Body Mechanics and Moving

BODY MECHANICS AND
MOVING
BY: Betelihem Tadesse(MSc)
BY Betelihem T. 1
objective
BY Betelihem T. 2
Maintaining body alignment
Mobility: refers to the ability to engage in activity and free
movement which includes walking, running, sitting, standing,
lifting, pushing, pulling, and performing activities of daily living
(ADLs).
It is often considered an indicator of health status because it

influences the correct functioning of many body systems
it enhances muscle tone, increases energy levels, and is associated

with psychological benefits such as independence and freedom.
BY Betelihem T. 3
Body alignment refers to the relative position of body parts in
relation to each other
Proper body alignment/Posture: is an individual’s ability to

maintain equilibrium and results in balance
When the body is in good posture, the center of gravity (the

center point of an object’s mass) is evenly distributed over the
foundation points
The normal alignment of the spine has a cervical concavity, a

thoracic convexity, and a lumbar concavity
BY Betelihem T. 4
Proper standing body alignment is characterized by the following:
• Head upright
• Face forward
• Shoulders squared
• Back straight
• Abdominal muscles tucked in
• Arms straight at side
• Hands palm forward
• Legs straight
• Feet forward BY Betelihem T. 6
• The sitting position in proper alignment has similar characteristics;
however, the hips and knees are flexed
Fig Proper Sitting Posture and Line of Gravity

BY Betelihem T. 8
• Proper alignment and posture of the client lying in bed appear
similar to the standing position; however, the client is supine
Fig Proper Supine Posture and Line of Gravity
BY Betelihem T. 9
Benefits of proper alignment and posture
Promote client comfort
Prevent contractures
To promote circulation
To lessen stress on muscle, tendons, nerves, and joints
To Prevent foot drop (plantar flexion)
Gives an appearance of confidence and health
BY Betelihem T. 10
Mal-alignment
Lordosis :Forward curvature of the lumbar spine
• More pronounced in obesity and pregnancy (due to change in

center of gravity)
BY Betelihem T. 11
Kyphosis: Abnormally increased convexity in the
curvature of the spine
• In advanced stages, can interfere with lung expansion
• Chin tilts downward onto chest with abdominal protrusion
• Decreased interval between lower rib cage and iliac crests
• Commonly seen: osteoporosis, Paget’s disease, elderly clients
BY Betelihem T. 12
Scoliosis: Lateral deviation in the normally straight vertical line of the
spine
One side higher than the other or one shoulder blade more
prominent
 Abnormal waistline tilt with more indentation on one side
Tilting of the hips with one hip more prominent
 A prominence of the posterior chest or the shoulder when bending

over.
BY Betelihem T. 13
BY Betelihem T. 14
• Contractures: develops when the muscle fibers become
unable to flex
Each muscle has an antagonist that works in the opposite direction
BY Betelihem T. 15
Body Mechanics:
The purposeful and coordinated use of body parts and

positions during activity.
is the effort; coordinated, and safe use of the body to

produce motion and maintain balance during activity
It governs Functional mobility
BY Betelihem T. 16
Basic Principles of Body Mechanics
1. It is easier to pull, push, or roll an object than to lift it. The
movement should be smooth and continuous, rather than
jerky.
2. Often less energy or force is required to keep an object
moving than it is to start and stop it.
3. It takes less effort to lift an object if the nurse works as close
to it as possible. Use the strong leg and arm muscles as
much as possible. Use back muscles, which are not as
strong, as little as possible. Avoid reaching.
4. The nurse rocks backward or forward on the feet and with
his or her body as a force for pulling or pushing.
BY Betelihem T. 17
• Principles under lying proper body mechanics involve three major
factors: center of gravity, base of support, and line of gravity.
 center of gravity is located in the middle of the pelvis about

halfway between the umbilicus and the symphysis pubis.
• This means that approximately half the body weight is distributed

above this area, half below it, when thinking of the body divided
horizontally.
• In addition, half the body weight is to each side, when thinking the
body divided vertically.
BY Betelihem T. 18
Base of Support is the foundation on which a person or
object rests.
feet provide the base of support. The wider the base of support, the
more stable the object with in limits.
 The feet are spread side wise when lifting, to give side-to side
stability.
One foot is placed slightly in front of the other for back-to-front
stability.
The weight is distributed evenly between both feet. The knees are
flexed slightly to absorb jolts.
The feet are moved to turn the object being moved.
BY Betelihem T. 19
Line of Gravity
• Draw an imaginary vertical (up and down) line through the

