Activityexercisepattern

ACTIVITY
&
EXERCISE PATTERN
Fundamentals of nursing BScN
Nursing Instructor: Sir Jerry
8/21/2021 1

Objectives
At the end of this lecture, the learners will
be able to:
•Define terms mobility, joint mobility,
body alignments, and body mechanics.
•Discuss the benefits of exercise and
activity.
•Identify the principles of gravity that
effect balance.
•Discuss factors effecting mobility
•Discuss the effect of immobility on human
body.
8/21/2021 2

Objectives
•Review A/P of muscular skeletal system
and characteristics of normal movements.
•Describe the impact of immobility on
physiologic and psychological functioning.
•Apply nursing process while planning for
the client with altered muscular skeletal
system.
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An activity –exercise pattern:
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Refers to a person's routine of
exercise, activity, leisure, and
recreation: it includes
Activities of daily living (ADLs) that
require energy expenditure such as
hygiene, cooking, shopping, eating,
working, and home maintenance.
The type, quality, and quantity of
exercise, including sports.

Mobility and Immobility
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Mobility refers to the ability to engage in
activity, and free movement which includes
walking, running, sitting, standing, lifting,
pushing, pulling and performing daily living
activities
Immobility refers to the inability to move
about freely.

Body mechanics
Good body mechanics is the
efficient, coordinated, and safe use of the body
to produce motion and maintain balance during
activity.
Three basic elements of body mechanics:
BODY ALIGNMENT (POSTURE), BALANCE
(STABILITY), and COORDINATED BODY
MOVEMENT.
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Normal movement
Body Alignment: the geometric
arrangement of body parts in relation to
each other.
Joint mobility
Balance: a state of equipoise
(equilibrium) in which opposing forces
counteract each other
Coordinated Body Movement: Integrated
functioning of the musculoskeletal and
nervous system as well as joint mobility
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Alignment and posture
A person maintains the balance as long as
the line of gravity (an imaginary vertical
line drawn through the body center of
gravity) passes through the center of
gravity (the point at which all the body
mass is centered) and the base of support
( the foundation on which body rests)
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Joint mobility
Joint: functioning unit of the musculoskeletal
system.
Bones articulate at the joints
Skeletal muscles attach to two bone at the
joint
Range of Motion: maximum movement that
is possible for the joint.
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Joint mobility
Joints are functional units of
musculoskeletal system. The bones of
skeletal articulates at the joints, most of
the skeletal muscles attach to the two
bones at joint . These muscles are
categorized according to the type of joint
movement they produce on contraction.
Muscles are therefore called flexors,
extensors, internal rotators, and so on
8/21/2021 11

Balance
The mehanism involved in maintaing balance
and posture are complex and involve
informational inputs from labyrinth , from vision
( vestibulo occular input), from stretch
receptors of muscles and tendons( vestibulo
spinal input).
Labyrinth (inner ear )
Cochlea – hearing
Vestibule – equilibrium-receptors
Semicircular canal – equilibrium- receptors.
These equlibrium receptors collectively called
vestibulae appratus
8/21/2021 12

proprioception
Is the term used to describe awareness of
posture, movements, and changes in
equilibrium and the knowledge of position,
weight and resistance of objects in
relation to the body.
8/21/2021 13

Coordinated movements
Balanced, smooth, and purposeful
movements is the result of proper
functioning of cerebral cotex , cerebellum,
and basal ganglia .
Cerebral cortex – voluntary motor activity
Cerebellum – muscles involved in motor
activity
Basal ganglia – maintain posture
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Types of joint
movements
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Exercise
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Physical activity is "bodily movement
produced by skeletal muscles that
requires energy expenditure and
produces progressive health benefits."
Exercise is "a type of physical activity
defined as a planned, structured, and
repetitive bodily movement done to
improve or maintain one or more
components of physical fitness."
Activity tolerance is the type and
amount of exercise or daily living
activities an individual is able to perform
without experiencing adverse effects.

Type of exercise:
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Exercise involves the active contraction
and relaxation of muscles.
Exercise can be classified according to the
type of muscle contraction
(isotonic, isometric, or isokinetic)
and according to the source of energy
(aerobic or anaerobic).

Isotonic (dynamic) exercises:
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Muscle shortens to produce contraction and
active movement .e.g. running, walking,
swimming, cycling)
* Advantages:
1 Increase muscle tone, mass, strength.
2 Maintain joint flexibility and circulation.

Isometric (static or setting)
exercises:
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There is muscle contraction without moving
the joint
*useful for strengthening abdominal, gluteal
muscles
* No change in muscle length
* No joint movement
*Maintaining strength in immobilized muscle

Isokinetic (resistive) exercises:
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It involves muscle contraction or tension
against resistance, can be either isotonic
and isometric.
These exercises are used in physical
conditioning & are often done to build
up certain muscle groups.

Aerobic exercise:
 It is an activity during which the amount of
oxygen taken in the body is greater than that
used to perform the activity.
 These exercises use the large groups of
muscle, are performed continuously, & are
rhythmic in nature. E.g: walking, running,
dancing, aerobic exercise improve
cardiovascular conditioning & physical fitness.
8/21/2021 24

Anaerobic exercise:
involves activity in which the muscles cannot
draw out enough oxygen from the
bloodstream.
And anaerobic pathways are used to
provide additional energy for the short
time. this type of exercise is used in
endurance training for athletes.
8/21/2021 25

Factors effecting body alignment
and mobility
 Growth and
Development
 Physical Health
 Mental Health
 Nutrition
 Lifestyle
 Personal Values
 Fatigue and Stress
 External Factors
 Prescribed
limitations
8/21/2021 26

Benefits of exercise on body system
8/21/2021 27
Musculoskeletal System:
*Increase and maintain muscle tone, size,
shape
* Increase joint mobility, flexibility, and
range of motion.
*Maintain bone density & strength.
Cardiovascular System:
*Improve cardiovascular function, by increasing
cardiac output and strength of heart muscle
contraction.

