BODY MECHANICS BODY MECHANICS Objectives To promote the

BODY MECHANICS

BODY MECHANICS Objectives: • To promote the safety of the patient, the Nurse; and other health personnel • To prevent risk for injury • To assist patient with positioning and mobilization of patient

Body mechanics – the coordinated effort of the musculoskeletal and nervous systems to maintain balance, posture, and body alignment during lifting. - It facilitates body movement so that a person carry out a physical activity without using excessive muscle energy.

Body mechanics is the utilization of correct muscles to complete a task safely and efficiently, without undue strain on any muscle or joint Body Mechanics is the term used to describe the efficient, coordinated, and safe use of the body to move objects and carry out the activities of daily living.

§ A sagging mattress increases the risk of hip contractures. These knee and hip contractures can cause future gait and posture problems, making mobility more difficult. § Body alignment is essential to prevent complications.

Complications include: • pressure ulcers • contractures and footdrop (this happens when joints become less flexible because of lack of mobility and incorrect alignment. - Pillows placed under the knees or an elevated knee and hip contractures.

SKILL PERFORMANCE GUIDELINES 1. Know the physiological influences of body alignment and mobility that affect clients throughout the life span. 2. Know the pathological conditions that affect a client’s body alignment and mobility.

3. Know the history of underlying conditions such as chronic disease (e. g. diabetes, COPD) or malnutrition. 4. Control factors that can indirectly affect body mechanics by altering the safety of the environment

5. Know the client’s fluid balance status. Ø Dehydration or edema may require more frequent position changes because clients with alterations in fluid balance are prone to skin breakdown. 6. Know the client’s range of joint motion.

7. Determine the client’s level of sensory perception. Ø Loss of sensation increases vulnerability to the hazards of immobility.

8. Know the client’s baseline vital signs. Ø The client with low blood pressure may not be able to tolerate sudden position changes and is at risk of fainting while transferring from bed to chair.

9. Assess the client’s cognitive status and stage of psychological adaptation to illness. Ø Both factors affect the ability to learn and participate in transfer and positioning.

Body alignment refers to the conditions of the joints, tendons, ligaments, and muscles in various body positions. = the body is in line with the pull of gravity and contributes to body balance. Without this balance the center of gravity is displaced which increases the force of gravity and predisposes the person to falls and injuries.

Factors affecting body Alignment and Activity 1. Growth and development – at early age, development of gross motor skills precedes the fine motor skills (a child learns to walk before they can tie their shoe lace). Gross motor skills – a head-to-toe fashion (progression from head control, to crawling, to pulling up to a standing position, to standing and to walking.

Ø as age advances, muscle tone and bone density decrease, joints lose flexibility, reaction time slows, and bone mass decreases, specially in women who have osteoporosis (bones become brittle and fragile) Ødue to calcium depletion. All these changes affect older adults’ posture, gait, or balance.

2. Physical health – mobility and activity tolerance are affected by any disorder of the following: - nervous system - musculoskeletal system - cardiovascular system - respiratory system - Congenital Anomalies (cerebral palsy, muscular dystrophies that affect motor functioning)

3. Mental health – Mental or afffective disordes 4. Nutrition – undernourished or overnourished. 5. Personal Values and attitudes 6. External factors

ANYONE HURT? APOLLO BRAMWELL NURSING SCHOOL

ANATOMY Spine Three main functions To protect the spinal cord To allow movement. To support the upper body Complex System Spinal Cord Nerves Ligaments Muscles & Tendons APOLLO BRAMWELL NURSING SCHOOL

The Spine Composes: Seven Cervical (neck) vertebrae 12 thoracic (chest) vertebrae Five Lumbar (lower Back) vertebrae Five sacrum and four coccyx, which are fused together APOLLO BRAMWELL NURSING SCHOOL

ANATOMY Spine - Strong and Flexible Gentle ‘S’ bend Move or lift in wrong way, balance can be disturbed Problems – contributory factors Poor physical condition Posture Lack of exercise Excess weight Illness APOLLO BRAMWELL NURSING SCHOOL

