MOBILITY

&
IMMOBILITY
 Mobility refers to a person's ability to move

about freely, and immobility refers to the inability

to do so.
 "Mobility is defined as the ability of the human body and its

parts to move easily, freely, rhythmically and purposefully in

the environment.
 Mobility is the potentiality of a body part or a body

structure in order to allow the occurrence of range of

motion for functional activities.

 Mobility encompasses body mechanics.

 BODY MECHANICS involves the coordinated effort

of muscles, bones, and the nervous system to maintain

balance, posture, and alignment during moving,

transferring, and positioning patients.

 It is defined as synchronized effort of musculoskeletal

and nervous system.

 It includes maintenance of correct body posture that

reduces musculoskeletal fatigue, strain and injury,

maintenance of adequate muscle tone that, promotes

comfort and helps to conserve energy to perform activities

of daily living.
 ELEMENTS
OF
NORMAL MOVEMENT
 There are four basic elements of normal movement, i.e.,
body alignment,
 joint mobility,
 balance and
 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.
2 Joint mobility:
 Joint mobility or range of motion of 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.

 Coordination is the ability to select the right muscle at the

right time with proper intensity to achieve proper action.

 PHYSIOLOGY
OF
MOBILITY/MOVEMENT
AND ALIGNMENT
 Abuduction Lateral movement A person's arm is
of a body part away abducted when it is
from the midline of moved away from
the body. the body.

Adduction Lateral movement A person's arm is

of a body part abducted when it is
towards the midline moved from an
of the body. outstretched
position to a
position alongside
the body.

Circumduction Turning in a circular Circling the arm at

motion; combines the shoulder, as in
abduction, bowling or a serve
adduction, extension in tennis.
and flexion.
 Flexion The state of being A person's cervical
bent. spine is flexed when
the head is bent
forward, chin to chest.

Extension The state of being in a A person's cervical

straight line. spine is extended when
the head is held
straight on the spinal
column.

hyperextension The state of A person's cervical

exaggerated extension. spine is in hyper
It often results in an extension when
angle >180°. looking overhead,
towards the ceiling.
 Dorsiflexion Backward bending of A person's foot is in
the hand orfoot. dorsiflexion when the
toes are brought up as
to point them at the
knee.

Plantar Flexion Flexion of the foot. A person's foot is in

plantar flexion in foot
drop position.

Internal Rotation Turning on an axis- the A thumb is rotated

turning of a body part when it is moved to
on the axis provided make a circle.
by its joint.
External Rotation A body part turning on its A leg is rotated externally
axis away from the midline when it turns outward at the
of the body. hip and the toes point away
from the midline of the
body.

Pronation The assumption of the A person is in the prone

prone position. position when lying on the
abdomen; a person's palm
is prone when the forearm
is turned so that the palm
faces downward.

Supination The assumption of the A person is in the supine

supine position. position when lying on the
back; a person's palm is
supine when the forearm is
turned so that the palm
faces upward.
Inversion Movement of the sole Occurs at the ankle
of the foot inward

Eversion Movement of the sole Occurs at the ankle.

of the foot outward.

Opposition Rotation of the thumb Movement of the

around its long access. thumb across the palm
to touch each fingertip
of the same hand.
BODY MECHANICS
 "Body mechanics is the utilization of correct body muscles

to complete a task safely and efficiently, without undue

strain on any muscle or joint."

 Body mechanics involves the coordinated effort of

muscles, bones, and the nervous system to maintain

balance, posture, and alignment during moving,

transferring, and positioning patients.

 PURPOSES OF GOOD BODY MECHANICS
 To provide maximum body comfort and relaxation
 To aid in normal body functions
 To conserve maximum possible energy by preventing
unnecessary strain
 To prevent contractures and neuromuscular deformities and
complications
FACTORS AFFECTING
MOVEMENT
AND
ALIGNEMNT
 EFFECTS
OF
IMMOBILITY
ON THE BODY
 Lack of exercise, inactivity or immobility related to illness

or injury place a person at high risk for serious health

problems.

 Complications of immobility depends on individuals age

as well as health status.

1. CARDIOVASCULAR –
 decreased heart reserve,
 venous stasis,
 orthostatic hypotension,
 thrombophlebitis,

 dependent edema (lower limbs will swell)

 2. RESPIRATORY –
 difficulty breathing
 pulmonary embolism,
 pneumonia,

 decreased vital capacity,

 decreased chest expansion
 3.MUSCULOSKELETAL –

 atrophy,

 contracture,

 osteoporosis,

 decreased muscle tone, size, strength.

4. METABOLIC –
 Increase risk for electrolyte imbalance
 Altered exchange of nutrients and gases.

5. DIGESTIVE SYSTEM:-
 Disturbance in appetite
 Altered protein metabolism
 Altered digestion and utilization of nutrients
 Decreased peristalsis leading to constipation
6. RENAL SYSTEM:-
 Increased urine stasis
 Increased risk for renal calculi
 Decreased bladder muscles tone.

7. INTEGUMENTARY SYSTEM:-
 Increased risk for skin breakdown and formation of
pressure injuries.
8. PSYCHOLOGICAL WELL BEING:-
 Increase sense of powerlessness
 Decreased self concept
 Decreased social interaction
 Altered sleep-wake pattern
 Increased risk for depression
 Risk for learned helplessness.
 EXERCISE
TYPES AND BENEFITS
 Exercise is that activity which requires alignment, posture,

balance and coordinated movement.

 It provides many physiological and psychological benefits.

 For obtaining maximum benefit, exercise must be

integrated into the individual's lifestyle.

PURPOSE
 Decrease risk factors for chronic diseases and increase
health and well-being.
 Functional Strength is defined as the ability of the body to
perform work.
 Activity tolerance is the type and amount of exercise/ADLs
an individual perform without experiencing adverse effects.
CLASSIFICATION
 Exercise may be classified in two ways:

1. Based on the source of energy

a) Aerobic

b) Anaerobic

2. Based on the muscle tension it requires

c) Isotonic

d) Isometric

e) Isokinetic
1. Aerobic exercise:

 It is intended to increase the oxygen consumption

thereby promoting cardiovascular conditioning and

health of the lungs.

 Example of aerobic exercise include running, cycling,

dancing etc.
2. Anaerobic exercise:
 When the muscle cannot extract enough oxygen from
the blood, anaerobic pathways are used to provide
additional energy for a short time.
 Example of aerobic exercise include Strength training and
weight lifting, jump squats,
1. Isotonic (dynamic) exercise:
 Isotonic exercises involve muscle shortening and active
movement of particular muscle group.
 This exercise increase muscle tone, mass, and strength
and maintain joint flexibility and circulation.
 Eg.Walking, running, performing ADL
2. Isometric (static or setting) exercise:
 Isometric exercise involves muscle contraction without
shortening,
 i.e., there is no movement or only a minimum shortening
of muscle fibers.
 Here the muscles contract, but there is no movement
e.g.Yoga Pose.
 Increased muscle mass, strength and tone;
3.Isokinetic (resistive) exercise:
 Isokinetic exercise includes muscle contractions with
resistance. The resistance is provided at a constant rate by
an external device, which has a capacity for variable
resistance.
 Examples: Lifting weights
 It can increase muscle strength and range of motion.