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.
-Proper body mechanics allows individuals to carry out activities without excessive use of
energy, and helps prevent injuries for patients and health care providers.
Body alignment
- is achieved by placing one body part in line with another body part in a vertical or
horizontal line
- Correct alignment contributes to body balance and decreases strain on muscle- skeletal
structures.

Balance
- is the ability to control your body's position, whether stationary (i.e. a complex yoga
pose) or while moving (e.g. skiing).
Center of gravity
- the centre of the weight of an object or person. A lower centre of gravity increases
stability.
Line of gravity
- an imaginary vertical line from the centre of gravity to the ground or surface the object
or person is on. It is the direction that gravity is acting upon the person or object.
Base of support
- refers to the area beneath an object or person that includes every point of contact that
the object or person makes with the supporting surface. These points of contact may be
body parts e.g. feet or hands, or they may include things like crutches or the chair a
person is sitting in.
Coordinated body movement
- definition of coordination is the ability to execute smooth, accurate, controlled motor
responses. are characterized by appropriate speed, distance, direction, timing and
muscular tension.
Weight
- is the amount that something or someone weighs.
friction
- is the force of rubbing two surfaces against one another.
Force
- is any action that tends to maintain or alter the motion of a body or to distort it.
fulcrum
- or pivot point is located on the lever between the effort force and load or resistance
being moved

Inertia
- is the resistance of any physical object to any change in its velocity. It is the tendency
to either stay where we are or to keep going where we’ve been going.
leverage
- simply put is doing more with less. In terms of grappling it is gaining more control
without applying a ton of force
Posture
- is defined as the attitude assumed by the body either with support during the course of
muscular activity, or as a result of the coordinated action performed by a group of muscles
working to maintain the stability.
Stance
- is the way in which someone stands, especially when deliberately adopted; a person's
posture.
Principle of body mechanics
• Body mechanics is the manner as to which or how you hold your body when you
move around.
• It Helps assist you with staying away from muscle exhaustion and wounds as you
walk, twist around, lift protests, or perform different exercises of daily day to day
basis. For example a nurse Dealing with patients with the use of the standards of
body mechanics secures the both the patient and the medical attendants safety.
- Patients advantages more since they are being lifted and moved by at least one or more
individuals who are utilizing the most grounded muscles of the body and medical
attendants can use the principle of body mechanics since this can help avoid patient injury
and also protected themselves from sometimes severe and permanent injuries,
particularly to their back, which can sometimes cease the nurse's ability to return to
nursing
Importance of body mechanics
• Safe and efficient use of appropriate muscle groups.
• Body Balance can be greatly enhanced
• Greater stability and balance
• Decreases the risk of injury
• Safe use of body to move objects and carry out the ADLs
• Good body alignment
Elements of body mechanics
Body Alignment (Posture)
- Body alignment and posture bring body parts into position to promote optimal
balance and body function.
Balance - can be greatly enhanced by:
a.) widening the base of support
b.) lowering the center of gravity. Allowing someone to remain upright and steady.
Coordinated Movement - characterized by appropriate speed, distance, direction,
timing and muscular tension. The ability to execute smooth, accurate, controlled motor
responses.
Factors of body mechanics
Growth and Development
- the age, musculoskeletal and nervous system development of a person affects the
posture, body proportions, body mass and body movements.
Physical Health
- a person experiencing an acute or chronic disease may experience the inability to move
freely also known as immobility. Congenital or acquired abnormalities, stroke and
orthostatic hypotension may also result to immobility.
Mental Health
- bodily processes tend to slow down in depression because of what an individual feels.

Nutrition
- both under nutrition and over nutrition can influence the body mechanics. Poorly
nourished individual tends to have muscle weakness and experiences fatigue.

Personal Values and Attitudes

- a person who values their physical self often engages in physical activity like exercise
and this will reduce the risk of immobility.
Certain External Factors
- high humidity, high/low temperature, availability of recreational activity and unsafe
environment are the external factors.
Prescribed Limitations- people who have health problems are often prescribed to
move less because this might cause more complications for them.
Guidelines of body mechanics
a.) Bend at your hips and knees instead of your waist. This helps you maintain your
balance by dividing your weight evenly between your upper and lower body.
b.) Spread your feet apart to create a foundation of support. This helps you maintain
your balance from side to side.
c.) Keep your back, neck, pelvis, and feet aligned when you turn or move. Do not twist
or bend at your waist.
d.) When you stand:

