376 Unit 4 Healthcare Skills Copyright Goodheart-Willcox Co., Inc. devices (such as canes, crutches, and walkers), and receive proper positioning and range-of-motion exercises when needed. Proper body mechanics are also an important part of ensuring safety for yourself and your patients. Ambulation Ambulation, or the ability to walk around, is key to performing activi- ties of daily living. It improves circulation and muscle tone, preserves lung tissue and airway function, and helps promote muscle and joint mobility. Ambulation is essential for optimal well-being. When hospital patients are able to ambulate early in their stay, their lung function has been found to improve greatly. In a recent study, patients who increased their walking by at least 600 steps between the fi rst and second 24-hour days in the hospital were discharged approximately two days earlier than those who did not. Ambulation requires an action called double pendulum. When people walk, their leg leaves the ground, swinging forward from the hip. This is the fi rst pendulum. When that leg strikes the ground, with the heel touching fi rst and rolling through to the toe, this motion is the second pendulum. When walking, the movement of the two legs is coordinated so that one foot is always in contact with the ground. Walking differs from running. When walking, one leg is always in con- tact with the ground, while the other is swinging. When running, there is a ballistic phase that occurs when both feet are off the ground at the same time. ambulation the ability to walk from one place to another Think It Through Think It Through How are your body mechanics? Think about how you lift something or bend down to pick up an object from the floor. Do you bend your knees to a full squat position, bring the object close to you, and then hold it close to your body as you pick it up? Do you tighten your abdominal muscles to support your movements so you can lift from your legs to a standing position? Do you avoid twisting and making quick, jerky actions? Ask a friend to watch you and give you feedback. On average, children first walk independently at approximately 11 months old. By adulthood, the average walking speed is about 3.1 miles per hour (mph), though walking speed for older adults is slower. Walking speed varies depending on a person’s height, weight, age, fitness level, effort, and culture. The ground, surface, and how much a person is carrying also influence walking speed. Did You Know? Average Walking Speed Average Walking Speed The Stages of Patient Ambulation There are usually three stages needed to assist a patient in moving from a bed to being able to ambulate. Healthcare workers have an important role to play in each of these stages. They are also responsible for making sure these stages occur safely and appropriately. The three stages of assisting a patient to ambulate follow: 1. Assist the patient to lift his body from lying in bed to sitting on the side of the bed. This is called dangling because the patient’s legs and feet are hanging off the side of the bed (Figure 13.3). Having patients dangle after lying in bed avoids a drop in blood pressure, helping prevent potential dizziness and possibly fainting when standing. This is called orthostatic hypotension, a condition you learned about in chapter 11.