top of the head, the center of gravity, and the base of support.
• This becomes the line of gravity, or the gravity plane.
• This is the direction of gravitational pull (from the top of the

head to the feet).
BY Betelihem T. 20
Positioning the patient
Positioning: is turning or putting the patients in a proper body
alignment for diagnostic or therapeutic purpose
• It
Promoting comfort
Restoring body function
Relieving pressure and preventing deformities
Restoring proper respiration and circulation
Giving nursing treatment.
 Prevent decubiti (pressure sores)
Make client’s body accessible for procedures
Help clients access their environment
BY Betelihem T. 21
• Clients who cannot move independently must be
repositioned every 2 hours
type
Supine
Fowler
Lateral
Dorsorecumbenent
Knee-chest
Lithotomy
Prone
Sim’s/semi-prone
Trendelenburg
BY Betelihem T. 22
Supine (Back-lying position).
• The client lies on the back with the legs extended. The arms are
placed, folded on the chest, or along side the body. One small pillow
may be used
BY Betelihem T. 23
Equipment
• bed with side rails
• Turn sheet or draw sheet
• Pillows
• Foot board
• Documentation sheet
BY Betelihem T. 24
1.Great the patient ( if conscious ) and explain the procedure
2. Perform hand washing
3. Collect all necessary equipment's
4. Provide privacy
5. Elevate bed to highest position.
6.Place bed in a flat position.
7. Place small pillows at back, under head, and under ankles.
12. Assess client’s comfort level.
13. Lower height of bed and elevate side rails.

BY Betelihem T. 25
Prone Position:
• The client lies on the abdomen with head turned to the side
for comfort, Face-down position. The arms are held along
side the body
Purpose
• To Promote drainage from mouth
• To prevent contractures of hips and knee
• To examine the spine and the back
BY Betelihem T. 26
Contraindication
• Unconscious clients
• pregnant women
• clients with abdominal incisions,
• clients with breathing difficulties
• Foot drop
BY Betelihem T. 27
Equipment

• Pillows
• Foot board
• Documentation sheet
BY Betelihem T. 28
Procedure
1. Great the patient ( if conscious ) and explain the procedure
3. Collect all necessary equipment's
4. Provide privacy
6.Assist the client to lie on abdomen.
7.Place a small pillow under client’s head
BY Betelihem T. 29
8.Place a small pillow under chest for female clients and for
clients with barrel chest.
9. Place a small pillow under ankles or allow toes
to rest in space between foot of bed and the mattress.
10. Assess client for comfort.
11. Lower the bed and elevate the side rails.
12.Wash your hand
13. Document the procedure
BY Betelihem T. 30
Dorsal recumbent position
• The client lies on the back, with the knees flexed and the
soles of the feet flat on the bed
BY Betelihem T. 31
Purpose
 Promote comfort
 For visualizing the perineum
 To insert urinary catheter
 To relief pressure on knee and ankle
BY Betelihem T. 32
Indication
• Rectal , vulval and vaginal examination
• Pelvic surgical procedures
• Vaginal douche/irrigate/
• Perineal care
• Catheterization
• Supra-pubic puncture
BY Betelihem T. 33
Contraindication
• Spinal injury
• Cardiac patient (CHF)
• Breathing impairments
• Pressure sore (buttock, sacrum, heal and shoulder )
Equipments
1. Pillows
2. Bed with side rails
3. Draw sheet or turn sheet
4. Bath Blanket or sheet
5. Air rings
6. Cotton ring, Documentation format
BY Betelihem T. 34
Procedure
3. Collect all necessary equipments
4. Provide privacy
6. Place bed in a flat position.
7. Cover the client with a sheet or a bath blanket
8. Place the patient’s head in a straight line with his or her back,
shoulders, hips and knees
BY Betelihem T. 35
Cont…
9. Place small pillows under head and shoulder or elevate the top of
the bed.
10. Place air ring under the hips/buttock
11. Flex the leg and wide apart
12. Place cotton ring under the heels
13. Lower the bed and elevate the side rails
14.Wash your hand
15. Note the patient reaction
BY Betelihem T. 36
Sim’s position/semi-prone
• The client rests on the left side, usually with a small pillow under
the head. The right knee is flexed against the abdomen, the left knee
is flexed slightly, the left arm is behind the body and the right arm is
in a comfortable position
• Semi-prone position is putting or assisting patients with:
Upper arm flexed at shoulder and elbow;
Lower arm positioned behind client and
Both(optional) legs flexed in front of client with more flexion in

