EXERCISES

Exercises

Exercise is the performance of physical exertion for improvement of the health or the correction of physical deformity.

The beneficial effects of exercise

On the musculo-skeletal system

• Maintains the muscle tone.
• Maintains the joint mobility.(prevent stiff joint)
• Prevents and corrects deformities like foot drop, ankylosis etc.
• Maintains the bone density and prevents osteoporosis.

On the cardio-vascular system

• Stimulates the blood circulation and prevents venous stasis.
• Assists in the exchange of oxygen and nutrients into the tissues and waste products from the tissues.
• Prevents varicose veins.
• Helps to reduce oedema.
• Reduce the work load on the heart.
• Prevents venous thrombosis and pulmonary embolism.

On metabolism

• Prevents obesity.
• Regulates body temperature.
• Oxygen consumption and metabolic rate are increased thus providing good lung expansion to meet the additional requirement of the body.

On the gastro-intestinal system

• Improves appetite and digestion.
• Prevents constipation.
• Prevents flatulence.

On the excretory system

• Promotes urinary functions by stimulating the blood circulation through the kidneys and helps in the elimination of waste products.
• Prevents stagnation of urine and formation of renal calculi.
• Promotes elimination from the skin.

On the respiratory system

• Improves the lung ventilation.
• Prevents atelectasis.(collapse of lung)
• Prevents collection of secretions in the lungs.(hypo static pneumonia)

On the mental process

• Promotes the physical and mental well being.
• Prevents depression and boredom.
• Restore a sense of relaxation and equilibrium.
• Improves the memory.
• Provides an outlet for emotional tension.

Others

• Prevents bed sore.
• Adds to the beauty.

ACTIVE EXERCISE

Active exercises

Active exercise is the type of physical activity accomplished by the patient without assistance. These exercises help he patient to attain the normal physiological functions of the body. Some of the active form of exercises that can be done by the patients on the bed are: deep breathing and coughing exercise for the complete lung expansion usually employed for the post-operative patients.

Exercise of the limbs through full ranges of motion which includes flexion, extension, adduction, abduction and rotation.

• Moving in bed to change the position.
• Foot exercise to prevent foot drop and toe deformities.
• Abdominal and gluteal contraction exercise.
• Exercise to prepare the patient for ambulation eg; patient after amputation of legs needs a variety of exercise before he starts crutch walking.

The ambulatory patients can have both indoor and outdoor exercise. Some of the points to be kept in mind during the exercise are:

• The exercise should be planned according to the age , sex and physical condition of the patient.
• Check for the doctor's orders for any specific precautions taken regarding the movements of the patients.
• The room should be well ventilated.
• Exercise should not be done immediately after a meal.
• Avoid over fatigue.
• Avoid chills and draughts.
• Have loose garments to put on.
• Exercise are to be repeated daily at the same time if possible.

PASSIVE EXERCISE

Passive exercises

In passive exercise, the movements or activity is carried out by another person and the patient makes no voluntary effort to assist or resist the action. The passive exercise are usually carried out by the physiotherapist or the nurse. The performance of certain nursing procedures such as bathing the patient, giving back care and changing the position etc; provide some passive exercise for the patient. Passive exercise are useful for the patients with restricted movements, deformities and unconsciousness.

FOOT DROP

Patients with prolonged rest and restricted movements develop a deformity called foot drop in which the foot is plantar flexed (the ankle bends in the direction of the sole of the foot). If the condition continues without correction, the patient will walk on his toes without touching the ground with the heel of the foot.

The deformity is caused by the contraction of both gastrocnemius ans soleus muscles. Prolonged bed rest, lack of exercise, incorrect positioning in bed and the weight of the bed clothes forcing the toes in the plantar flexion are some of the factors that contribute to this crippling deformity.

The foot drop can be prevented by the use of foot board(foot rest) to maintain the position of the feet at right angles to the legs, flexion and extension exercise to the feet and toes.