Week 10 Mobility

Learning Objectives 1. Describe and list factors that affect mobility. 2. Explain common physical assessment procedures used to evaluate mobility of patients across the lifespan. 3. Identify priority mobility assessment findings. 4. Differentiate normal mobility assessment findings from abnormal findings. 5. Explain the process for assessment of mobility.

Mobility: Assessment of the Musculoskeletal System

Two Subsystems Work together … Bones and joints Plus Skeletal muscles Equal Gross and fine motor movements

Gross and Fine Motor Skills

Fireworks injury: Will it affect gross or fine motor movement?

Gross motor will be affected in this injury:

Bones perform many functions

Three Main Functions of Bones… *Support *Protection *Movement (Additionally, bones serve as storage sites for minerals, and contain bone marrow for blood cell production.)

Types of Joint Motion: Retraction and Protraction Flexion and Extension Circumduction Abduction and Adduction Internal and External Rotation Eversion and Inversion Pronation and Supination

Examples of Joint Motion: Retraction and Protraction- Jaw Flexion and Extension- Bending decreasing joint angle and straightening Circumduction- Arm in circular motion; shoulder Abduction and Adduction- Away from midline and towards midline Internal and External Rotation- Hip toward midline and away from midline Eversion and Inversion- Feet turn out, turn in Pronation and Supination- Hand; palm down prone, hand up supine

R.O.M (Range of Motion): Ideally, we should have full range of motion of all joints. If not, it’s considered an alteration. (This alteration may be what the patient is used to; document!)

Health History Questions to Ask: Do You Have: Pain Swelling Stiffness Weakness Deformity

Health History Questions to Ask (cont.) Does this affect your ADL’s? What do you use to treat this? (Ice, heat, medication, other remedies) What makes it better or worse? Past injuries or surgeries? Medications currently taking?

Observation General Observation: Note size and shape of joints, limbs and body regions

Observation (cont)

Palpate: Gently palpate the skin and tissues around the joint; swelling, pain, deformity

Assess Range of Motion: Two types of R.O.M; Active and Passive (What do they mean?)

Have the patient actively move all joints

When the patient is unable to participate, passive range of motion may be necessary (Remember not to use force on a joint)

Movement does not happen by itself… * Think neurologic, tissue perfusion, and electrolytes at the cellular level making this happen!

Central nervous and musculoskeletal system interrelated. Remember that weakness/ tremors could mean neurologic impairment

Impact?

Alterations in Mobility: *May affect activities of daily living (ADL’s) *Can alter body image, self image *Involves the lives of others involved in their care *Can affect communication, ability to participate in occupational and recreational activities *My result in embarrassment, frustration, pain and isolation *Will affect personal safety *Often leads to additional expenses

End of Week 10