ACTIVE AND PASSIVE RANGE OF MOTION EXERCISES
The body was designed for motion. Regular exercise contributes to a healthy
body; therefore immobility has a negative effect. A joint that has not been moved
sufficiently can begin to stiffen within 24 hours and will eventually become inflexible.
With longer periods of joint immobility, the tendons and muscles can be affected as well.
Most people move and exercise their joints through the normal activities of daily living.
When any joint cannot be moved in this way, the patient or nurse must move it at
regular intervals to maintain muscle tone and joint mobility. Range of motion (ROM)
exercises are ones in which a nurse or patient move each joint through as full a range
as is possible without causing pain. The effect of both regular exercise and immobility
on major body systems are discussed in this lesson.
THE EFFECTS OF IMMOBILITY
a. Cardiovascular System.
(1) Venous stasis caused by prolonged inactivity that restricts or slows
venous circulation. Muscular activity, especially in the legs, helps move blood toward
the central circulatory system.
(2) Increased cardiac workload due to increased viscosity from dehydration
and decreased venous return. The heart works more when the body is resting,
probably because there is less resistance offered by the blood vessels and because
there is a change in the distribution of blood in the immobile person. The result is that
the heart rate, cardiac output, and stroke volume increase.
(3) Thrombus and embolus formation caused by slow flowing blood, which
may begin clotting within hours, and an increased rate in the coagulation of blood.
During periods of immobility, calcium leaves bones and enters the blood, where it has
an influence on blood coagulation.
(4) Orthostatic hypotension probably due to a decrease in the neurovascular
reflexes, which normally causes vasoconstriction, and to a loss of muscle tone. The
result is that blood pools and does not squeeze from veins in the lower part of the body
to the central circulatory system. The immobile person is more susceptible to
developing orthostatic hypotension. The person tends to feel weak and faint when the