• Keep your feet flat on the floor about 12 inches (30 cm) apart.
• Do not lock your knees.
• Keep your shoulders down, chest out, and back straight
e.) when you lift an object
• Your feet should be apart, with one foot slightly in front of the other.
• Keep your back straight.
 • Lift the object using your arm and leg muscles.
• Hold the object close to your body at your waist level.
• Use the same process if you need to push or pull something heavy.
f.) when you sit
• Sit with your back straight and place extra support behind your lower back.
• Get up and change positions often if you sit for long periods of time.
• Ask about exercises to stretch your neck and shoulders.
• Adjust your computer so the top of the monitor is at the same level as your eyes.
• Use a paper holder so that the document is at the same level as the computer
screen.
• Use a headset if you use the telephone often.
e.) when you lift an object
• Your feet should be apart, with one foot slightly in front of the other.
• Keep your back straight.
• Lift the object using your arm and leg muscles.
• Hold the object close to your body at your waist level.
• Use the same process if you need to push or pull something heavy.
Body mechanics
Abduction
- moving away from the midline of the body
Adduction
- – moving towards the midline of the body
Ankylosis
– abnormal adhesion/ union of bones in a joint
Atony
- muscular weakness, lack of muscular bone
Circumduction
– movement of the distal bone in a circle
Contracture
- a deformity involving shortening of muscle due to muscle spasm
Depression
– an area of surface that is pushed down relative to its surrounding
Dorsal flexion
- toes pointed upward
Elevation
- to raise up vertically from the ground
Eversion
- turning the foot away from the middle
• Body mechanics
Extension
- stretching of a body fat
External rotation
– outward rotation
Internal rotation
– inward rotation
Flexion
– act on bending
Gait
– manner of walking
Hyperextension
– an abnormal extension past the joints range of motion
Immobility
- inability to move
Inversion
– foot inward
Lateral flexion
- movement of a body part to a lateral direction or sideways
Muscle atrophy
- degeneration of the muscles
Plantar flexion
- foot pointed downwards
Muscle atrophy
- wasting (thinning) or loss of muscle tissue
Pronation
– palms downward
Plantar
– relating to the sole of the foot
Rom exercise
– activity aimed at improving movement of a specific joint
Rotation
- circulation motion around its long axis
Tonus
- state of normal continuous tension in muscle, keeping posture
Ulnar flexion
– the movement of bonding the wrist to the little finger, or ulnar bone
Importance of rom exercise
e.) when you lift an object
• Your feet should be apart, with one foot slightly in front of the other.
• Keep your back straight.
• Lift the object using your arm and leg muscles.
• Hold the object close to your body at your waist level.
• Use the same process if you need to push or pull something heavy.
Effects of rom exercise
Musculoskeletal System
• Muscle mass increase progressively
• Bones become stronger
• Increase in temperature of muscles
• increased pliability (elasticity)
• muscle fatigue
Cardiovascular System
• Respiratory is efficiently increased
• Increased arterial elasticity
• Increase in stroke volume (SV)
• increase in heart rate (HR)
• increase in cardiac output (Q)
• increase in blood pressure (BP)
• redistribution of blood flow
Respiratory System
• The endurance capacity of your respiratory muscles including the diaphragm and
intercostal muscles increases.
• With regular training you grow more capillaries, which means you can get more
oxygen to your muscles quicker.
• The more you run, the more alveoli you grow. These take oxygen and transport it
into the capillaries.
• Allows deeper, fuller and more efficient breaths when you exercise the next time.
Urinary System
• Allows the body to take more oxygen and expand lung capacity.
• More efficient blood flow.
• Prevents from having urinary retention.
• Prevents from having infection.
 • Help prevent bladder problems, as well as constipation. It can also help you keep
a healthy weight.
• Help clean the urinary bladder.
Skeletal System
• Bones will become stronger
• Increase in strength; increase in flexibility; increase in speed; increase in muscular
endurance
• Increase in bone density
• Provide and makes join stronger
• Improves joints
Psychoneurological System
• Enhance sense of well-being and improve tolerance to stress