upper leg BY Betelihem T. 37
Cont…sim’s
Purpose
 To promotes drainage from mouth
 To prevents aspiration
 Comfortable for sleeping.
Reduces pressure on sacrum and greater trochanter of hip
Indication
 For rectal examination
 Pressure sore on the buttocks/sacrum and hips
Contraindication
• Lumbar lordosis
• Foot drop
• Client with leg injuries or arthritis
BY Betelihem T. 38
Equipment
1. Small pillow
2. Bed with side rails
3. Draw sheet or turn sheet
4. Sand bag
5. Documentation format
6. Receiver for drainage( if any)
BY Betelihem T. 39
semi prone position…
Procedure
4. Provide privacy
6. Place turn or draw sheet under client’s back and head
7. Flexed at shoulder and elbow
8. Position lower arm behind and away from the back

BY Betelihem T. 40
semi prone position….
9. Put pillow between chest and upper arm;
10. Flex both legs in front with more flexion in upper leg.
11. Put pillow between legs
12. Support ankle with sand bag (if necessary )
14.Wash your hand

BY Betelihem T. 41
Figure. Semi prone position
BY Betelihem T. 42
Lateral/side lying position
• Is putting patient on either side • Purpose
with legs flexed at knee( the Promote comfort
upper leg is more flexed than the  To perform back care
lower leg)  To relieves pressure on sacrum
and heels
• Lateral aspects of lower scapula
 To perform enema
and lower ilium support most
 To take rectal body temperature
of body weight
 To insert suppositories
BY Betelihem T. 43
Indication
• Enema and colonic irrigation
• Pressure sore on heel and sacrum
• Rectal examination
• To measure rectal temperature
Contraindication
 Arm and rib fracture
 Spinal injury
 Flank injury
Equipments
Pillow of different size (4)
Bed with side rails
Draw sheet or turn sheet
Documentation format
BY Betelihem T. 44
Procedure
4. Provide privacy
5. Place turn or draw sheet under client’s back and head
6. Elevate bed to highest position
7. Logroll client to side
BY Betelihem T. 45
Cont…
8. Place a small pillow under client’s head.
9. Place pillow behind client’s back.
10. Put a pillow tucked by the client’s abdomen.
11. Place a pillow between client’s legs.
12. Run your hand under the client’s dependent shoulder and
move the shoulder slightly forward
13.Lower the bed and elevate the side rails
14.Wash your hand

BY Betelihem T. 46
BY Betelihem T. 47
Lithotomy position
 It is similar to dorsal recumbent position, except that the client’s

legs are well separated and the knees are a slightly flexed. The nurse
will usually place the client’s feet in stirrups.
Keep the client covered as much as possible for privacy
Purpose
• To provide good visual and physical access to perineum
• To perform simple pelvic procedures to major surgeries
• To conduct delivery
BY Betelihem T. 48
Lithotomy….
Indication
• Pelvic medical examination and surgeries
• Delivery
Contraindication
• Spinal injury
• Breathing impairments
BY Betelihem T. 49
Lithotomy position…
Equipment
 Pillow (1)
 Bed with side rails/examination table/delivery couch
 Draw sheet /drape
 Screen
 Documentation format
BY Betelihem T. 50
Procedure
1. Great the patient and explain the procedure
4. Provide privacy
6. Place bed in a flat position.
7. Cover the client with a sheet or a bath blanket
8. Lie the patient flat with pillow under the head
9. Flex the hips and support with knee rest over a couch ( if
available)
10. Wash your hand
12. Document the procedure BY Betelihem T. 51
Figure: Lithotomy position
BY Betelihem T. 52
Knee chest
• The client is on the knees with the chest resting on the bed and
the elbow rested on the bed, or with the arms above the head, the
client’s head is turned to the side.
• The thighs are straight up and down, and the lower legs are flat
on the bed.
• Purpose of knee chest position
1. Used for vaginal and rectal examination
2. Used as referral position in cord prolapse or retroverted uterus
3. Assumed for postpartum and gynecologic exercises
BY Betelihem T. 53
Indication
• Sigmoidoscopic examination
• Vaginal and rectal examination
• Cord Prolapse
• Retoverted uterus
Contraindication
 Cardio-pulmonary problem
 Upper arm, spine and ribs fracture
 Increased intra-cranial pressure (IICP)
Equipments
1. Pillow (1)
2. Drape/ Bath Blanket or sheet
3. Screen
4. Documentation format
BY Betelihem T. 54
Figure: knee chest position
BY Betelihem T. 55
Fowler's position (semi-sitting)
Fowler's position is sitting position in which the head
is elevated at different angle (15-90)0 angle and may
have knees either bent or straight
• used to promote drainage or to make breathing

easier
BY Betelihem T. 56
Types
1. High Fowler's position is when the patient's head is raised 70-90
degrees,
2. Fowler's which is 45-60 degrees
3. Semi-Fowler's position is when the patient's head is elevated 30-

