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