Assisting with Mobility

If you find this you are lucky

contracture

a condition characterized by the tightening or shortening of a body part, such as muscle, tendon, or skin, due to lack of movement

atony

lack of sufficient muscular tone

atrophy

a decrease in size or wasting away of a body part tissue

thrombus

a blood clot that forms in a blood vessel and remains at the site of formation

embolus

a mass, most commonly a blood clot, that become lodged in a blood vessel and obstructs the flow of blood

Activity of daily living (ADL)

any basic self-care task, including prooming, bathing, and eating

posture

position of the body when sitting or standing

body alignment

the optimal placement of body parts so that bones are used efficiently and muscles have to do less work to get the same effect

ambulation

the ability to walk from one place to another

gait belt

a device made of canvas, nylon, or leather that is used by healthccare workers to safely move patients to a standing position of to assist them during walking

ankylosis

the stiffening or immobility of a joint resulting from disease, trauma, surgery, or bone fusion

foot drop

a condition characterized by the inability to lift the front part of one or both feet due to weakness or paralysis of the muscles in the foot; causes the toes to drag on the ground while walking

immobility

a condition charaxterized by a limited, or complete lack of, ability to move

traction

the use of a pulling force to treat muscle and skeletal

decubitus ulcer

a skin sore that is a result of lying in one position too long; caused by pressure that interferes with blood circulation to the skin

necrotic

term that describes dead cells or tissues

trochanter roll

a rolled towel or blanket placed along the hip that prevents the hips from rotating externally

contraindicated

term that describes any situation or condition that causes a particular type of treatment to be improper or undesirable

AAROM

Active Assistive Range of Motion

ABD

Abduction

ADL

Activites of daily living

amb

abulation

BR

Bedrest

BRP

Bathroom privileges

CPM

Continuous passive motion

HOB

Head of bed

OOB

Out of bed

ROM

Range of motion

Up ad lib

Up as desired

W/C

Wheelchair

First Pendulum

Leg leaves the ground, swinging forward from the ihp

second pendulum

Movement of the two legs is coordinated so that one foot is always in contact with the ground

How does walking differ from running?

When walking, one leg is always in contact with the ground, while the other is swinging. When running, there is a ballistic phase that occurs when both feet are off the ground at the same time

Stage 1 of Ambulation

Assit the patient to lift his body from lying in bed to stiing on the side of the bed in a dangling position.

Orthostatic hyptension

Dizziness and possibly fainting when standing

Step 2 of ambulation

After putting on a gait belt assist the patient to stand

Step 3 of ambulation

Patient begins ambulating

What should you not do if your patient is collapsing

You should not try to carry, hold up, or catch her

What should you do if your patient is falling

Assume a broad stance with your preferred foot slightly ahead of the other and between the patient’s legs. Grasp the patient’s body firmly at the waist or under the axilla, and allow her to slide down against your leg.

Can family members or friends availalbe assist

Yes, however, the appropriate provider has to have given persmiision and each person understands and is comfortalbe with the preocedure. Family members and friends must know how to avoid any risks or harm to themselves and the patient as described.

What is useful for those who may have had surgery and are not yet able to maintain balance or need extra stability

Canes

Used often for short-term conditions such as a sprained ankle or broken leg

Crutches

What is helpful for people who may have had surgery on their lower limbs, such as a hip or knee replacement

Walkers

How do the elderly use canes

use a cane if they have recovered from a stroke and are not yet able to fully ambulate, or if they have arthritis that has resulted in restricted movement.

How are walkers used by the elderly

When they begin to lose their balance and stability and need extra assistance.

Cane that has a single shaft and resemble a candy cane

C canes

Has a straight handle for a steadier grip

functional grip cane

Quad cane

base with four prongs, each with a skid resistant tip

Which type of cane assists best with balance

Quad cane

How do you know that a cane is the best fit for you

The top of the cane is in line with the patient’s wrist crease when she stands up straight and her arms are hanging loosely at her sides. The patient should be able to slightly bend her elbow

Which side should the patient hold their cane

Should hold the cane on their stronger side

How far foward should the cane move

6-10 inches

Which leg should the patient ambulate with when using a cane

Weak leg

With what grip should you grip the gait belt

underhand grip

When using a cane to climb stairs which foot should you start with

Stronger foot; then put cane on step and lift weak leg

When coming down the stairs which foot should you lead with

Should put your cane on the first step and follow with the weak foot

What gait is this

Four-point gait

What gait is this

three-point gait

what gait is this

Two point gait

What gait is this

Swing through gait

Standard underarm/ acillary crutches

Generally made of wood or aluminum and can be adjusted fro height. They have padding on the underarms and also have hand holds. These crutches are usually for short-term use.

