Body Mechanics and PT Mobility

NURSING MEASURES
Body Mechanics and

Patient Mobility
1
Slide 1
Mosby items and derived items © 2006, 2003, 1999, 1995, 1991 by Mosby, Inc.
Body Mechanics
 The efficient and safe use of the
body during activity
 Prevents injury to yourself,
 Saves energy & increases efficiency
 Prevents back injury
 Lifting is the most common cause of

back injuries among healthcare
workers
Slide 2
Anatomy of a Healthy
Back
Slide 3
Anatomy of a Healthy Back
Three natural curves:
Cervical (7)
 Curve of the neck
Thoracic (12)
 Curve of middle
back
Lumbar (5)
 Curve of lower back
Slide 4
Discs
Round-shaped
cartilage
absorb shocks
and separate
vertebrae
Slide 5
Curves must be positioned in

straight line for proper
alignment:
 Ears-shoulders-hips
 Evenly distributes body weight

throughout vertebra and discs
Slide 6
Muscles and Joints
 Several muscle groups help
support spine
 abdomen, back
 Flexible joints allow back to

provide range of motion
 Hips, knees, ankles
Slide 7
BODY MECHANICS
The use of one’s body to produce
motion that is:
safe,
energy conserving, and
anatomically and physiologically
efficient and,
leads to the maintenance of a
person’s body balance and control
Slide 8
Q: To maintain a wise base of
support the PT will stand with
feet separated approximately:
A. 3 feet apart
B. 1x the length of their shoe
C. 1.5X the length of their shoe
D. Exactly the width of their shoulders
10
Slide 9
Vocabulary
 Alignment – The relation between
body parts that helps with balance,
movement and smooth coordination
 Base of support – Feet apart
providing stability ( 1.5 time length
of shoes)
 Body Mechanics – Proper use of
muscle groups to keep healthy
posture during movement
Slide 10
Q: The PT knows the body’s center
of gravity is:
A. Keeping feet 15-20 inches apart

B. Assuring the knees are always bent
C. In the abdomen
D. Different for each person
15
Slide 11
Using Appropriate Body Mechanics
BODY MECHANICS
1.Field of physiology that studies muscular
action and the function of muscles in
maintaining the posture of the body
2.Maintain a wide base of support.
3.Bend the knees and hips rather than the
back.
4.Stand in front of the object.
5.Adjust the working level to one of
comfort.
6.Carry objects close to the midline of the
body.
Slide 12
Figure 15-1:
Good position for
body mechanics
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals

of nursing. [6th ed.]. St. Louis: Mosby.)
Slide 13
Q: When Lifting objects…
A. Hold load away from body
B. Hold load close to body
C. Balance load on open palms
D. It does not matter
30
Slide 14
Figure 15-2: Picking up a box
using good body mechanics
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Slide 15
Carrying Objects or
Lifting items
When carrying objects:

 Test the load first
 Use a cart/transfer device whenever possible
 Pivot with your feet - don't twist at waist
 Take multiple trips
 Use both hands
 Keep objects near your body and directly in
front of you
 Ask for assistance with heavy items.
16
Slide 16
LIFTING
When lifting objects, DO NOT:
 Lift in a bent-over, stooped position
 Twist at waist
 Lift with one hand
 Lift with outstretched arms
 Keep feet together
 Lift above shoulders or below knees when

feasible
17
Slide 17
SITTING
1. Sit close to your work

2. Hips, knees and ankles are open to 90
degrees
3. Elbows are open to 90-120 degrees
4. Wrists are in relaxed and neutral
position (not bent)
5. Both feet are flat on the floor or use a
foot rest
6. Shoulders are low and relaxed
7. Head and neck are aligned with spine
18
Slide 18
SITTING
 Do not slump or lean forward or
downward to reach for work.
 Do not sit for more than 60
minutes without getting up or
changing position.
 Raise the height of the
computer screen so screen is
at or slightly below eye level.
19
Slide 19
STANDING
 Bring your work close to you.

