BODY MECHANICS
Body Mechanics
 It is the coordinated effort to maintain
balance, posture and body alignment
during moving and performing activities of
daily living
 A broad term used to describe coordinated
efforts of the musculoskeletal and nervous
systems to maintain proper balance, posture
and body alignment during lifting, bending,
moving and performing activities of daily
living.
 Reduces the risk of injury to the
musculoskeletal system.
TERMINOLOGIES
Alignment
Parts of an object in proper relationship to one
another.
Balance
A state of equilibrium in which opposing factors
counteracts each other.
Base of support
The area on which an object rests.
Center of gravity
Point at which all the mass of an object is centered.
Line of gravity
An imaginary, vertical line which passes through the
center of gravity.
Posture
Position of the body characterized by balance,
without undue tension to muscles, joints, ligaments.
Guidelines and Principles
 The wider the base of support, the greater the
stability.
 Move objects close to the center of gravity.
 Pulling creates less friction than pushing.
 Moving an object along a level surface requires
less energy than moving an object up in an
inclined position.
 The closer the line of gravity to the center of
the base of support, the greater the stability.
 The greater the friction against the surface, the
greater force required to move the object.
 Always face the direction of the movement.
 Start any body movement with proper
alignment.
 Before moving an object, contract your
gluteal, abdominal, leg and arm muscles to
prepare them for action.
 Avoid working against gravity. Pull, push, roll
or turn objects instead of lifting them.
 Distribute the workload between both arms
and legs to prevent back strain.
 When moving or carrying objects, hold them
as close as possible to your center of gravity.
 Alternate rest periods with periods of muscle
use to help prevent fatigue.
Range of Motion (ROM)
 is maximum movement possible for joint. It
varies from every individual and determined
by genetic makeup, development pattern,
the presence or absence of disease and the
amount of physical activity with the person
normally engage.
Purposes of ROM
 Maintains or increase muscle strength and
endurance
 Help maintain cardio respiratory function in
an immobilized client
 Prevents deterioration of joint capsules,
fixation of joint and contractions
 To maintain joint mobility.
 To prevent contracture, atony (insufficient
muscular tone), and atrophy of muscles.
 To stimulate circulation.
 To improve coordination.
 To increase tolerance for more activity.
 To maintain and build muscle strength.
Types of Exercises in Performing ROM
Passive. are carried out by the nurse, without
assistance from the patient.
Active Assistive. are performed by the patient with
assistance from the nurse.
Types of Exercises in Performing ROM
Active. are performed by the patient, without
assistance, to increase muscle strength.
Resistive. These are active exercises performed by
the patient by pulling or pushing against an
opposing force.
Types of Exercises in Performing ROM
Isometric. are performed by the patient by
contracting and relaxing muscles while keeping the
part in a fixed position.
Range of Motion Exercises
Techniques in Body Mechanics Pressure Points To Consider
Lifting
 Use the stronger leg muscles for lifting.
 Bend at the knees and hips; keep your back
straight.
 Lift straight upward, in one smooth motion.
Push and Pull
 In pushing and pulling patterns of motion,
the basic joint actions are flexion and
extension in one or more of the extremities.
 The joint actions in the upper extremities are
characterized by flexion and extension in
the elbow while the opposite movement is
occurring in the shoulder.
 In the lower extremities, extension occurs
simultaneously in the hip, knee, and ankle.
This simultaneous and opposite joint action is
a primary characteristic of push-pull
patterns. All joint motions occur at the same
time or very near the same time.

Pivoting
 Place one foot slightly ahead of the other.
 Turn both feet at the same time, pivoting on
the heel of one foot and the toe of the What do we use in Positioning
other.
 Maintain a good center of gravity while  Pillows
holding or carrying the object  Blankets
 Heel protectors
 Splints, slings & braces
Positioning Clients  Seat cushions
 Why do we spend time on positioning?  Wedges
 Patient comfort/decrease pain
 Support and stability to patients’ trunk & Standard Positions
extremities. Supine
 Prevent development of pressure sores  Pillow under head to keep c-spine neutral.
 Prevent joint contractures  Small pillow or towel roll for cervical support.
 To have easier access to area being  Support under popliteal space to ↓ lumbar
treated lordosis.
 Decrease edema  Ankle support to relieve pressure on
 Increased function calcaneus.
 The most comfortable for the patient may  Support under elbows to relieve pressure on
not be the best for them bony prominence.
 May need to be positioned to aid in the
treatment of a specific diagnoses or Purpose
condition  CBR
Positioning Clients  Liver biopsy
Considerations with Positioning  Post spinal anesthesia
 Who is at risk?