• Enhance of sleep pattern related to increase energy level
• Improve self-concept and self-esteem by decrease depression
Gastrointestinal System
• Appetite improvement
• Increased GI tract tone
• Improved digestion
• Improved elimination
Metabolic System
• Boost your metabolism.
• Slightly increase your resting metabolic rate even hours after exercises.
• Helps digest food more easily.
• Helps burn up more calories.
• Can help ward of illness and build up immune system for stronger resistance
Factors affecting rom exercise
Joint structure
 - There are several different types of joints in the human body. Some have a greater
range of motion (ROM) than others
Example:
- The ball and socket joint in your shoulder has the greatest range of motion of all joints.
Compare your shoulder joint, which moves in virtually every direction, to the hinge joint
in your elbow, which only allows you to flex and extend.
Factors affecting rom exercise
Age and gender
- Rom and flexibility naturally decreases as you get older.
- due to a degradation of the fibrous connective tissue that takes the place of muscle
fibers through fibrosis
- Because of bone structure, females tend to be more flexible than males, despite
how old they are
- Just as with strength and endurance, flexibility can be increased at any age with training,
like yoga, or proper stretching.
Connective tissue
- Deep connective tissue such as fascia and tendons can limit ROM
- These tissues differ in their ability to return to their original resting length
(elasticity) and their tendency to keep a new and greater length after stretched
(plasticity)
- Ligaments aren’t elastic, but can respond to stretching. Over time connective tissues
lose water content and the collagen in ligaments and tendons can become thicker and
less flexible.
Muscle bulk
- Big muscles can adversely affect ROM. It may be difficult for very bulky athletes
to complete certain stretches because their muscle mass gets in the way.
- If exercises employ heavy weights, flexibility can also be reduced as muscle density
and mass increases.
Example:
- A person with huge pec muscles, for example, may have trouble extending their arms
above their head. For some athletes, big muscles are more important than ROM
Proprioceptors
 - are tiny sensors located inside muscle fibers that provide information about joint
angle, muscle length, and muscle tension.
- Careful, purposeful, slow stretching can ensure that these sensors don’t trigger
spasms or reflex actions that don’t help build flexibility.
- There are other factors, like previous injury, that can cause a loss of flexibility.
Regardless of the cause, massage by a qualified professional can go a long way
toward restoring lost flexibility and increase ROM.
Joint Articulation
- Joint articulation refers to how the bones, tendons, ligaments and muscles are
oriented in a joint to permit certain range of motions.
- Some articulations provide only one range of motion, such as the elbow joint,
where it allows only the arm to flex or extend.
- Others allow a wide variety of movements, such as the ball-and-socket joint of the
shoulder, where it can flex, abduct, adduct and rotate.
Muscle or Fat Mass
- Extra fat or muscle mass may inhibit a joint's normal range of motion by physically
blocking its path of movement.
example:
- a protruding abdomen can limit how high you can flex your hip and pull your knee to
your ribs.
Body Asymmetry
- People who play asymmetrical sports, like tennis and baseball, are likely to have
less range of motion in the dominant shoulder or hip than the nondominant side,
although the dominant side may have more coordination, strength and stability
than the other side.
- This also applies to other daily activities, such as sweeping, vacuuming, writing
and carrying a purse.
Injury and Disease
- Pain from an injury or disease causes the muscles in the injured site to contract
reflexively to avoid further damage, thus limiting the joint's range of motion.
- Such conditions include arthritis, bursitis, bruises, dislocation and sprains.
 - Regular range of motion can be achieved over time with proper rehabilitation and
treatments, such as corrective exercises, massage, heat therapy and acupuncture.
Tissue Extensibility
- Tissue extensibility refers to the elasticity and flexibility of the muscles and their
surrounding connective tissues. If they are not stretched or moved regularly, they can
become stiff and lack extensibility, which affects how much you can move.

