Basic Principles of Body Mechanics PT 6280 Clinical

Basic Principles of Body Mechanics PT 6280: Clinical Assessment University of Minnesota Division of Physical Therapy Teresa Bisson, PT, DPT, NCS, ATP

Objectives • The student will be able to: – Discuss the principles associated with body mechanics – Demonstrate safe and effective body mechanics during a mobility activity – Teach another individual to apply body mechanics principles and provide constructive feedback

Biomechanical Principles Center of Mass (Co. M) § Internal/External Forces Base of Support (BOS) § Friction http: //www. surfscience. com

What are “body mechanics”? • Positioning our bodies during tasks for: – Efficiency/energy conservation • Control and balance – Effectiveness – risk of injury • Reduce stress and strain – Safety

AMAP/ANAP: Patients should do…. • AMAP = • ANAP = • Get your patient active! • Invest in the patient’s future mobility • Being too helpful can be detrimental

Principles of Body Mechanics starfactoryfitness. com

1. Plan ahead • Anticipate load • Clear path for travel • Good planning prevents a multitude of problems/risk of injury

2. Position yourself close to the load • “The load” also refers to your patients! • Close, but also allow movement healthsciencetechnology. wikispaces. com

3. Wide base of support (BOS) • Stagger feet if possible • Improved balance and control • Allows you to move by pivoting or moving your feet rather than twisting your back. movementdisorders. ufhealth. org

4. Maintain your normal spinal curves if possible. • Prevents excessive straining of structures in the low back www. spineuniverse. com

5. Bend at the hips and knees • • • Lower center of mass (Co. M) = stability Places leg muscles in a power position to lift Allows upright trunk and normal spine curve peakperformancetherapy. com

6. Hold objects close • distance to the load • amount of force needed to do the job www. physiotherapy. asn. au

7. “Set” the trunk muscles prior to lifting • Stable trunk allows better distal mobility • Less risk of lower back injury gethealthyroundrock. com

8. Use larger muscles to do the heavier work • Squat position • Leg muscles = power americanbonehealth. org

9. Exhale during exertion • Prevents valsalva maneuver • Lifting heavy objects + holding your breath = abdominal pressure • Exhaling during exertion lifts diaphragm = excessive abdominal pressure www. atlaswearables. com

10. Avoid twisting and bending at the same time Incorrect Correct

11. PUSH, rather than pull • Allows larger BOS and lower COM • Uses larger muscle groups • More force in the direction of desired motion media. lanecc. edu

12. Get help if needed! • Additional people • Mechanical lifts http: //www. tc. umn. edu • Transfer boards/sheets • Other equipment www. arjohuntleigh. us

Positional Body Mechanics

Seated Body Mechanics • Take a break every 20 to 30 minutes • Sit in a chair that supports your low back • Small pillow/“lumbar roll” • Feet supported evenly • Armrests supporting but not too high • Shoulders level

Standing Body Mechanics • Normal spinal curves • Avoid slouching • Abdominal wall flat • Head neutral • Shoulders level • Body weight evenly distributed • Avoid standing in 1 position for prolonged periods • Footstool under one foot can relieve lumbar stress

Pushing/Pulling Body Mechanics • Crouch and face the object squarely • Use arms and legs to push or pull • Push or pull in a straight line • Make sure no objects are in your path

Reaching Body Mechanics • Stand on a footstool or ladder to reach items overhead • Move object close to you and make sure you can control it • Do not simultaneously twist and reach

Lift Techniques

Lift techniques: Traditional Lift • Face object with feet on each side of the object • Deep squat • Lift with lower extremities, NOT THE BACK

Lift techniques: Straight Leg Lift • Lifter’s knees slightly flexed • Legs parallel to or straddling object • Trunk in vertical or horizontal, but keeping lordosis

Lift techniques: Golfer’s Lift • One legged stance lift • Face object • Non-weight bearing leg counters trunk and comes off ground • Lean forward to grasp • Can stabilize with nonreaching UE

Lift techniques: Half Kneel Lift • Kneel on 1 knee positioned on one side of the object • Grasp object and bring close to you and place on the thigh • Lift with legs • Good for shorter people, ↓ UE strength, or ↓ strength in one leg

Lift techniques: Stoop Lift • When object rests below level of the waist, but can be reached without squatting and lifted with 1 extremity • Keep lordosis • Feet shoulder width apart

Practice Time! Work through Body Mechanics Lab sheet with a partner Regroup for discussion

Clinical Application • Split up into pairs again, but with a different lab partner • Determine who will be Patient #1 and #2

Clinical Application • Patient #1’s goals for therapy are to be able to make the bed and shovel the driveway in the winter without back pain • Patient #2’s goals for therapy are to be able to do laundry and vacuum the house without back pain

Clinical Application • Take turns as the PT, and instruct your patient on the proper body mechanics for their goal activities • What principles apply to each activity? • What modifications or challenges do you face?

Objectives Revisited • The student will be able to: Discuss the principles associated with body mechanics Demonstrate safe and effective body mechanics during a mobility activity Teach another individual to apply body mechanics principles and provide constructive feedback

References • Johansson C. & Chinworth SA. Mobility in Context: Principles of Patient Care Skills. FA Davis, Philadelphia, 2018: 1 -12 & 45 -64.

Questions?