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)
• osteoporosis fracture
• 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.