- In practical application, before exercise, you should perform warm-up exercises that
move your joints in its full range of motion. For example, before you run, you can do hip
swings in the sagittal plane (front to back), frontal plane (side to side) and transverse
plane (rotation). This exercise not only elevates your body temperature to improve tissue
extensibility, but also moves the hip joint in all plane to motion to minimize stiffness and
increase neural stimulation.
Types of rom
Isotonic
– Involving muscle contraction. Increases muscle tone, mass, strength, maintain joint
flexibility and circulation.
Isometric
– Person consciously increases the tension of the muscle. Produces mild increase in heart
rate and cardiac output.
isokinetic
– Maximum force extended by a muscle. Performed at a consistent speed, which can be
increased as you progress.
Passive rom exercise
– The joint of an individual receiving exercise is completely relaxed while the outside
force moves the body part, such as a leg or arm, throughout the available range.

Active- assistive exercise

– done without manual assistance from therapist. Performed by patient with nurse
assistance.
• Indications and contradiction of performing rom exercise
arthritis
 - An individual who has arthritis needs to practice exercise in order to maintain their
range of motion
- They may feel more comfortable when they keep their joints bent, but exercises
that emphasize range of motion can actually improve joint movement and
flexibility.
Sedentary lifestyle
- People who live sedentary lifestyles usually have weak muscles and are unable to
execute even the simplest exercises.
- If you want to improve agility and overall muscle strength, it is advisable to add
low-impact exercises into your workout regimen.
• Not only will this improve the strength of your muscles but will also enhance
physical performance as well.
• Indications and contradiction of performing rom exercise
improves circulation
- Range of motion exercises primarily entail flexibility and stretching training to improve
blood flow, as well as oxygen circulation throughout the body.
- Increased activity during these exercises increases blood circulation through your
muscle
- Better circulation nourishes the cell and transport nutrients efficiently to other body
organs. In other words, better circulation provides sufficient amounts of oxygen
needed to fuel the body during intense physical exertion.
Alleviates back pain
- Physical therapists recommend range of motion exercises for back pain.
- If you have chronic back pain, complement your exercises with supine workouts
to challenge different muscle groups.
- While there are no downsides associated with performing range of motion
exercises, always remember to use proper form when exercising to reduce the risk
of strain and injuries.

Contradictions rom exercise

Heart and Respiratory Diseases
 - Range of motion exercises require energy and tend to increase circulation. It will then
increase the level of energy expended or increase the demand for circulation. It is
potentially hazardous to patients with heart and respiratory diseases.

Connective Tissue Disorders

- Range of motion exercises put stress on the soft tissues of the joint and on the bony
structures. These exercises should not be performed if the joints are swollen or inflamed
or if there has been injury to the musculoskeletal system in the vicinity of the joint.
Principles of rom exercise
Physics
- ROM exercise improves the range of movement of the joins and ligaments.
- The exercise also improved muscle strength.
- With the help of internal and external forces, when a muscle contracts, it applies
an internal pulling force on a bone, which causes movement. External forces are
generated outside of the body.
Psychology
- Promotes well-being of the patient and helps the mental recovery of an injured
patient.
- It gives positive effects in enhancing psychological function to bedridden people
with stroke and decreases depression level among
Body Mechanics
• It helps with the body alignment and proper posture of the body.
• In combination with body mechanics the body will be more coordinated with itself.
And thus, able to execute smooth, accurate, and controlled motor actions.
Physiology
- ROM helps physical rehabilitation for stroke survivors have been well established.
- And it also improves in flexibility, joint angles, activity function, and perception of
pain.
- It is also used to prevent weakening of the muscles and muscle atrophy after an
injury or surgery.
Anatomy
 - ROM secures bones together and they allow the body to be mobile. It also
configures the bone surfaces within the joint, joint capsule, ligament, tendons, and
muscle acting on the joint.
- It increases the distance and direction a joint moves flexed and extended position
and improves movement efficiency.

Guidelines of rom exercise

• Plan when range of motion should be done.
• Position yourself so that proper body mechanics can be used
• Expect an increase in the patient's heart rate and respiratory rate during exercise.
• Range of motion exercises should be done at least twice a day ( during bath is one
appropriate time. The warm bath water relaxes the muscles and decrease
spasticity of the joints.)
• The motion is done with free form
• The joints of helpless immobile patients should be exercised once every night to
prevent contracture from occurring.
• Assistance is given only as need for smooth motion
• Joints should be exercised sequentially, starting with the neck and moving down.
• Monitor vital signs before, during and after exercise.
• Avoid overexerting the patient. Some exercises need to be delayed until the
patient’s condition improve
Beginning skills of rom
Neck [pivot joint]:
Flexion, Extension, Hyperextension and Lateral flexion
Shoulder [ball and socket joint]:
Flexion, Extension, Hyperextension, Abduction, Adduction, Circumduction, External
Rotation and Internal Rotation
Elbow [hinge and joint]:
Flexion, Extension, Rotation for supination and Rotation for pronation
Wrist [condyloid joint]: Flexion, Extension, Hyperextension, Radial flexion (abduction)
and Ulnar flexion (adduction)
Thumb [saddle joint]: Flexion, Extension, Abduction, Adduction, Opposition
Hip [ball and socket joint]: Flexion, Extension, Hyperextension, Abduction, Adduction,
Circumduction, Internal rotation, External rotation
Knee [hinge joint]: Flexion, Extension: straighten each leg, returning the foot to its
position beside the other foot

Ankle [gliding joint]: Extension (plantar flexion), Flexion (dorsiflexion)

Foot [gliding joint]: Eversion and Inversion
Toes [Interphalangeal joints-hinge; metatarsophalangeal joints-hinge;
intertarsal joints-gliding]: Flexion, Extension
Trunk [gliding joint]: Flexion, Extension, Hyperextension, Lateral Flexion and Rotation