Activity/Exercise FHP Elola Maberry, MSN, RN

Range-of-Motion Exercises The movement of a joint to the extent possible without causing pain.The movement of a joint to the extent possible without causing pain. Active ROM- done by the person.Active ROM- done by the person. Passive ROM- done by another person.Passive ROM- done by another person. Active-assistive ROM- the person does some of the movement with help form another person.Active-assistive ROM- the person does some of the movement with help form another person.

Purpose of Range of Motion exercises Improve joint mobility.Improve joint mobility. Increase circulation to the affected part.Increase circulation to the affected part.

Joint Movements Abduction- moving a body part away from the midline of the bodyAbduction- moving a body part away from the midline of the body Adduction- moving a body part toward the midline of the bodyAdduction- moving a body part toward the midline of the body Extension-straightening a body partExtension-straightening a body part Flexion – bending a body partFlexion – bending a body part Rotation- turning the jointRotation- turning the joint Internal rotationInternal rotation External rotationExternal rotation Plantar flexionPlantar flexion PronationPronation SupinationSupination

Heat & Cold Therapy Heat and cold are applied to bring about a local or systemic change in body temperature for various therapeutic purposes.Heat and cold are applied to bring about a local or systemic change in body temperature for various therapeutic purposes. Heat causes “vasodilation”Heat causes “vasodilation” Cold causes “vasoconstriction”Cold causes “vasoconstriction”

Effects of Applying Heat Dilates peripheral blood vesselsDilates peripheral blood vessels Vasodilation increases local blood flow.Vasodilation increases local blood flow. Increases tissue metabolismIncreases tissue metabolism Reduces blood viscosityReduces blood viscosity

Effects of Applying Heat Increases capillary permeabilityIncreases capillary permeability Reduces muscle tensionReduces muscle tension Helps relieve painHelps relieve pain Heat reduces muscle tension to promote relaxation and helps to relieve muscle spasmHeat reduces muscle tension to promote relaxation and helps to relieve muscle spasm

Uses of Heat Therapy Treat infectionsTreat infections Surgical woundsSurgical wounds ArthritisArthritis Joint and muscle painJoint and muscle pain DysmenorrheaDysmenorrhea Chronic painChronic pain

Effects of Applying Cold Constricts peripheral blood vesselsConstricts peripheral blood vessels Reduces blood flow to tissuesReduces blood flow to tissues Decreases the local release of pain-producing substances (promotes comfort)Decreases the local release of pain-producing substances (promotes comfort) Decreases tissue metabolismDecreases tissue metabolism Reduces edema formationReduces edema formation Reduces muscle spasmReduces muscle spasm Alters tissue sensitivity (producing numbness)Alters tissue sensitivity (producing numbness)

Uses of Cold Therapy After direct traumaAfter direct trauma Dental painDental pain Muscle spasmMuscle spasm SprainsSprains To treat some chronic pain syndromes.To treat some chronic pain syndromes.

Physiological Considerations Rebound phenomena is important to the therapeutic value of heat and cold.Rebound phenomena is important to the therapeutic value of heat and cold. Heat produces maximum vasodilation in 20 to 30 minutes; then vasoconstriction occurs.Heat produces maximum vasodilation in 20 to 30 minutes; then vasoconstriction occurs. With cold, vasoconstriction occurs when the skin reaches 15 degrees Celsius; then vasodilation begins.With cold, vasoconstriction occurs when the skin reaches 15 degrees Celsius; then vasodilation begins.

Do not apply Heat! Open wound immediately after traumaOpen wound immediately after trauma During hemorrhageDuring hemorrhage A localized malignant tumorA localized malignant tumor The testesThe testes The abdomen of a pregnant womenThe abdomen of a pregnant women Over metallic implantsOver metallic implants

Do not apply Cold!!! Open woundsOpen wounds Clients with impaired peripheral circulationClients with impaired peripheral circulation Clients who have an allergy to coldClients who have an allergy to cold

Nursing Diagnosis Ineffective ThermoregulationIneffective Thermoregulation Ineffective Tissue PerfusionIneffective Tissue Perfusion Acute PainAcute Pain Chronic PainChronic Pain Risk for InjuryRisk for Injury Risk for TraumaRisk for Trauma

Applying Heat Hot water bagsHot water bags Electric heating padsElectric heating pads Aquathermia PadsAquathermia Pads Hot packsHot packs Warm moist compressesWarm moist compresses Sitz bathsSitz baths Warm soaksWarm soaks Heat lamp/cradleHeat lamp/cradle

Applying Cold Ice bags/collarIce bags/collar Cold packsCold packs Cold compressesCold compresses

Ace Bandage A stretchable band used to create localized pressure.A stretchable band used to create localized pressure. Used to treat muscle sprains and strains by reducing blood flow to the area which can reduce swellingUsed to treat muscle sprains and strains by reducing blood flow to the area which can reduce swelling Mobilize the affected jointMobilize the affected joint

Anti-Embolic Stockings Used for patients at risk for deep vein thrombosis, pulmonary embolism and to help prevent phlebitis.Used for patients at risk for deep vein thrombosis, pulmonary embolism and to help prevent phlebitis. Elastic material available in either knee-high or thigh- high length.Elastic material available in either knee-high or thigh- high length. Pressure increases the velocity of blood flow in the superficial and deep veins and improve venous vale function in the legs promoting venous return to the heart.Pressure increases the velocity of blood flow in the superficial and deep veins and improve venous vale function in the legs promoting venous return to the heart.

Anti-Embolism Stockings Measure the client’s leg to determine the proper size of the stocking.Measure the client’s leg to determine the proper size of the stocking. Assess the skin and the neurovascular status of the legs.Assess the skin and the neurovascular status of the legs. Apply the stockings in the morning before the client is out of bed and while the client is supine.Apply the stockings in the morning before the client is out of bed and while the client is supine. Do not massage the leg.Do not massage the leg. Assess the leg for redness, blistering, swelling and pain.Assess the leg for redness, blistering, swelling and pain.

Compression Devices May be used in conjunction with antiembolism stocking.May be used in conjunction with antiembolism stocking. High-risk surgery clients, decreased mobility, chronic venous disease, and client’s at risk for deep-vein disorders.High-risk surgery clients, decreased mobility, chronic venous disease, and client’s at risk for deep-vein disorders. Apply intermittent or sequential pressure to the leg to enhance blood flow and venous return, simulating the normal muscle pumping action in the legs.Apply intermittent or sequential pressure to the leg to enhance blood flow and venous return, simulating the normal muscle pumping action in the legs.