Question

a) What is mobility, and how does it affect the body's health? what are common alterations related to mobility?

b) with mobility, what is happening to the cell, tissues and the body? what is the basic problem? Apply the concept to a specific disease?

c) What evidence do you see of alteration in the body with mobility? and what can be done to improve balance or counteract imbalances?

Answer 1

Mobility is the joy of moving freely and easily. Healthy muscles, bones and joints allow us to perform all types of movements - from everyday tasks to enjoying our favorite hobbies.

Mobility impairment refers to the inability of a person to use one or more of his/her extremities, or a lack of strength to walk, grasp, or lift objects. The use of a wheelchair, crutches, or a walker may be utilized to aid in mobility.

Mobility impairment is defined as a category of disability that includes people with varying types of physical disabilities. This type of disability includes upper or lower limb loss or disability, manual dexterity and disability in co-ordination with different organs of the body. Disability in mobility can either be a congenital or acquired with age problem. This problem could also be the consequence of disease. People who have a broken skeletal structure also fall into this category of disability. Persons with physical impairment disabilities often use assistive devices or mobility aids such as crutches, canes, wheelchairs and artificial limbs to obtain mobility.

The hazards or complications of immobility, such as skin breakdown, pressure ulcers, contractures, muscular weakness, muscular atrophy, disuse osteoporosis, renal calculi, urinary stasis, urinary retention, urinary incontinence, urinary tract infections, atelectasis, pneumonia, decreased respiratory vital capacity, venous stasis, venous insufficiency, orthostatic hypotension, decreased cardiac reserve, edema, emboli, thrombophlebitis, constipation and the loss of calcium from the bones, are highly costly in terms of health care dollars and in terms of client suffering. Many of these costly complications of immobility can, and should be, prevented whenever possible.

Some of the first visible signs of aging may be changes to posture and gait, as well as fatigue and general weakness doing everyday tasks. People may notice an impact on mobility when engaging in activities such as walking. Aging affects muscle mass and strength, bone density, and can make joints stiffer and less flexible due to reduction of cartilage thickness1.

As we age, muscles, bones and joints undergo physiological changes that affect mobility and which can ultimately impact our independence. Daily physical activity combined with weight management and a healthy balanced diet that includes proper intake of protein, vitamin D and C, and calcium can support the health of your muscle, bones and joints and keep you moving. Embrace the allies of positive aging.

The age-related loss of muscle may decrease mobility. Loss of muscle mass can begin as early as 30 years and it can become more prominent from the age of 50 onwards. The rate of muscle loss is influenced by the amount of regular physical activity people do throughout their lives. An injury or temporary illness can also affect the amount of skeletal muscle mass. Daily consumption of protein contributes to healthy muscle mass.

Bone health is important at any age. The reduction in bone density that is common in older age makes bones weaker which in turn may lead to increased risk of fractures. Good nutrition including the necessary amounts of vitamins and minerals like Calcium and Vitamin D combined with exercise can help maintain good bone health during later stages of life.

Joints become more vulnerable to damages as the cartilage that lines them becomes thinner and the lubricating (synovial) fluid is reduced as we age. This means that joint surfaces aren’t able to slide as smoothly over one another, causing discomfort. Joints become stiffer as the ligaments and tendons become more rigid and muscle tone and bone strength is reduced. These changes make physical tasks more and more difficult.

Physiotherapy can help by enhancing and working on the level of mobility the individual is at through a variety of physiotherapeutic techniques. The experienced Physiotherapists can:

• Optimise independence
• Improve mobility (with full compliance of the client)
• Provide and educate on walking aids
• Education carers on manual handling techniques
• Provide a rehabilitation programme designed to improve the clients mobility
• Improve self-confidence with mobility

There are many techniques used by the experienced Physiotherapists to improve a client’s mobility. Some of the techniques may include the following, but are dependent upon the outcome of the assessment and the judgement of the Physiotherapist:

• Walking aid provision
• Strengthening exercises
• Stretching exercises
• Pain Management
• Electrotherapy (PSWD, Interferential, TENS)
• Acupuncture
• Gait re-education

Decrease in mobility can have a significant impact on a person’s wellbeing especially when it interferes with one’s ability to enjoy favorite hobbies, social outings and to remain independent. Key ways of tackling the issue include:

Good nutrition – consume the daily recommended amount of protein - essential for maintenance of muscle mass and strength. Older adults currently do not consume enough protein. Ensure proper intake of micronutrients such as vitamins (e.g. C and D) and minerals (e.g. calcium, magnesium, potassium, zinc).
Regular physical activity – including weight / resistance training to help maintain muscle mass
Weight management – maintain the optimal weight for your height and age.