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Impaired Physical Mobility and Activity Intolerance in the Elderly

Impaired Physical Mobility and Activity Intolerance

Definition of Impaired Physical Mobility

A state of the limited ability of independent physical movement experienced by a person.

Defining characteristics:
  • Inability to move with purpose in the environment, including mobility on the bed, moving and ambulation.
  • Reluctance to perform the movement.
  • Limitation of range of motion.
  • Decreased strength, control, or muscle mass.
  • Experiencing restrictions on movement, including the protocols mechanical and medical.
  • Impaired coordination.

Related factors :
  • Activity intolerance.
  • Decreased strength and endurance.
  • Pain and discomfort.
  • Perceptual or cognitive disorders.
  • Neuromuscular disorders.
  • Depression.
  • Severe anxiety.

Definition of Activity Intolerance

A state of energy insufficiency physiologically or psychologically a person to survive or complete daily activities necessary or desirable.

Defining characteristics:
  • Verbally reported fatigue or exhaustion.
  • Heart rate or blood pressure that is not normal to the activity.
  • Discomfort, dyspnea after activity.
  • Electrocardiographic changes indicating ischemia or dysrhythmia.

Related factors :
  • Bed rest and immobility.
  • General weakness.
  • A sedentary lifestyle.
  • The imbalance between oxygen supply and needs.

Internal Factors

Various internal factors in the immobilization of the body or body parts, among others:

  1. Decrease in musculoskeletal function
    The muscles (atrophy, dystrophy, or injury), bone (infections, fractures, tumors, osteoporosis, or osteomalacia), joints (arthritis and tumors), or a combination of structures (cancer and drugs).
  2. Changes in neurological function
    Infection, tumor, trauma, medication, vascular diseases, demyelinating diseases, degenerative diseases, exposure to toxic products, metabolic disorders, or nutritional disorders.
  3. Pain
    The cause of multiple and varied as chronic disease and trauma.
  4. Deficit perceptual
    Excess or lack of perception of sensory input.
  5. Reduced cognitive abilities
    Impaired cognitive processes such as severe dementia.
  6. Fall
    Physical effects: injury or fracture, the psychological effects: the syndrome after a fall.
  7. Changes in social relations

* Actual factors, perception factors
1. Psychological aspects
Powerlessness in learning, depression

External Factors 

These factors include:
  • Therapeutic program.
  • Characteristics occupants institution.
  • Characteristics staff.
  • Nursing care delivery systems.
  • Barriers.
  • The policies of the institution.


The impact of problems in the elderly

An understanding of the impact of immobilization can be obtained from the interaction of physical competence, threats to immobility, and interpretation of the events. Immobility affects the body that has been affected previously. For example, after early adulthood there is a clear decrease in strength and continue permanently.

Between the ages of 20 to 60 years, muscle strength decreased by 10-30%, at the age of 80 years about 50% of muscle has been lost. People who are 20 years old may use about 50-60% of voluntary muscle contraction, of the quadriceps muscle to get up from a chair is low and without armrests, a 80-year-old can use almost 100% strength of muscle contraction.

Therefore, physical competence of an elderly may be at or near the threshold level for the activity of specific mobility. Further changes or loss of immobility can make a person dependent. The greater the number of causes immobility, the greater the potential for experiencing the effects due to immobility. As well as one's perception of events that affect the overall reaction to and the potential to negate the physiological consequence of immobility.

Immobilization effect also depends on the assessment of the resources and limitations inside and outside the person and on the interaction between the internal and external environments. The internal environment or the competence of the client is the determinant factor mobility is most important when the degree of immobility of the lower case. Because the client competence declines, larger depending on the external environment to maintain mobility. For example, if a hemiplegic elderly patients with severe muscle weakness encouraged to use electric wheelchair, sources from the external environment to help negate the limitations of the internal environment.

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