Benefits of exercise on body
system
Respiratory System:
*Improves gas exchange by increasing the
ventilation & oxygenation.
GI tract System:
*Improve appetite, digestion and elimination.
Metabolic System:
*Increase metabolic rate, thus increase the
production of body heat and calorie use.
8/21/2021 28

Benefits of exercise on body
system
8/21/2021 29
Urinary System:
*Improve excretion of body waste through the kidneys.
Psycho- neurologic System:
*Enhance sense of well-being and help to relieve stress.
* Improves the quality of sleep.
*Improve self concept and self esteem by decreasing
depression.

Intugumentary System:
* Maintain skin integrity
COGNITIVE FUNCTION:
Current research supports the positive effects of
exercise on cognitive functioning, in particular
decision-making & problem-solving
processes, planning, and paying attention.
Physical exertion induces cells in the brain to
strengthen and build neuronal connections
8/21/2021 30

SPIRITUAL HEALTH:
Yoga-style exercise improves the mind–body–
spirit connection, relationship with God, and
physical well-being by establishing balance
in the internal and external environment.
The RELAXATION RESPONSE (RR), first described
by Dr. Herbert Benson, is beneficial for
counteracting some of the harmful effects of stress
on the body and mind. The RR is a healthful
physiological relaxation that can be elicited through
recitation of a word or phrase or prayer while sitting
quietly and relaxing your muscles.
(Varvogli & Darviri, 2011).
Zahid (RN, Post RN) GFNC
8/21/2021 31

Effects of immobility
Mobility and activity tolerence are effected by any
disorder that impairs the ability of the nervous system,
musculoskeletal system, cardiovascular system, vestibular
apparatus . Congenital problems such as hip dysplasia,
spinal bifida, cerebral palsy, and muscular dystrophies
effect motor functioning.
Head and spinal cord injuries can leave muscle group
weakened paralyzed, spastic, or flaccid.
8/21/2021 32

Effects of immobility & exercise on body
 Problem Related to
Immobility:
 Disuse osteoporosis
 Disuse atrophy
 Contractures
 Stiffness and pain in
joints
 Cardiovascular System
 Problems related to
Immobility:
 Diminished cardiac
reserve; Orthostatic
hypotension, venous
vasodilatation and
stasis, dependent
edema , thrombus
formation.
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Respiratory System:
Immobility:
 Decreased
respiratory movement;
 Pooling of respiratory
excretions;
 Atelectasis;
 hypostatic pneumonia
 Metabolic System:
Immobility
 Decreased metabolic
rate
 Anorexia
 Negative calcium
balance
 Negative nitrogen
balance
8/21/2021 35

Urinary System:
◦ Problems related to Immobility:
Urinary stasis;
renal calculi
Urinary retention;
Urinary Infection
Gastrointestinal System:
◦ Problems related to Immobility: Constipation;
decreased peristalsis and colon motility
8/21/2021 36

Effects…..
Intugumentary System:
 Problems related to Immobility: Reduced
skin turgor; skin breakdown
 Effects of exercise: improved blood
circulation (peripheral) and promoted
delivery of nutrients and oxygen.
8/21/2021 37

Effects……
Psycho neurologic System
◦ Problems related to Immobility: Increased
dependence; lower self-esteem; Exaggerated
emotional reactions; lack of intellectual
stimulation
◦ Effects of exercise: improves tolerance to
stress; sense of relaxation; improvement of
body image; improves sleep
8/21/2021 38

Assessment
 Nursing history
 Physical examination
Body alignment
 Gait
 Appearance
 Movement of joints
 Capabilities and
limitations of joints
 Muscle mass and
strength
 Activity tolerance
8/21/2021 39

Nursing Diagnoses
8/21/2021 40
Activity Intolerance
Impaired Physical Mobility
Self-Care Deficits
Altered Health Maintenance
Risks for Falls

Planning
The client will have;
•Increased tolerance for physical activity
•Restored or improved capabilities to ambulate or
participate in ADLs
•Absence of injury from falling
•Enhanced physical fitness
•Absence of any complication associated with
immobility
•Improved social , emotional, intellectual wellbeing
8/21/2021 41

Nursing intervention
Maintaining good posture
Positioning Clients
◦ Fowler’s Position
◦ Orthopneic Position
◦ Dorsal Recumbent Position
◦ Prone Position
◦ Lateral Position
◦ Sim’s Position
8/21/2021 42

Nursing interventions
Nursing strategies to maintain or promote body
alignment and mobility involve
•Positioning client appropriately
•Moving and turning clients in bed
•Transferring clients
•Providing ROM exercises
•Ambulating clients with or without mechanical
aids
•Prevent the complications of immobility
8/21/2021 43

Nursing intervention
Moving and Turning Clients in Bed
◦ Moving a client up in bed
◦ Moving a client to the side of the bed in segments
Transferring Clients
◦ Transferring a client between a Bed and a
Wheelchair
◦ Transferring a Client between a Bed and a Stretcher
◦ Moving a Client Using a Hydraulic Lift
Exercise
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Nursing interventions
Ambulating Clients
◦ Ambulation: act of walking; function that most
people take for granted
Perambulatory Exercises
Assisting Clients to Ambulate
8/21/2021 45

Evaluation
The goals established during planning
phase are evaluated according to specified
desired outcome.
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References
8/21/2021 47
Kozier, Barbara, et al. (2004) Assessing,
Fundamentals of Nursing: concepts,
process and practice, 2nd ed .

THANKS FOR THE
ATTENTION
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8/21/2021 49

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