45 degrees.
4. Low Fowler's position is when the head of bed is elevated 15-30

degrees
BY Betelihem T. 57
Cont’d…fowler position
Indication
• Cardio-pulmonary problem (Respiratory distress, CHF,

pulmonary edema..)
• Increased intra abdominal pressure
• Abdominal, back and thigh muscle strain
• Nasal or oral passageway procedures (e.g. NGT…)
BY Betelihem T. 58
Cont…
Contraindication
• Comatose/unconscious patients
• Spinal injury
• Foot drop
• Head injury
• Shoulder dislocation
Equipment
1. Small pillows
2. Foot rest/foot board
3. Back support
4. Hand wrist support
5.Turn sheet or draw sheet
6. Screen if necessary
BY Betelihem T. 59
Procedure
1. Greet the patient ( if conscious ) and explain the procedure
4. Provide privacy
5. Place the patient in sitting position with arms at sides, knees
raised with pillow
6. Place bed in a 15° to 30° angle for low-Fowler’s position, 45° to

60° angle for Fowler’s position, or 70° to 90° angle for high-
Fowler’s position.
BY Betelihem T. 60
7.Place pillows under ankles, under the arms, and under head of
client, between client’s leg, Support the backs
8.Lower the bed and elevate the side rails
9.Wash your hand
11.Document the procedure
BY Betelihem T. 61
Figure fowler’s position
BY Betelihem T. 62
Trendelenburg position
is putting the patient in a flat on the back with the feet higher
than the head by 15-30 degree
Purpose
• To increase cerebral perfusion pressure
• To allow better access to pelvic organ during pelvic surgery
• To help in surgical reduction of hernea
• To enhance access to central venous line
BY Betelihem T. 63
Trendelenburg…..
Indication
• Hypotension/shock
• Abdominal and gynecologic surgery
• Placing central venous line
• Surgical reduction of hernea
Contraindication
Cervical –spine fracture
Respiratory impairment/breathing difficulties
Brain injury with increased intracranial pressure
BY Betelihem T. 64
Trendelenburg….
Equipment's
Hospital bed with side rails
Drape
Screen
Documentation format
BY Betelihem T. 65
Procedure
4. Provide privacy
5. Place the patient’s head lower than the feet with arms at the side
6. Place bed blocks at the foot end of the bed.
8. Wash your hand
BY Betelihem T. 66
Fig Trendelenburg position
BY Betelihem T. 67
Patient ambulation
• ambulation is encouraged soon after the onset of illness or surgery to

prevent the complications of immobility
• It assisted or unassisted walking
• In order to maintain client safety, ambulation must occur in

progressive stages.
• First the client should be able to tolerate sitting on the bedside and
dangling the feet. The next step is client tolerance of standing at the
side of the bed. Then progressive ambulation can be initiated;
BY Betelihem T. 68
Preparing the Client to Walk
Progressive exercises and activities that promote independent

mobility include:
1. Turning. The client can turn in bed using side rails for
stabilization
2. Sitting. The client can raise the head of the bed and lower the
height of the bed. Then the client turns to the side of the bed
and swings legs over the side of the bed to assume the
dangling position. Arms held in the tripod position give
balance to the sitting position.
BY Betelihem T. 69
3. Standing. The client dangles for a few minutes to assure
balance and then bears weight with both feet at the side of
the bed. For additional stability and balance, the client can
perch on the edge of the bed for several minutes.
4. Walking. The client assesses strength and balance while

walking, thus allowing a gradual progression of the duration
of walking. Instruct clients to rest by sitting or standing still
stabilized with a guide rail if fatigued.
BY Betelihem T. 70
2. Perform hand washing and done glove
3. Elevate the head of the bed and wait several minutes.
4. Lower the bed height.
5. With one arm under the client’s back and one arm under the client’s upper
legs, move the client into the dangling position
Fig Assist the client from a supine to a seated position

