Immobility
From Anvita Health Wiki
Contents |
Etiology
-
- arthritis
- sarcopenia
- osteoporosis, fractures (especially hip & femur)
- podiatric (foot) problems
- Paget's disease
- neurologic disorders
- stroke
- Parkinson's disease
- cerebellar disorders
- neuropathies
- severe congestive heart failure ( CHF)
- coronary artery disease (frequent angina)
- peripheral vascular disease (frequent claudication)
- severe COPD
- sensory impairment
- visual impairment
- fear of falling
- environmental causes
- forced immobility ( nursing home, hospital)
- inadequate aids for mobility
- severe systemic illness (i.e. widespread malignancy)
- deconditioning (after prolonged bedrest)
- malnutrition
- other
- pain
- depression
- adverse pharmaceutical effects ( antipsychotic-induced rigidity)
History
- nature & duration of disabilities causing immobility
- medical conditions contributing to immobility
- drugs that can affect mobility
- motivation & other psychological factors
- environment
Physical-examination
- skin
- cardiopulmonary status
- musculoskeletal assessment
- muscle tone & strength
- joint range of motion
- foot deformities & lesions
- levels of mobility
- bed mobility
- ability to transfer (bed to chair)
- wheelchair mobility
- standing balance
- gait
Complications
- skin -> pressure ulcers
- musculoskeletal
- muscular deconditioning & atrophy
- contractures
- bone loss ( osteoporosis)
- decreased ventilation
- atelectasis
- aspiration pneumonia
- altered body composition -> decreased plasma volume
- negative nitrogen balance
- impaired glucose tolerance
- altered drug pharmacokinetics
- sensory deprivation
- dementia, delirium
- depression
Management
- physical therapy
- occupational therapy if appropriate
- individualize specific goals
- prevention & treatment of pressure ulcers
More General Terms
Additional Terms
References
Essentials of Clinical Geriatrics, 4th ed, Kane RL et al (eds) McGraw Hill, NY, 1999