Strutter crutches

have a u-shaped underarm support that distributes weight over a larger area of the skin surface and also has a larger base. This provides better balance and helps alleviate any possible injury of nerves and blood vessels in the axilla

Platform crutches

Feature a horizontal, padded armrest. Patient using these crutches straps his arms onto each armrest and is then able to maneuver the crutches

Forearm crutches

Typically used for patients with disabilites. Are often selected for long-term use.

How do you know which crutch is right for you?

The tops of the crutches should be about one and a half inches below the acilla, while the patient is standing up straight and shoulders are relaxed adn the hand grips of the crutches should be even with the hips.

What can damge nerves in the axilla

When the crutches are presssing into the axilla

What is tripod position

The crutch tips are placed about four to six inches to the side and slightly in front of each foot. The strong foot bears weight of the body

When is a four point gait used

Used when there is some weight bearing ability on both legs

When is a three-point gait used

When there should be no weight bearing on the affected, or injured leg

When is a two-point gait used

when both legs can bear some weight

When is a swing-through gait used

When legs are paralyzed and in braces

What is one of the ways that patients can go down and up the stairs with crutches

Tucking both crutches under the opposite axilla. When going up stairs, have the patient lead with the strong foot keeping the weak foot raised behind. When going down stairs, the patient should hold the weak foot up and in front of the body, hopping down each stair on the strong foot, taking if one step at a time.

What is another way to go down stairs with crtuches

Patients sit on the stairs and inch up or down each step. The patient should hold the weak leg out in front of her body, and carry both crutches flat against the stairs the hand opposice of the railing. She should scoot her bottum up or down to the next step, using the free hand and strong leg for support

Standard walker

Lightweight metal and has four solid legs with rubber tips on the bottoms of legs. This type of walker is used when the patient is able to pick up the walker while ambulating

Rolling walker (rollator)

Has wheels or casters on the end of each of the four legs so the walker rolls during ambulation. To proivde stability, some walkers have two wheels on the front two legs and no wheels on the back two legs.

How do you know that a walker height is best for you?

The handles or tops of the walker should be at height even with the patients’s wrist when she is standing in an upright position with arms relaxed at her sides. When holding a walker a patients arms should be comfortably bent

How much space should you keep when you have a gait belt on

3 fingers

Which leg should you step with first when using a walker

Take first step with weakest leg. The heel of the foot should touch the ground first and the foot should flatten.

After how many hours should a patitent be repositioned

2 hours

Stage 1

The skin is not open but is discolored, turning red on people with light complexions and blue or purple on those who have darker complexion; Skin does not turn white when pressed.

Stage 2

Decubitus ulcer is still considered superficial but the skin is now open. A blister filled with fluid, an abrasion, or a shalow sore that looks like a crater can be seen, and the surrounding area may be irritated and red in color

Stage 3

The ulcer is much deeper and may affect the underlying connective tissue. The sore looks more like a crater and may ooxe, blled, or contain pus

stage 4

The damage is deep and may reach the muscle, tendons, ligaments, joints, and bone. The uclcer will bleed and the skin and tissue become necrotic

How many body positions should patients be rotated through?

4 body positions

Fowler’s position

* The patient is seated in bed and the head of the bed is raised to 45º
* The patient’s knees may be elevated by placing a pillow under the knees

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Semi-Fowler’s Position

* The patient is seated in bed and the head of the bed is raised to a 30º
* Support the patient’s head with a pillow
* The patient’s knees may be elevated by placing a pillow under the knees
* Use a foot support such as a foot board to prevent foot drop.

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Supine Postion

* The patient is lying face up, flat of her back
* The bed is flat and both of the patient’s arms and legs are extended.
* Support the patient’s head with a pillow
* Support the patient’s arms and hands with pillows
* Support the small of the patient’s back with a small rolled towel or blanket.

Prone

* The patient is lying face down, flat on the abdomen
* The patient’s legs are extended and his head is to one side
* The patient’s arms are bent upwards at the elbows or extended down at the sides.
* The patient’s head and abdomen may be supported with pillows, if preferred

Lateral Position

The patient is lying of her left side, called left lateral, or right side, called right lateral

Sims’ position

is a partly left-side lygin and partly prone-lying position

Active motion

used when there is a full range of motion of one or more parts of the body and the patient does not require physical help to perform exercises. Healthcare workers may need to remind or observe the patient to make sure exercises are being done correctly.

Active-assistive range of motion

Used when the patient needs help with a full range of motion for one or more body parts because the muscles are too weak or stiff. Healthcare workers help with reange of motion by encouraging normal muscle function

Passive range of motion

used when a patient cannot move one or more body parts. healthcare workers perform the full range of motion wihtout any help from the patient. Keeps joint flexible; will not preserve muscle mass

On whom do you not perform ROM exercises

Those with heart and respiratory diseases and conditions

Flexion

The act of bending a joint

Extension

The act of straightening a joint

Hyperextension

An exaggerated, or extreme, extension

Abduction

Lateral movement away from the midline

adduction

lateral movement toward the midline of the body

Rotation

turning of a body part around an axis or fixed point