BY Betelihem T. 71
6. Encourage client to dangle at side of bed for several minutes.
7. Stand in front of client with your knees touching client’s knees.
8. Place arms under client’s axillae
Fig Assist client to a standing position by supporting the client’s trunk with your arms
under the client’s axillae. BY Betelihem T. 72
9. Assist client to a standing position, allowing client time to balance
10. Help client ambulate desired distance or distance of tolerance by placing
your hand under the client’s forearm and ambulating close to the client
Fig. Assisting a Client with Ambulation

BY Betelihem T. 73
Assisting patient with Assistive Devices
Clients who are unable to ambulate independently can use
devices designed to help them walk safely.
Determination of which device to use is based on the following:
• Upper arm strength
• Endurance (stamina)
• Presence or absence of one-sided weakness
• Weight-bearing ability
Most common devices used to assist in walking: canes, walkers,
and crutches
BY Betelihem T. 74
Gait belt
• Is an assistive used during simple assisted ambulation

Purpose
• To aid patient/client in ambulation
Indication
• One body part weakness
Equipment
• Gait belt
BY Betelihem T. 75
Figure …..Gait belt
BY Betelihem T. 76
Canes
A cane is to be used by clients who can bear weight on both legs but have
some weakness in one leg or hip.
The straight (standard) cane is used most often
Canes with three or four legs are used with clients who need more
stability than provided by the straight cane.
Quad canes provide more stability but are sometimes more difficult to use
than the straight cane
BY Betelihem T. 77
A B C D
A. Standard Cane Figure ….. Canes

B. T-handle Cane
C. Tripod Cane
D. Quad (Quadruped) Cane
BY Betelihem T. 78
Fig Nurse promotes safety of a client using a quad cane. Note the use of gait belt
for added stability.
BY Betelihem T. 79
Walkers
A walker is a waist-high metal tubular device with a handgrip and

four legs.
Some walkers have rubber tips on all four legs, whereas others have
wheels on the two front legs.
 advantages
 provision of extra support,
provision of a sense of security,

provision of a sense independence.
BY Betelihem T. 80
Walkers…
• The nurse should determine the following for clients using walkers:
1. Amount of weight bearing allowed on lower limb
2. Appropriateness for client’s height
3. Type of walker (pick-up or rolling)
4. With pick-up walker: client’s ability to grip, lift, and
propel the walker forward
5. With rolling walker: client’s ability to grip and propel
the walker forward
BY Betelihem T. 81
Fig …..walker
BY Betelihem T. 82
Fig Client Using
BY Betelihem T. a Walker 83
Crutches
are walking aids made of wood or metal in the form of a
shaft that used to increase client mobility.
can be used by clients who are unable to bear any weight on

one leg, clients who can bear partial weight on one leg, as
well as clients who have full weight bearing on both legs.
BY Betelihem T. 84
Crutches…
There are two types of crutches: axillary and forearm.
Axillary
• The most commonly used type,
• fits under the axilla with the weight being placed on the
handgrips.
Figure. BYAxillary
Betelihem T. crutch 85
Crutches…
• forearm crutch : which has a handgrip and a metal cuff that
fits around the arm, is more convenient but provides less
stability than the axillary crutch
Fig ….Forearm crutchBY Betelihem T. 86

• gaits used with crutches are: the four-point gait, three-point gait, two-
point gait, and swing-through gait.
• The four-point gait for weight bearing with both legs follows the pattern of
right crutch forward, left foot forward, left crutch forward, then right foot
forward. The four-point gait with crutches is very stable but slow.
Fig. four point gait

BY Betelihem T. 87
• The three-point gait for weight bearing with one leg has the
pattern of crutches and weak leg forward together, then weight-
bearing leg forward.
Three gait point
BY Betelihem T. 88
• The two-point gait for weight bearing with both legs has the pattern
of right crutch and left foot forward together, then left crutch and
right foot forward together. The two-point gait requires more balance
but is a faster gait.
Fig Two- Gait Point

BY Betelihem T. 89
swing-through gait….
• swing-through gait has the pattern of crutches forward, then
legs swing forward together. The swing-through gait has the
advantage of speed; however, it requires good balance
BY Betelihem T. 90
Comparison
BY Betelihem T. 91
Equipment
• One pair of crutches