 Put one foot up, shift your weight and
position frequently.
 Keep your work at a comfortable height.
 Wear comfortable shoes and stand on an
anti-fatigue mat, if possible.
Slide 20
STANDING
DO NOT:
 Stand in one place too long.
 Stand bent forward at your waist or neck.
 Lock your knees into a straight or over-

extended position.
Slide 21
PUSHING
 Push whenever possible.
 Keep head up, knees bent, and
back straight.
 Keep the load in front and use
both hands.
 Remain close to the item being
pushed.
Slide 22
PULLING OR TWISTING
DO NOT:
 Pull when you can
push
 Twist your body
 Lean forward
23
Slide 23
REACHING
When reaching for an object, remember to:
 Keep back straight
 Reach with two hands
 Face the object
 Stand on a stable step-stool to reach high
items
 Bend knees slightly.
24
Slide 24
Vocabulary
 Dorsal – toward the back
 Dorsal recumbent – lying on back
(supine) with extremities flexed slightly
 Genupectoral – (knee-chest (kneeling
with weight of body supported/head
turned
 Immobility – lack of ability to move
freely
 lithotomy – lying on back (supine) with
hips/knees flexed
Slide 25
Vocabulary
 Mobility – ability to move freely
 Orthopneic – sitting in bed leaning
forward supported by table.
 Prone – lying face down on abdomen
 Semi-Fowler’s – lying on back in bed
with head (30 and knees raised
 Sims’ position – lying on left side with
right knee bent toward chest
Slide 26
POSITIONING PATIENTS
-There are many positions to use to prevent
patients from developing complications.
Dorsal (supine)
 Lying horizontally on the back
Dorsal Recumbent
 Supine position with patient lying on back, head,
and shoulders, with extremities moderately
flexed, legs may be extended
Fowler’s position
 Head of bed raised 45 to 60 degrees
Slide 27
Dorsal Recumbent
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis:
Mosby.)
Positioning patients
Slide 28
Semi-Fowler’s Position
Slide 29
Orthopneic Sim’s Position
position
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.]. St.
Louis: Mosby.)
Slide 30
Prone Position
Mosby.)
Slide 31
Knee-chest position
Mosby.)
Slide 32
Lithotomy
(From Seidel, H.M., Ball, J.W., Dains, J.E., Benedict, G.W. [2003]. Mosby’s guide to physical
examination. [5th ed.]. St. Louis: Mosby.)
Slide 33
MORE BODY POSITIONS FOR
PHYSICAL EXAM
Slide 34
Mobility versus Immobility
Mobility
 A person’s ability to move around freely in his
or her environment
Serves Many Purposes
 Express emotion
 Self-defense
 Attain basic needs
 Perform recreational activities
 Perform activities of daily living (ADLs)
 Maintain body’s normal physiological activities
Slide 35
Mobility versus Immobility
Immobility
 Inability to move around freely
Complications of Immobility
 Muscle and bone atrophy; contractures;
pressure ulcer
 Constipation; urinary tract infection
 Disuse osteoporosis; kidney stones
 Pneumonia; pulmonary embolism;
postural hypotension
 Anorexia; insomnia
 Asthenia (weakness)
 Disorientation
Slide 36
Bony Prominences
Slide 37
Slide 38
Decubitus Ulcers (Bed Sores)
Slide 39
Complications of immobility include
all of the following, EXCEPT:
1. Skin breakdown
2. Increased vital signs
3. Muscle atrophy
4. Joint contractures
15
Slide 40
PERFORMING RANGE-OF-
MOTION EXERCISES
Range-of-Motion (ROM)
 Any body action involving the muscles and
joints in natural directional movements
Exercises may be performed by physical
therapy department personnel or by the
nurse, PT’S and allied staff.
Exercises are indicated for patients
confined to bed for long periods.
Exercises may be preformed passively by
nurses, PT’S or actively by patients.
Slide 41
PERFORMING RANGE-OF-
MOTION EXERCISES
 The total amount of activity required to
prevent physical disuse syndrome is only
about 2 hours for every 24-hour period.
 Designated body joints are moved to the
point of resistance or MILD pain, using
care to avoid injury.
Slide 42
ROM Vocabulary
 Range of motion -normal joint
movements
 Flexion -decreases angle between two
joints
 Hyperextension -maximum extension
 Lateral flexion -away from midline
 Extension -movement increasing angle
 Rotation –circular movement
 Abduction -moving extremity away from
body
 Adduction-moving extremity toward the
body
Slide 43
ROM Vocabulary
 Contracture – atrophy/shortening
of muscles usually causing
permanent abnormal mobility
 Dorsiflexion – bending/flexing
backwards, upwards
 Pronation – palm of hand turned
down
 Supination – palm of hand upward
Slide 44
Skill 15-2: Step 8
Louis: Mosby.)
Performing range-of-motion exercises

