MOBILISING PATIENTS

Definition
Mobilization is a person's ability to move
freely, easily, regularly, have a purpose to
meet the needs of healthy life, and
essential to independence (Barbara
Kozier, 1995).

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Mobilization capability can be reduced or
disappear on a person suffering from
disorders muscle or bone such as
fractures, neurological disorders such as
stroke, inadequate energy such as heart
problems or with pain such as a person of
after surgery.
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Immobilization conditions were long and
continuous, can interfere with a person's
health because cardiovascular untrained,
constant muscle so it can occur atrophy,
can also lead to psychological disorders
because independence is not optimal.
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Mobilization needs to carried step by step,
adapted to the patient's physical abilities
and psychological readiness of patients.
Before the mobilization exercises also
need to be assessed the ability of the
client's body tolerance to the activity, to
avoid collapse, for example in patients
with cardiovascular disorders and severe
pain.
Mobilization capability can be reduced or
disappear on a person suffering from
disorders muscle or bone such as
fractures, neurological disorders such as
stroke, inadequate energy such as heart
problems or with pain such as a person of
after surgery.
Mobilization
Passive
mobilization
mobilization where the
patient in moving the
body in a way assisted
by other people in total.
Active
mobilization
mobilization where the
patient in moving the
body done
independently without
the assistance of other
people
Purpose
Increasing functional independence
Meet the basic human needs
Prevent the occurrence of trauma
Maintain the level of health
Preventing the loss of the body's ability to
function

Additionally, for critically ill patients,
mobilisation may reduce the incidence of
respiratory complications, hasten
recovery, decrease the duration of
mechanical ventilation, and reduce the
length of ICU or hospital stay.


Types of Mobilization
1. Full Mobilization
Is a person's ability to move fully and
freely so it can doing social interactions
and daily roles. The full mobility shows
motor nerve and sensory nerve function
can control all areas of the body.
2. Partial Mobilization
Is a person is not able to move freely as
influenced by disturbances of sensory and
motor nerves. Commonly encountered in
stroke patients, after an accident, and
others.
Activity Tolerance
Sign which can be examined on the activity
intolerance, among others (Gordon, 1976):
Increased pulse frequency and irregular
rhythm
Usually there is a decrease in blood
pressure

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An increase in respiratory rate, rapid and
shallow breathing
A decrease in skin color and body
temperature
Instability of the position of the body
Status emotional instability.

Important things to know:
Activity tolerance assessment is very
important, especially in clients with
cardiovascular disorders such as angina
pectoris, myocardial infarct or in clients
with long immobiliasi due to paralysis. It is
usually assessed at the time before doing
mobilization, while mobilization and after
mobilization.

Mobilization Guidelines
1. Mobilization Exercise in Patients Post-
Surgery
Mobilization after surgery is the process of
post-surgical activities carried out starting
from light exercise on the bed (breathing
exercises, effective coughing exercises and
move the legs) until the patient can get out of
bed, walked to the bathroom and walked out
of the room (Brunner & Suddarth , 1996).

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Stages of mobilization in patients with
post-surgery by Rustam Mochtar (1992),
include:
1. On the first day of 6-10 hours after the
patient is conscious, the patient can
doing breathing exercises and effective
coughing exercises then right oblique -
left oblique already be started.

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2. On the second day, the patient is
seated for 5 minutes, prompting
breathing exercises and coughing
effective to loosen respiratory .
3. On the third day to the fifth day, the
patient is advised to learn to stand and
then walk around the room, to the
bathroom, and left the room alone.

2. Mobilization Exercise on Client Fractures

Conditions fracture will receive medical
treatment appropriate severity levels.
Fractures that require surgery, need to be
mobilization exercise guidelines in
accordance with the guidelines on post-
surgical patients at point 1.

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On fracture healing without surgery, such
as is done immobilization with cast, need
to be supervised vascularization
conditions in the fracture area.

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Passive mobilization of the joints in the
area of the fracture needs to be done to
prevent contractures.
Active mobilization is done phased when
the muscle and bone strength is adequate.
Active mobilization is done by moving the
fracture area, then phased done to the
Activity Daily Living corresponding fracture
area strength.

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Usually in adults, the unification of upper
limb bones occurred in 2 months, and the
lower extremities in 4-6 months.
To ascertain whether has occurred union
of bone, necessary roentgen.

3. Mobilization Exercise in Patients After
Stroke Attack
Mobilization of stroke patients can be done
with:
1) passive exercise is client limb actuated by
other people to stimulate blood flow and
stimulates muscle contraction
2) active exercises which the client try to move
his own body
Exercises are carried as early as possible
and repeated will be motion controlled.