• Measuring tape
• Gait belt (optional)
BY Betelihem T. 92
PROCEDURE Four-Point Gait
1. Explain
2. Assess client for strength, mobility, range of motion, visual
acuity, perceptual difficulties, and balance.
3. Adjust crutches to fit the client.
With the client supine, measure from the heel to the axilla.
With the client standing, set the crutch position at a point 4 to 5
in. lateral to the client and 4 to 6 in. in front of the client.
The crutch pad should fit 1.5 to 2 in. below the axilla
The hand grip should be adjusted to allow for the client to have
elbows bent at 30° flexion.
BY Betelihem T. 93
4.Lower the height of the bed.
5. Dangle the client at the side of bed for several minutes. .
6. Instruct client on method to hold the crutches; that is, with elbows bent 30°
and pad 1.5 to 2 in. below the axilla. Instruct client to position crutches lateral
to and forward of feet.
7. Apply the gait belt around the client’s waist if
8.balance and stability are impaired. Assist the client to a standing position
with crutches
BY Betelihem T. 94
9.Position the crutches 4.5 to 6 in. to the side and in front of
each foot. Move the right crutch forward 4 to 6 in. then move
the left foot forward, even with the left crutch
Fig Moving Right Crutch Forward and Left Foot

Forward BY Betelihem T. 95
• Move the left crutch forward 4 to 6 in. then move the right
foot forward, even with the right crutch
.fig Moving Left Crutch Forward and Right
BY Betelihem T. 96
PROCEDURE three-Point Gait
1. Explain
BY Betelihem T. 97
with crutches
BY Betelihem T. 98
9.Advance both crutches and the weaker leg forward together
4 to 6 in. Move the stronger leg forward, even with the
Crutches
Fig Three-Point Gait, Advancing Both Crutches and Weaker

Leg Forward Together
BY Betelihem T. 99
PROCEDURE two-Point Gait
1. Explain
BY Betelihem T. 100
with crutches
BY Betelihem T. 101
9.Move the left crutch and right leg forward 4 to 6 in
simultaneously
10.Move the right crutch and left leg forward 4 to 6 in
simultaneously
BY Betelihem T. 102
PROCEDURE Swing-Through Gait
1. Explain
BY Betelihem T. 103
with crutches
BY Betelihem T. 104
9.Move both crutches forward together 4 to 6 in. Move both legs
forward together in a swinging motion, even with the crutches
Fig Swing-Through Gait

BY Betelihem T. 105
up stairs and down stairs ambulation with crutches
Equipment
• Properly fitted crutches
• Regular, hard soled streed shoes
• Safety belt, if needed
BY Betelihem T. 106
Up stair gait
• It is a crutch gait used to climb up stairs
Procedure
• Start with the crutches and unaffected extremity on the same level
• Put weight on the crutch handles and lift the unaffected extremity
on the first step of the stairs.
• Put weight on the unaffected extremity and lift other

extremity and the crutches to the step.
• Repeat until client understands the procedure.
BY Betelihem T. 107
Down stair gait
• Crutch walking gait helps to move down stair.
Procedure
• Start with weight on uninjured leg and crutches on the same
level.
• Put crutches on the first step
• Put weight on the crutch handles and transfers unaffected
extremity to the step where crutches are placed.
• Repeat until the client understands the procedure
BY Betelihem T. 108
Performing Range-of-Motion(ROM)
Range-of-motion reflects the extent to which a joint

can move
are performed several times a day by placing each joint through its
full functional motion.
purposes
• to maintain full flexibility,
• maintain muscle tone and strength,
• prevent contractures,
• improve circulation. BY Betelihem T. 109

ROM…
Types
1. Active- movements of the joints independently by the

client/patient on a nonfunctioning joints. client moves various
muscle groups
2. Active-passive:-movement of nonfunctioning joint from partial

assistant from others
3.Passive:-movement applied by a nurse or other person or passive

motion machine on a pt’s immobilized joint help maintain
• or restore a client’s mobility by achieving several outcomes.

BY Betelihem T. 110
Procedure
1. Wash hands
2. Explain the procedure to the client
3. Adjust the bed to a comfortable height.
4. Select one side of the bed to begin PROM exercises.
5. Uncover only the limb to be exercised
6. Support all joints during exercise activity.
7. Use slow, gentle movements when performing exercises.
8. Repeat each exercise three times.
9. Stop if the client complains of pain or discomfort.
10. Begin exercise with the client’s neck and work down ward.
BY Betelihem T. 111
Procedure…
11. Exercise the neck. Turn the head from side to side.
Flexion and extension—Tilt the head toward the chest and then
tilt slightly upward
Lateral flexion—Tilt the head on each side so as to almost touch
the ear to the shoulder.
BY Betelihem T. 112
Procedure…
12. Exercise the client’s shoulder and arm
Arm: Flexion and extension—Extend the arm in a straight position

upward toward the head, then downward along the side. Extend the
arm in a straight position toward the midline (adduction) and away
from the midline (abduction).
Shoulder: Internal and external rotation—Bend the elbow at a 90°
angle with the upper arm parallel to the shoulder; rotate the shoulder
by moving the lower arm upward and downward.
BY Betelihem T. 113
Procedure…
12. Exercise the client’s elbow

