joint flexibility, stability and range of motion Bone density and strength are maintained Cardiovascular system Increases heart rate , strength of muscle contraction and the blood supply to the heart and muscles through cardiac out put. Meditate harmful effect of stress Increases oxygen uptake

9. Benefits of exercise Respiratory System Improves ventilation, oxygen intake and gas exchange More toxins are eliminated by deep breathing Prevents pooling of secretions Gastro intestinal system Improves appetite and increases gastrointestinal tract tone Facilitate peristalsis Relieves constipation Metabolic or endocrine system Elevates metabolic rate Reduces level of serum triglycerides and cholesterol Stabilize blood sugar and make cells more responsive to insulin

10. Benefits of exercise Urinary system Promotes blood flow and body excretes waste more effectively Prevent stasis of urine Decreases risk for UTI Psychoneurologic system Exercise can energize the person and facilitate coping Prevent weight gain ( eating disorder) Improve sleep Elevate mood and relieve stress and anxiety Elevating the level of serotonin and norepinephrine Increases level of oxygen and endorphins Immune system Moderate exercise seems to enhance immunity Strenuous exercise may reduce immune function Adequate rest is important after exercise

11. Benefits of exercise Cognitive function Improves mood, learning, problem solving and performance Used for ADD,ADHD learning disorders and mood disorders Spiritual health Improves mind body -sprit –connection ,Relationship with god Establish a balance between internal and external environment

12. Range of motion exercises

13. Range of motion ROM of a joint is the maximum movement that is possible for the joint Differ from individual to individual Effected by Genetic makeup Developmental patterns Disease Amount of physical activity in which the person normally engages

14. Range of motion exercises The movement of a joint to the extent possible without causing pain Purposes Promote and maintain joint mobility Prevent contractures and shortening of muscles and tendons Increase circulation to extremities. Facilitate comfort for the patient

15. Range of motion exercises Types Of ROM Exercises Active ROM exercises – Exercises the client is able to perform independently. Passive ROM exercises – Exercises performed for the client by someone else. Active assisted ROM exercises – Performed by a client with some assistance. Client can move a limb partially through its ROM, but needs help completing the ROM

16. Guidelines For Performing ROM Exercises Start with the head and move down, always do bilaterally Do not grasp the joint directly Do not grasp fingernail or toenail. Be sure to support the distal and proximal end of the limbs Important joints – thumb, hip, knee, ankle Move joint through movement 5 times/session Return body part to normal anatomical position Move each joint through full range of motion Move to point of resistance not pain

17. Guidelines For Performing ROM Exercises Allow for rest periods whenever required Avoid friction LIFT body part don’t drag Note drastic change in vital signs, extreme fatigue. Should not disrupt the healing process Warm water relaxes the muscles and joints, bathing is an ideal time to perform ROM

18. Joint movements

19. Abduction - moving a body part away from the midline of the body Adduction - moving a body part toward the midline of the body Extension - straightening a body part Flexion - bending a body part Rotation - turning the joint Internal rotation - turning the joint inward External rotation - turning the joint outward Plantar flexion - bending the foot down at the ankle Pronation - turning the joint downward Supination - turning the joint upward Inversion - turning the sole of the foot towards the midline Ev e rsio n - t u r n i n g the sol e o f the foo t away from the mid line

20. Neck

21. SHOULDER Circumduction

22. Elbow Flexion Extension Rotation for supination Rotation for pronation

23. Wrist Flexion Extension Hyperextension Radial flexion (abduction) Ulnar flexion (adduction)

24. Hand and fingers Flexion Extension Hyperextension Abduction Adduction Thumb Flexion Extension Abduction Adduction Opposition

25. Hip Flexion Extension Hyperextension Abduction Adduction Circumduction Internal rotation External rotation

26. Knee Flexion Extension Ankle Extension (plantar flexion) Flexion (Dorsiflexion)

27. Foot Eversion Inversion Toes Flexion ( dorsiflexion ) Extension (plantar flexion)

28. Trunk Flexion Extension Hyperextension Lateral flexion Rotation

29. Conclusion