Nursing Key Terms: Exercise, Mobility, Sleep, and Rest

Fundamental Principles of Movement, Mobility, and Daily Living

• Active Exercise:

  • Definition: Moving one's own body and muscles independently without external assistance.

  • Mechanism: The individual initiates and controls muscular contraction and joint movement entirely through their own physical effort.

• Passive Exercise:

  • Definition: Movement where another individual moves a person's arms or legs on their behalf because the person cannot move them independently.

  • Clinical Context: Utilized when a patient lacks voluntary motor control, consciousness, or sufficient strength to execute movements alone, preventing joint stiffness and preserving joint mobility.

• Activities of Daily Living (ADLs):

  • Definition: Everyday foundational tasks performed to take care of oneself and maintain basic personal bodily care.

  • Specific Included Activities:

  • Bathing

  • Eating

  • Dressing

  • Using the bathroom (toileting)

• Instrumental Activities of Daily Living (IADLs):

  • Definition: Complex tasks that support independent living within a community or home environment.

  • Specific Included Activities:

  • Cooking

  • Shopping

  • Paying bills and financial management

  • Taking medication as prescribed

• Range of Motion (ROM):

  • Definition: The full distance or degree to which a joint can be moved.

  • Clinical Examples:

  • Bending the elbow.

  • Lifting the arm.

• Safe Patient Handling and Mobility (SPHM):

  • Definition: Safe protocols, techniques, and ergonomic equipment used to lift, transfer, reposition, or assist patients.

  • Objective: Facilitating movement and rehabilitation without causing injury to the patient or physical strain and injury to healthcare staff.

• Ergonomics:

  • Definition: The practice of designing and arranging work environments, workflows, or physical equipment so the human body stays comfortable, well-supported, and protected from injury.

Exercise Modalities and Muscle Dynamics

• Aerobic Exercise:

  • Definition: Continuous physical activity that increases heart rate and elevates respiratory rate to meet higher oxygen demands.

  • Core Examples:

  • Walking

  • Swimming

  • Riding a bicycle

• Isokinetic Exercise:

  • Definition: Muscle contractions and limb movements executed at a constant, steady speed against specialized mechanical equipment that regulates resistance.

  • Mechanism: The equipment matches the force exerted by the muscle throughout the entire range of motion while maintaining an unvarying velocity.

• Isometric Exercise:

  • Definition: Muscle contraction that increases tension without shortening the muscle or causing movement at the joint.

  • Exemplar: Squeezing abdominal muscles while staying completely still in a fixed position.

• Isotonic Exercise:

  • Definition: Dynamic physical exercise involving muscle contraction where muscles shorten (concentric) or lengthen (eccentric) through a range of motion against a constant load.

  • Exemplar: Lifting a weight.

• Strength and Endurance Exercises:

  • Definition: Targeted physical activities that increase muscle power and enhance stamina.

  • Outcome: Builds muscular force and allows an individual to sustain movement and activity for prolonged periods without early fatigue.

• Stretching Exercise:

  • Definition: The lengthening and elongating of muscles and connective tissues.

  • Physiological Goal: Promotes overall flexibility, increases range of motion, and improves the ease and quality of bodily movement.

• Tonus (Muscle Tone):

  • Definition: The baseline, slight state of continuous tension or tightness maintained by healthy muscles at rest.

  • Function: Supports upright posture and ensures muscles remain primed and ready to initiate movement immediately.

Musculoskeletal Alterations, Pathologies, and Clinical Practice

• Atrophy:

  • Definition: A reduction in the size and strength of a muscle resulting from disuse or lack of physical activity.

  • Pathophysiological Mechanism: Muscle fibers waste away when they are not challenged or stimulated by routine movement.

• Contractures:

  • Definition: The abnormal shortening, tightening, and hardening of muscles, tendons, or connective tissues.

  • Clinical Result: Creates resistance to stretch and makes moving the affected joint difficult or impossible, resulting in permanent or semi-permanent joint deformity.

• Flaccidity:

  • Definition: Complete loss of muscle tone characterized by loose, floppy muscle tissue displaying little to no strength, firmness, or resistance to passive stretch.

• Footdrop:

  • Definition: A clinical condition marked by difficulty or inability to actively lift the anterior portion of the foot (dorsiflexion).

  • Functional Impact: Leads to toes dragging along the floor during ambulation, creating a significant tripping hazard.

• Fracture:

  • Definition: A structural break or crack in the continuity of a bone.

• Orthopedics:

  • Definition: The branch of medical science and surgery focused on the diagnosis, care, and treatment of disorders affecting the musculoskeletal system, specifically bones, muscles, ligaments, and joints.

• Paralysis:

  • Definition: The total loss of voluntary motor function and movement in a specific body part or muscle group.

• Paresis:

  • Definition: Partial or incomplete paralysis characterized by significant weakness in a body part where movement is difficult, but minimal voluntary control remains.

• Spasticity:

  • Definition: An abnormal increase in muscle tone and stiffness caused by altered neuromuscular pathways.

  • Clinical Result: Muscles become hypertonic, rigid, and resistant to stretching, making coordinated motor movement difficult.