• Elbow: Flexion and extension—Supporting the arm,
flex and extend the elbow
Pronation and supination—Flex elbow, move the
hand in palm-up and palm-down position
•.
Flexion of Elbow Extension of Elbow
BY Betelihem T. 114
Procedure…
13. Perform all exercises on the client’s wrist and fingers
Wrist: Flexion and extension—Supporting the wrist, flex and

extend the wrist. Supporting the lower arm, turn wrist right to
left, left to right, then rotate the wrist in a circular motion
BY Betelihem T. 115
Procedure…
14. Exercise the client’s hip and leg

• Hip and Leg: Flexion and extension—Supporting
the lower leg, flex the leg toward the chest and
then extend the leg (Figure 34-18). Internal and
external rotation—Supporting the lower leg,
angle the foot inward and outward.
Flexion of Hip and Leg Extension of Hip and Leg
BY Betelihem T. 116
Procedure…
15. Perform exercises on ankle and foot
Knee: Flexion and extension—Supporting the lower leg, flex and extend the
knee.
Ankle: Flexion and extension—Supporting the lower leg, flex and extend the
ankle.
Foot: Adduction and abduction—Supporting the ankle, spread the toes apart
and then bring them close together. Flexion and extension
Supporting the ankle, extend the toes upward and then flex the toes downward.
BY Betelihem T. 117
Procedure…
16. Move to the other side of the bed and repeat exercise.
17. Position and cover the client. Return the bed to low
position.
18. Wash your hands.
19. Document completion of PROM exercise
BY Betelihem T. 118
Moving and transferring a patient
1. Dangling: is sitting on the side of the bed with the feet hanging
down
Purpose
• To prepare patient before walking ,moving to chair or wheelchair
or performing others
• To relive pressure in case of pulmonary edema
Indication
 Moving patient out of bed
BY Betelihem T. 119
Contraindication
• Unconscious patient
• Spinal injury
Precaution
 Do not leave the patient alone when dangling
 If the patient becomes dizzy lie him down.
 Have the patient cough, deep breath, and exercise their leg
muscles when dangling
 Check the person’s pulse and respirations
BY Betelihem T. 120
Moving and transferring patient
Logrolling the Client
• Logrolling is a technique for moving a client whose body

must remain in straight alignment. Situations requiring total
alignment of the spine include spinal injury or recovery from
spinal surgery
BY Betelihem T. 121
Equipment

• Pillows
• glove
BY Betelihem T. 122
1. Inform client
2. Wash hand and done glove
3. Elevate hospital bed to high position.
4. Using one or more staff members, place a turn/draw sheet under the
client’s back and head.
5. The lead nurse tells the client and other personnel the direction of the
move.
6. One person stands on each side of bed. The lead nurse gives the signal
for the move. The staff member on side of the bed in the direction of
the move holds the turn/draw sheet to guide the move. The second
staff member applies gentle pressure on client’s back toward the
direction of the move, assisting client to roll
BY Betelihem T. 123
Fig Logrolling: Two-Person Move
BY Betelihem T. 124
7. Tuck pillows at client’s back and abdomen.
8. Assess the client for comfort and proper alignment.
9. Elevate side rails and lower the bed height
10.Wash hand and document
BY Betelihem T. 125
3. Moving patient up in bed
Definition
 Moving patients up in bed refers to returning the patient to

previous correct position in bed if he/she slides to the foot side of
the bed.
Purpose
• To make patients in comfortable position in bed
• To maintain good body alignment
Indication
 Patient slides to the foot of the bed

BY Betelihem T. 126
Procedures
1. Inform client of reason for the move and how
to assist (if able)
2. Elevate bed to high position and lower head of bed
3. With two nurses, place draw sheet under client’s
back and head
4. Nurses stand on each side of client. Position
client with knees flexed to push with feet if able
to assist with move
5. Have client use a bed trapeze, if available
BY Betelihem T. 127
Procedures…con’t
6.Nurses lift up on the draw sheet & move the client up toward
the head of the bed. With the signal from the lead nurse
7.Elevate head of bed, if tolerated by client.
8.Assess client for comfort.
9.Lower bed and elevate side rails
BY Betelihem T. 128
Fig… two nurses moving
BY Betelihema
T. patient up in bed 129
Transferring patient form bed to stretcher
• Stretcher is used to facilitate client transfer for a patient who