 Elderly Contraindicated for patients with DOB,risk for
 Those unable to change their own aspiration.
position Prone
 Those with decreased sensation
 Pillow under head
 Those who may be unable to
communicate their discomfort  Pillow under lower abdomen to ↓ lumbar
lordosis
 Rolled towel under anterior shoulder to
adduct (retract) scapula
  Towel roll/pillow/bolster under ankles to
relieve stress on hamstrings, also allows pelvis
and lumbar spine to stay relaxed
PURPOSE –for patients who underwent BKA for the
first 24 hours
Contraindicated for patients with abdominal
surgery and respiratory problems
Side lying
 Patient in center of bed – not near edge
 Head, trunk, pelvis in alignment
 LE’s are flexed at hip & knee with pillows
between legs & top Le slightly forward of
bottom LE
 Pillow at chest &/or back for to prevent patient
from rolling
 Pillow under top arm to keep chest open
Semi-fowler
 Head of bed is lifted 30° - can use pillow,
wedge or bolster as well .Pillow under popliteal
space
 For a Fowler position head of bed is 45°
 Used for NGT feeding
High Fowlers Position – 90 degrees angle with head ,
arms and leg support
 NGT insertion
 DOB
 facilitates the relaxing of tension of the
abdominal muscles, allowing for improved
breathing
Contraindicated for post spine and brain surgery
Lithotomy Position
 a common position for surgical procedures and
medical examinations involving the pelvis and
lower abdomen, as well as a common position
for childbirth
Dorsal Recumbent
 Patient is on his back with knees flexed and
soles of feet flat on the bed.
Trendelenburg Position
 the body is laid supine, or flat on the back on a
15-30 degree incline with the feet elevated
above the head. For improvement of patients
with low cardiac output
Sims Position
 used for rectal examination, treatments, and
enemas.
 It is performed by having a patient lie on
their left side, left hip and lower extremity
straight, and right hip and knee bent. It is also
called lateral recumbent position.
Knee Chest /Genupectoral Position
 The knee-chest position is a position used in
a number of medical situations including
gynecological examination and surgery and
lumbar spine surgery.
 The knee-chest position is recommended in
those with a cord prolapse until delivery can
occur.
Moving and Transferring/Turning Clients in Bed
Transferring
 refers to moving a patient from bed to a
chair or to a stretcher, or to a wheelchair
with maximum comfort and safety for
patient and nurse.
Reasons for transferring:
 Improvement of the patient’s condition
(from ICU to medicine unit .
 Worsens of patient’s condition (to ICU)
 The need for surgery or X ray
 Transfers at the patient’s request
 For any other diagnostic tests.
Reasons for moving
 Change position
 Repositioning the client
 Client’s slid down in bed from fowler’s
position
 Changing the bed linen
Methods of transferring
 By wheel chair
 By stretcher
 By a movable bed
Actions applicable before moving the Client
Assess:
 The client’s physical abilities
 Degree of comfort or discomfort when moving
 Client’s weight
 Your own strength and ability to move the
client
 Prepare supportive equipment (pillows)
 Explain the procedure to the client and listen
to any suggestions of the client
 Raise the height of the bed to bring the client
close to your center of gravity
 Lock the wheels on the bed and raise the rail
on the side of the bed opposite you to ensure
client safety
 Face in the direction of the movement to
prevent spinal twisting
Logrolling
 the log roll or logrolling is a maneuver used to
move a patient without flexing the spinal
column. Patient's legs are stretched, the head
is held, to immobilize the neck.
Transferring Clients
Transferring the patient from bed to wheel
chair:
 Review the medical record and nursing plan
of care for conditions that may influence the
patient’s ability to move or to be positioned
 Perform hand hygiene and put on PPE, as
indicated. Identify the patient. Explain the
procedure to the patient
 Provide privacy
 Raise the head of the bed to a sitting
 Make sure the bed brakes are locked. Put the
chair next to the bed. If available, lock the
 brakes of the chair. If the chair does not have
brakes, brace the chair against a secure
object.
 Lower the side rail, if necessary, and stand
near the patient’s hips. Stand with your legs
shoulder width apart with one foot near the
head of the bed, slightly in front of the other
foot
 Assist the patient to sit up on the side of the
bed.
 Wrap the gait belt around the patient’s waist,
based on assessed need and facility policy.
 Stand facing the patient. Spread your feet
about shoulder width apart and flex your hips
and knees
 Ask the patient to slide his or her buttocks to
the edge of the bed until the feet touch the
floor.
 Position yourself as close as possible to the
patient, with your foot positioned on the out
side of the patient’s foot
 Using the gait belt, assist the patient to stand
Rock back and forth while counting to three.
On the count of three, use your legs (not your
back) to help raise the patient to a standing
position . If indicated, brace your front knee
against the patient’s weak extremity as he or
she stands.
