Impaired physical mobility can affect nearly every patient in the hospital. Illness, age, and sudden change in mental or physical well being are only a few reasons for mobility alterations. Unfortunately, the ability to move and ambulate affects almost every body system. That is why mobilizing patients early and progressively is so essential.
Preserving muscle strength and promoting independence is the goal. Immobility may lead to other problems, such as skin beak down, muscle wasting, respiratory infections, and other complications that can arise from lack of movement.
The cause of impairment can be physical, psychological, or motivational. The reason why the patient is physically impaired builds the foundation of the plan of care. For example, suppose one patient’s reason for limited activity is mental problems, whereas another patient’s reason is obesity or a fractured limb. In that case, the treatment plan will look very different between the two.
Physical and occupational therapy may be consulted. This assessment provides a baseline and guides treatment.
Specific equipment such as mechanical lifts, canes, wheelchairs, and other assistive devices can increase mobility.
Obstacles in the room can impede activities, especially transferring and ambulating.
Factors that worsen the patient’s condition need to be treated simultaneously. The patient’s nutritional status might affect overall strength. Weakness from poor nutrition might lead to less effort to engage in activities. Inadequate nutrition also puts the patient at risk of developing skin breakdown more quickly.
Working with PT and OT ensures the patient engaging in exercises regularly. Daily exercise helps the patient maintain and also gain muscle strength over time.
Pain management is an integral part of the treatment plan. Patient performance and ability to move might be increased with appropriately timed pain medication administration.
Even passive range of motion increases circulation. Range of motion exercises will help the patient increase muscle strength and prevent contractures.
Assistive devices increase mobility and promote safety.
Early progressive ambulation can decrease the risk of complications.
Patient’s conditions and illnesses change over time. With that, their activity level and mobility changes. This shift might require different use or types of mobility aids. For example, a patient who could mobilize with the help of a wheelchair might need more assistance, such as a mechanical lift. Frequent evaluation promotes patient and staff safety.
Considering the unique condition and abilities of each patient allows for maximum mobility of that specific patient.
Some patients are severely deconditioned. Engaging in activities might lead to higher oxygen requirements, orthostatic hypotension (drop in blood pressure), and tachycardia (elevated heart rate). Use progressive measures, such as sitting on the side of the bed, dangling legs, or marching in place so that the body can adjust to increased activity levels.
Positive reinforcement helps with motivation and might reduce the fear of falling or pain.
Breaks are essential to allow time to recover and conserve energy. The patient might be more successful in completing activities with rest periods.
Breathing exercises and stretching helps to conserve energy and recharge.
Assisting only in necessary steps prevents the patient from becoming dependent. The goal is to further independence and maximize the patient’s capabilities.
Heel off-loading devices
Sequential compression devices
Anti embolic stockings
Air mattresses
Foam wedge
These measures and devices reduce skin breakdown and increase circulation.
Frequent position changes help reduce burdening pressure points for an extended period and reduce break down.
A dietitian can personalize the nutritional needs of a patient depending on their condition and the type of illness.
Lack of exercise, bed rest, and pain medication often lead to constipation. Stool softeners and laxatives help alleviate constipation.
Family and caregivers need to know about the proper usage of equipment at home and the appropriate handling of the patient. Clear instructions keep the caregivers safe as well as the patient.
The patient’s condition might require some adjustments to the home, such as installing modified accessibility or adding equipment needed to move and transfer the patient.
A safe home environment reduces the risk of falls and injury.
Besides family support, the patient will benefit from professional help in the home.
