Wilk: Sorrentino's Canadian Textbook for the Support Worker, 5th Edition

Chapter 15: Exercise and Activity

Chapter 15

Exercise and Activity

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Exercise and Activity (1 of 2)

 Being active is important for physical and
mental well-being.
 Illness, surgery, injury, pain, and aging can
cause weakness and some activity limits.
 Inactivity, whether mild or severe, affects:
 All body systems
 Mental well-being
• Support workers can sustain injuries while
assisting clients with exercise and activity–
make sure you practice proper body
mechanics.
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Exercise and Activity (2 of 2)

 Health team members promote exercise and
activity in all clients to the extent possible.
 Deconditioning is the loss of muscle size,
strength, and function (muscle atrophy) that
results from immobility and inactivity.
 To help promote exercise and activity, you
need to understand:
 Bed rest
 How to prevent complications from bed rest
 How to help clients exercise
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 Bed Rest (1 of 4)
 Generally, bed rest is ordered to:
 Reduce physical activity
 Reduce pain
 Encourage rest
 Regain strength
 Promote healing

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Bed Rest (2 of 4)
 These types of bed rest are common:
 Strict bed rest
• Everything is done for the client.
 Bed rest with commode privileges
• Some ADLs are permitted.
 Bed rest with bathroom privileges
• Client can use the bathroom for elimination needs.
• Written as bed rest with BRP

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Bed Rest (3 of 4)
 Complications of bed rest and immobility
include:
 Pressure ulcers
 Constipation and fecal impaction
 Urinary tract infections and renal calculi (kidney stones)
 Blood clots (thrombi)
 Pneumonia (inflammation and infection of the lung)
 Contractures (lack of joint mobility)
 Muscle atrophy
 Orthostatic hypotension (postural hypotension)
 Syncope

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 Bed Rest (4 of 4)
 Good support care prevents complications
from bed rest:
 Promote good alignment.
 Assist with range-of-motion exercises.
 Ensure frequent position changes, at least once
every 2 hours.
• These are part of the care plan.

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Positioning
 Supportive devices are often used:
 Bed boards prevent the mattress from sagging.
 Foot boards prevent plantar flexion and serve as bed
cradles.
 Trochanter rolls prevent the hips and legs from
external rotation.
 Hand rolls or hand grips prevent contractures of the
thumb, fingers, and wrist.
 Splints keep the elbows, wrists, thumbs, fingers,
ankles, and knees in normal position.
 Bed cradles keep the weight of top linens off the feet
and toes.
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Supportive Devices (1 of 4)

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 Supportive Devices (2 of 4)

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Supportive Devices (3 of 4)

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Supportive Devices (4 of 4)

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 Exercise
 Exercise helps prevent:
 Contractures
 Muscle atrophy
 Other complications of bed rest

 Some exercise occurs:

 With ADLs
 When turning and moving in bed without help
 A trapeze is used:
 For exercises to strengthen arm muscles
 For client to move up and turn in bed
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Range-of-Motion Exercises
 Range-of-motion exercises involve moving
the joints to the extent possible without
causing pain.
 Active range-of-motion exercises are done by the
client.
 With passive range-of-motion exercises, someone
moves the client’s joints through their range of
motion.
 With active-assistive range-of-motion exercises,
the client does the exercises with some help.
 See box: Focus on Long-Term Care: Activity Programs (p.
265)
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Ambulation
 Ambulation is the act of walking.
 After bed rest, activity increases slowly and in
steps.
 To achieve the goal of walking:
 Contractures and muscle atrophy must be
prevented.
 Proper positioning and exercises are needed during
bed rest.
 Walking regularly helps to prevent
deconditioning (loss of muscle size, strength,
and function).
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 Obesity and Lifestyle and Their
Effect on Ambulation
 People who are overweight subject their
joints to increased wear, which can contribute
to osteoarthritis (OA).
 Obesity and a sedentary lifestyle are the main
contributors to OA.
 See procedure: Helping the Client to Walk (pp.
271-272)
 See Figure 15.22: Assist with ambulation by
walking slightly behind the client’s side (p. 271)

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Falls
 When a client is falling, the support worker’s
instinct is to try to prevent the fall.
 However, trying to prevent a fall could cause
greater harm.
 You could injure yourself and the client as you
twist and strain to stop the fall.
 If a client starts to fall, ease the client to the
floor, and protect the client’s head.
 See procedure: Helping the Falling Client (p. 274)
 See box: Focus on Home Care: When a Client
Falls (p. 275)

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Walking Aids (1 of 10)

 Walking aids support the body.
 The type of walking aid ordered depends on:
 The client’s condition
 The amount of support needed
 The type of disability

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 Walking Aids (2 of 10)
 Crutches
 Used when the client cannot use one leg or when one
or both legs need to gain strength.
 Follow these safety measures:
• Check the crutch tips.
• Check crutches for flaws.
• Tighten all bolts.
• Make sure the client wears street shoes with flat, nonskid
soles.
• Make sure the client’s clothes fit well.
• Practice safety rules to prevent falls.
• Keep crutches within the client’s reach.

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Walking Aids (3 of 10)

 Canes
 Used to help support a side of the body that is
unsteady or weak
 Help provide balance and support
 Single-tip and four-point (quad) canes are
common
 A cane is held on the nonaffected side of the body

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Walking Aids (4 of 10)

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 Walking Aids (5 of 10)
 Walkers
 A walker is a four-point walking aid.
 It gives more support than a cane.
 There are many kinds of walkers.
 Baskets, pouches, and trays can attach to the
walker.

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Walking Aids (6 of 10)

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Walking Aids (7 of 10)

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 Walking Aids (8 of 10)
 Braces
 Support or align affected body parts
 Also prevent or correct deformities or prevent joint
movement
 A brace is applied over the ankle, knee, or back.
 An ankle-foot orthosis (AFO) is placed in the shoe.
 You need to:
• Keep client skin and bony points under braces clean and dry.
• Report redness or signs of skin breakdown at once.
• Report complaints of pain or discomfort.
 The care plan tells you when to apply or remove a
client’s brace.
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Walking Aids (9 of 10)

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Walking Aids (10 of 10)

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