 Pivot on your back foot and assist the patient
to turn until the patient feels the chair against
his or her legs
 Ask the patient to use an arm to steady him-
or herself on the arm of the chair while slowly
lowering to a sitting position . Continue to
brace the patient’s knees with your knees and
hold the gait belt. Flex your hips and knees
when helping the patient sit in the chair.
 Assess the patient’s alignment in the chair.
Remove gait belt , if desired. Depending on
patient comfort, it could be left in place to
use when returning to bed. Cover with a
blanket, if needed
Transferring between bed and stretcher and vice
versa:
Transferring the patient from bed to stretcher
and from the stretcher to the bed is done to patients who
cant help themselves and need help. The selection of
transfer technique is individualized.
The following methods can be used.
 Draw sheet method
 Patient is lifted by three persons
 Mechanical devices like hydro ureter lift
Draw sheet method
 Lower the head of the bed until it is flat.
Raise the bed so that it is slightly higher than
the surface of the stretcher. Ensure that the
wheels on the bed are locked.
 Pull the draw sheet out from both sides of
the bed. Place the stretcher parallel to the
bed.
 Four nurses or helpers are required. One
stands at the opposite side of the bed.
Remaining three stands across the stretcher
one supporting the head and shoulders,
second one supporting the hips and thighs
and the third one supporting the feet and
legs.
 Grasp the draw sheet tightly
 Co-ordinate lifting by counting the numbers
of 1, 2, 3 and receive the patient in stretcher
by pulling the draw sheet and the patient
towards the stretcher, quickly and gently.
 The sheet can be removed by turning the
patient from side to side
Three persons lifting the patient
 Three people, all standing on the same side
of the patient, slip their hands, palms facing
up, beneath the patient.
 First person holds the head and shoulder,
second person holds the trunk up to thigh
and the third person holds the legs.
 Cradle the patients in the arms so that the
patients weight rests against the nurses
chests and the patient faces nurses.
 Care must be taken so that the patient will
not be dropped down suddenly.
 The nurses should bend over and release the
weight of the patient gradually and until it
rests gently upon the bed or stretcher
Moving the client up in bed
 Review the medical record and nursing plan
of care for conditions that may influence
the patient’s ability to move or to be
positioned . Assess for tubes, IV lines,
incisions, or equipment that may alter the
positioning procedure. Identify any
movement limitations.
 Consult patient handling algorithm for
moving the patient. Perform hand hygiene
and put on PPE. Identify the patient. Explain
the procedure to the Patient
 Close curtains around bed and close the
door to the room, if possible
 Adjust the head of the bed to a flat position.
Remove all pillows from under the patient.
Leave one at then head of the bed, leaning
upright against the headboard. Moving the
client up in bed
 Position at least one nurse on either side of
the bed, and lower both side rails . Ask the
patient (if able) to bend his or her legs and
 put his or her feet flat on the bed to assist
with the movement.
 One nurse should be positioned on each
side of the bed. Grasp the friction-reducing
sheet securely, close to the patient’s body
Moving the client up in bed
 Flex your knees and hips. Tighten your
abdominal and gluteal muscles and keep
your back straight.
 On the count of three, move the patient up
in bed. Assist the patient to a comfortable
position and readjust the pillows and
supports, as needed. Return bed surface to
normal setting
Ambulating Clients
 To walk from place to place or move about.
 It is a technique of post operative care in which
a patient gets out of bed and engages in light
activity (as sitting, standing, or walking) as soon
as possible after an operation.
 Some time this term is also use in the place of
walking.
 Ambulating the client keeps him more active
and improves muscle tone and strength in his
legs. It also slows loss of bone mass and
density related to osteoporosis.
 The client who is up walking has increased
peristalsis and circulation. The client also gets
a sense of accomplishment and maintains
greater independence.
Gait
 is a term to describe human locomotion, it is
pattern of walking or a sequence of foot
movements.
Gait cycle or walking cycle
 A cycle of walking is the period from the
heel-strike of one foot to the next heel-strike
of the same foot
 When a subject is walking on level ground,
than the movements of the lower limbs may
be divided into “swing” and “stance”
phases.
 The swing phase occurs when the limb is off
the ground, and the stance phase when it is
in contact with the ground and is bearing
weight.
Procedure for Ambulating Client using a Gait Belt
 Wash your hands.
 Explain what you are going to do.
 Assist the client to sit on the edge of the
bed.
 Pause and allow the client to sit on the
edge of the bed for a few moments to
regain his balance.
 Assist the client in putting on socks and
nonskid shoes.
 Put a gait belt around the client's waist.
 Stand in position of good body mechanics.