Slide 45
Performing Range-of-Motion
Exercises
-With partner practice ROM

performing:
 Flexion (decreases angle between two
joints )
 Hyperextension (maximum extension)
 Lateral flexion
 Extension ( movement increasing
angle)
 Rotation (circular )
Slide 46
Basic transfer procedures are:
A. Adapt to each situation
B. Always transfer the same say
C. Transfer twice; mentally then
physically
D. Ask the patient how to do it.
30
Slide 47
To transfer pt to head of bed (HOB):
A. Grab under arms and pull up
B. Keep pts. knees flat
C. Bend pts. knees
D. Use a lift sheet
15
Slide 48
To assist pt. to sit up in bed
1. Pull patients arms
2. Have patient hug your neck
3. Raise HOB and lower legs
4. Whatever works for the situation
20
Slide 49
BASIC LIFTING PROCEDURES are
1. Adapt to each situation
2. Always transfer the same way
3. Transfer twice: mentally then
physically
4. Ask the patient how to do it.
25
Slide 50
MOVING THE PATIENT
 Moving includes lifting the patient up into
bed, to the side of the bed, to the tub,
and into a car.
 Moving also includes turning, dangling,
and assisting the patient in and out of
the bed for ambulation.
 Mechanical Equipment for Lifting Patients
 Hydraulic lift
 Roller board
 Gurney lift
Slide 51
Figure 15-4: HAND ROLL
Mosby.)
Slide 52
Figure 15-5:
Patient using a
trapeze bar
Mosby.)
Slide 53
To transfer a heavy patient…
1. Get help from another staff
2. Use a mechanical lift
3. Just use your own strength
4. Follow patients care plan
15
Slide 54
MOVING THE PATIENT
 Lift twice
 Once mentally and then once physically
 Be certain to have sufficient assistance.
 Assess patient’s ability to assist with
moving.
 If moving may be painful for the
patient, the PT will want to administer
medication to the patient before any
such activity.
Slide 55
Using the Lift for Moving Patients
Mechanical devices, such as the

hydraulic lift used with a Hoyer sling,
will:
 Move patients safely
 Protect the nurse’s and PT’s back
 Provide full-weight lifting of patients
who cannot assist
Slide 56
Figure 15-6: A-C
A. The lift is over the patient.
B. The sling is attached to a

swivel bar.
(From Sorrentino, S.A. [2004]. Assisting with

C. The lift is raised until the sling and
patient care. [2nd ed.]. St. Louis: Mosby.) patient are off of the bed.
Slide 57
Figure 15-6: D-E
D. The patient’s legs are

supported as the patient and lift
are moved away from the bed.
E. The patient is guided into

(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.].
St. Louis: Mosby.)
a chair.
Slide 58
Skill 15-3: Steps 9f(3), 9f(4)
Louis: Mosby.)
Moving the patient.

Slide 59
Skill 15-3: Step 11e
(From Sorrentino, S.A.[1992]. Mosby’s textbook for nursing assistants. [3rd ed.]. St. Louis: Mosby.)
Moving the patient.

Slide 60
Skill 15-3: Step 12e
Moving the whole body of the patient to sides
Slide 61
Skill 15-3: Steps 13c, 13f
Mosby.)
Moving the patient.

Slide 62
To assist with walking staff stands by…
1. Patients strong side
2. Patients weak side
3. Stand behind patient
4. Any of the above are fine.
15
Slide 63
Skill 15-3: Step 13j(7) & 13j(8)
Moving the
patient alone (From Sorrentino, S.A. [2004]. Assisting with patient
care. [2 ed.]. St. Louis: Mosby.)
nd
Slide 64
Skill 15-3: Step 14f
Louis: Mosby.)
Moving the patient with multiple carriers

Slide 65

Body Mechanics and PT Mobility

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NURSING MEASURES

Body Mechanics and

 Saves energy & increases efficiency

 Prevents back injury

 Lifting is the most common cause of

 Curve of the neck

 Curve of lower back

Curves must be positioned in

 Evenly distributes body weight

 Flexible joints allow back to

A. Keeping feet 15-20 inches apart

(From Potter, P.A., Perry, A.G. [2005]. Fundamentals

When carrying objects:

 Lift with one hand

 Lift with outstretched arms

 Keep feet together

 Lift above shoulders or below knees when

1. Sit close to your work

 Bring your work close to you.

 Stand bent forward at your waist or neck.

 Lock your knees into a straight or over-

Performing range-of-motion exercises

-With partner practice ROM

Mechanical devices, such as the

A. The lift is over the patient.

B. The sling is attached to a

(From Sorrentino, S.A. [2004]. Assisting with

D. The patient’s legs are

E. The patient is guided into

Moving the patient.

Moving the patient.

Moving the whole body of the patient to sides

Moving the patient.

Moving the patient with multiple carriers

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