Vertebrae 33 bones – the top 24 are Disc Spinal Cord separated by discs Each vertebrae has 4 joints which enables movement Vertebrae are larger towards the bottom of the spine These individual bones give the spine strength and flexibility Vertebrae APOLLO BRAMWELL NURSING SCHOOL

ANATOMY Nucleus polposus Discs Act as shock absorbers Firmly attached to vertebrae Poor blood supply Annulus stretches and relaxes during movement. Disc Annulus fibrosus Annulus – contains a gel like substance that resists compression APOLLO BRAMWELL NURSING SCHOOL

ANATOMY Discs Repeated stresses can cause minute tears and bulging of the disk. Presses on adjacent nerves and ligaments – pins & needles, pain, numbness Commonly called a slipped disc APOLLO BRAMWELL NURSING SCHOOL

MUSCLES Muscles are bundles of fibre which enable movement Messages from the brain cause them to contract and relax Connected by tendons and when muscles contract the bones are drawn closer together A damaged muscle is called a strain APOLLO BRAMWELL NURSING SCHOOL

LIGAMENTS & NERVES Ligaments • Strong fibrous tissue • Small degree of elasticity • Stooped back posture can result in permanent elongation – weakness and pain • Damaged if stretched too far and torn – called a sprain. Nerves • Millions of fibres transmitting electrical impulses • Vertebrae enclose and protect • Nerves branch out from the spinal cord and pass between vertebrae • Irritated nerves can be felt right along there length – called sciatica APOLLO BRAMWELL NURSING SCHOOL

§ Abnormally increased convexity in the curvature of the spine § Chin tilts downward onto chest with abdominal protrusion § Decreased interval between lower rib cage and iliac crests

Lordosis - Forward curvature of the lumbar spine

Lateral curvature of the spine

MECHANICS v Balance point is through centre of body when standing v A load held in front disturbs the balance tension is generated in the back muscles to compensate v Forms a lever effect APOLLO BRAMWELL NURSING SCHOOL

v Average person holding a 10 kg load at arms length generates a counterbalancing tension up to 10 times more – to avoid falling over v High or repetitive levels of tension in the back can cause damage – called muscle strain

REASONS FOR THE USE OF PROPER BODY MECHANICS Use proper body mechanics in order to avoid following: q Excessive fatigue. q Muscle strains or tears. APOLLO BRAMWELL NURSING SCHOOL

q. Skeletal injuries. q. Injury to the patient. q. Injury to assisting staff members

TECHNIQUES OF BODY MECHANICS Lifting v Use the stronger leg muscles for lifting. v Bend at the knees and hips; keep your back straight. v Lift straight upward, in one smooth motion APOLLO BRAMWELL NURSING SCHOOL

3 MAIN PRINCIPLES OF BODY MECHANICS 1. Centre of gravity 2. Stable base 3. Keeping external levers short APOLLO BRAMWELL NURSING SCHOOL

APOLLO BRAMWELL NURSING SCHOOL

APOLLO BRAMWELL NURSING SCHOOL

APOLLO BRAMWELL NURSING SCHOOL

1. Maintain a Stable Center of Gravity by: • Keep your center of gravity low. • Keep your back straight. • Bend at the knees and hips APOLLO BRAMWELL NURSING SCHOOL

2. Maintain a Wide Base of Support § This will provide you with maximum stability while lifting • Keep your feet apart. • Place one foot slightly ahead of the other. • Flex your knees to absorb jolts. • Turn with your feet APOLLO BRAMWELL NURSING SCHOOL

The broader the base of support and the lower the center of gravity, the greater the stability and balance. Body balance can be enhanced by: a) widening the base of support – done by spreading the feet farther apart. b) lowering the center of gravity, bringing it to the base of support – done by flexing the hips and knees until a squatting position is achieved. APOLLO BRAMWELL NURSING SCHOOL

Two movements to be avoided due to potential cause of back injury: Ø Twisting (rotation) of the thoracolumbar spine Ø Acute flexion of the back with hips and knees straight (stooping). APOLLO BRAMWELL NURSING SCHOOL