 Assist the client to a standing position by
straightening your legs as you lift with the
gait belt and the client pushes down with his
hands on the mattress.
 Pause to allow the client to regain balance.
 Walk with the client by placing one hand on
the gait belt in front of his waist and your
other hand in back under the gait belt. Walk
on the weaker side and encourage the
client to hold the handrail, if available, with
strong arm.
 Walk in the same pattern as the client (both
step with left foot at the same time). Assist
the client to step forward with strong foot
first.
 Walk the client the distance instructed by
supervisor or as indicated by the service
plan.
NOTE: IF THE CLIENT LOSES WEIGHT-BEARING ABILITY,
PULL THE CLIENT'S BODY INTO CLOSE ALIGNMENT
WITH YOUR HIP/THIGH AREA BY USING THE GAIT BELT
AND LOWER HIM TO THE FLOOR USING THE LARGE
MUSCLES OF YOUR LEGS.
 Return the client to the bed/chair.
 Make sure the client is comfortable.
 Remove the gait belt.
 16. Wash your hands.
Procedure for Ambulating a Client With a Walker:
 Wash your hands.
 Explain what you are going to do.
 If using a hospital bed, lower the bed to
lowest level.
 Assist the client to sit on the edge of the
bed.
 Pause and allow the client to sit on the
edge of the bed a few moments to regain
his balance.
 Assist the client in putting on socks and
nonskid shoes.
 Apply a gait belt.
 Stand in a position of good body
mechanics.
 Assist the client to a standing position by
straightening your legs as you lift with the
gait belt and the client pushes down with his
hands on the mattress.
 Instruct the client to position his body within
the frame of the walker.
 Instruct the client to move the walker
forward by lifting it up, moving it forward,
and setting it down.
 Instruct the client to take a step forward with
the weak leg.
 Instruct the client to move strong leg
forward
  Instruct the client to take short steps and
keep his head up and eyes looking forward.
 Walk the client the distance instructed by
supervisor/nurse as indicated in the service
plan.
 Return the client to bed or a chair. To
ambulate backward, the client steps back
with his strong foot, takes a step back with
his weak foot, then walker is moved back.
Have the client feel for the arm of chair or
top of mattress with his hand.
 Assist the client into the chair or bed; make
sure the client is comfortable.
 Wash your hands.
Procedure for Ambulating a Client with a Cane:
 Wash your hands.
 Explain what you are going to do.
 Lower the bed to lowest level; assist client to
sit on edge of bed.
 Pause and allow the client to sit on the
edge of the bed a few moments to regain
his balance.
 Assist the client in putting on socks and
nonskid shoes.
 Apply a gait belt.
 Stand in a position of good body
mechanics.
 Assist the client to a standing position by
straightening your legs as you lift with the
gait belt and the client pushes down with his
hands on the mattress.
 Instruct the client to move the cane forward
and a little to the outside of his strong leg.
Client should use the cane on his stronger
side.
 Instruct the client to take short steps and
keep his head up and eyes looking forward.
 Instruct the client to move his weak foot
forward to line up evenly with the tip of the
cane.
 Instruct the client to put weight on the cane
and weak foot while swinging his strong foot
forward.
 Walk in the same pattern as the client (both
step with left foot at the same time).
 Walk the client the distance instructed by
supervisor/nurse as indicated in the service
plan.
 Return the client to bed/chair.
 Make sure the client is comfortable.
 Wash your hands.
Using Mechanical Aids for Walking
Walking
 Walking is the manner or way in which you
move from place to place with your feet.
 It is a Movement at a regular and fairly slow
pace by lifting and setting down each foot
in turn, never having both feet off the
ground at once.
 it is the highest level of motor control skill.
The major requirements for successful walking
include:
 Support of body mass, by the lower
extremities
 Production of locomotors rhythm
 Dynamic balance control of the moving
body
 Propulsion of the body in the intended
direction
Walking aid
 is a device designed to assist walking and
improve the mobility of people who have
difficulty in walking or people who cannot
walk independently
Different Types of Walking aids
 walker
 Cane/Stick
 Crutches
Purpose of walking aids
 Increase area of support or base of support
 Maintain center of gravity over supported
area
 Redistribute weight-bearing area by
decreasing force on injured or inflamed part
or limb
 Can be compensate for weak muscles
 Decrease pain
 Improve balance
Crutches
 These are devices which are used to reduce
weight bearing on one or both legs and also
give support where balance is impaired and
strength is inadequate
Prerequisites for crutches
 Good strength of upper limb muscles is
required.
 Range of motion of upper limb should be
good.
 Muscle group which should be strong is
given below.
 Shoulder flexor, extensors and depressor
 Shoulder adductors
 Elbow and wrist extensors
 Finger flexors