Mobility is of significance importance to those in older age groups  participate in exercise, explorations and pleasure  allows opportunity for maintaining independence. Mobility is essential to the health and well-being of the older person. The incidence of problems associated with mobility increases with age. A number of chronic diseases predispose the older person to dysmobility.

• rapid cardiac and muscular deconditioning
• decreased ability to carry out everyday activities  affects lifestyle, independence
• risk factor for decreased health status
• impaired mobility  risk factor for falls
• instability and loss of confidence
• dependence (maybe institutionalisation)
• social impacts

Potential consequences of long term immobility and bed rest:
Pressure ulcers; stiffness and loss of muscle strength; constipation; urinary tract infections; malnutrition; orthostatic hypotension; hypothermia; deep vein thrombosis; pulmonary embolus; osteoporosis; contractures; depression

Most common causes (usually multifactorial):
• rheumatogical (eg rheumatoid arthritis, osteoarthritis, fibromyalgia)
• stroke
• osteoporosis  fracture
• falls
• sensory deficits (vision and hearing)
• foot problems (painful feet  impediment to mobility)

Patients with mobility problems are common in podiatric practice – ie due to dysmobility  unable to reach feet for self care. Often can have risk factors (eg vascular disease; anticoagulant therapy; oedema) that puts them at greater risk from inappropriate/injudicious foot care.

Management of immobility:
Exercise (can reverse most of adverse consequences); prompt rehabilitation; anticoagulants; lower extremity elastic stockings; adequate nutrition and hydration; daily toileting routine; frequent body repositioning; physical therapy; attention to psychological and social needs.

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