must lay during transfer
• Stretchers have several safety features, including side rails,

safety belts/straps, and locking wheels.
• As it is more narrow than the bed cautiousness is necessary

when using stretchers
• Ideally the stretcher should be the same height as the bed so that
the patient can be easily slipped from one to the other
BY Betelihem T. 130
Transferring patient …
• Place the stretcher parallel to and close against the bed, with the
head of the stretcher at the patient’s head, and secure it with the
brakes.
• If the patient is mobile, put a clean sheet on the stretcher and

assist the patient as he transfers himself on to the trolley.
• Always allow the patient to help as much as he can
• Up to four people may be required to lift a week patient from

bed to stretcher, or five people if there is a fracture
BY Betelihem T. 131
Procedure
1.Inform client
2. Assess client’s ability to assist with the transfer
3. Lower the bed.
4. Allow client to dangle for a few minutes.
5. Bring wheelchair close to the side of the bed, toward the foot of the
bed.
6. Lock wheelchair brakes and elevate the foot pedals.
7. Assist client to side of bed until feet touch the floor.
8. Assess client for dizziness. Remain in front of client until dizziness
has subsided.
BY Betelihem T. 132
9.Apply gait belt if necessary.
10. Reach under client’s axillae and place hands on client’s
scapulae (or grasp gait belt).
11. Assist the client to a standing position and provide support.
12. Pivot client so client’s back is toward the wheelchair
Fig Pivot client so back is toward wheelchair
BY Betelihem T. 133
13 Instruct client to place hands on the arm supports of the
wheelchair.
14. Bend at the knees, easing the client into a sitting position
BY Betelihem T. 134
15 .Assist client to maintain proper posture.
16. Secure the safety belt, place client’s feet on feet
pedals, and release brakes.
BY Betelihem T. 135
THE END!!!!
BY Betelihem T. 136

Body Mechanics and Moving

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Body Mechanics and Moving

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BODY MECHANICS AND

BY: Betelihem Tadesse(MSc)

It is often considered an indicator of health status because it

it enhances muscle tone, increases energy levels, and is associated

Proper body alignment/Posture: is an individual’s ability to

When the body is in good posture, the center of gravity (the

The normal alignment of the spine has a cervical concavity, a

Fig Proper Sitting Posture and Line of Gravity

Fig Proper Supine Posture and Line of Gravity

Promote client comfort

To promote circulation

To lessen stress on muscle, tendons, nerves, and joints

To Prevent foot drop (plantar flexion)

Gives an appearance of confidence and health

Lordosis :Forward curvature of the lumbar spine

• More pronounced in obesity and pregnancy (due to change in

 Abnormal waistline tilt with more indentation on one side

Tilting of the hips with one hip more prominent

 A prominence of the posterior chest or the shoulder when bending

The purposeful and coordinated use of body parts and

is the effort; coordinated, and safe use of the body to

It governs Functional mobility

 center of gravity is located in the middle of the pelvis about

• This means that approximately half the body weight is distributed

• Draw an imaginary vertical (up and down) line through the

• This becomes the line of gravity, or the gravity plane.

• This is the direction of gravitational pull (from the top of the

• bed with side rails

• Turn sheet or draw sheet

2. Perform hand washing

3. Collect all necessary equipment's

5. Elevate bed to highest position.

6.Place bed in a flat position.

7. Place small pillows at back, under head, and under ankles.

12. Assess client’s comfort level.

13. Lower height of bed and elevate side rails.

• clients with abdominal incisions,

• clients with breathing difficulties

• bed with side rails

1. Great the patient ( if conscious ) and explain the procedure

2. Perform hand washing

3. Collect all necessary equipment's

5. Elevate bed to highest position.

6.Assist the client to lie on abdomen.

7.Place a small pillow under client’s head

12.Wash your hand

13. Document the procedure

• Semi-prone position is putting or assisting patients with:

Upper arm flexed at shoulder and elbow;

Lower arm positioned behind client and

Both(optional) legs flexed in front of client with more flexion in

1. Great the patient ( if conscious ) and explain the procedure

2. Perform hand washing

3. Collect all necessary equipments

5. Elevate bed to highest position.

6. Place turn or draw sheet under client’s back and head

7. Flexed at shoulder and elbow

8. Position lower arm behind and away from the back

9. Put pillow between chest and upper arm;

11. Put pillow between legs

12. Support ankle with sand bag (if necessary )

13. Lower the bed and elevate the side rails

14.Wash your hand