Immobility

Immobility: Description, Causes and Risk Factors:Alternative Name: Immobility Syndrome.Abbreviation: IS.ImmobilityImmobility is a common pathway by which a host of diseases and problems in the elderly produce further disability. Persons who are chronically ill, aged, or disabled are particularly susceptible to the adverse effects of prolonged bed rest, immobilization, and inactivity. The effects of immobility are rarely confined to only one body system. It may later cause a wide range of complications. Immobility in the elderly often cannot be prevented, but many of its adverse effects can be. Improvements in mobility are possible for the immobile older adults. Relatively small improvements in mobility can decrease the incidence and severity of complications, improve the well-being of the elderly as well as relieve the burden of caregivers.The immobility syndrome is a geriatric problem characterized by a marked reduction in tolerance for exercise, the consequences of which include tachycardia, arterial hypertension, loss of automatisms and postural reflexes, making movement impossible. The immobility syndrome consists of a reduction in the capability to perform daily activities due to a motor function deterioration that leads to characteristic body structural and physiological changes. The prevalence of this syndrome is linked to people longevity and their environment.It was found a reduced glomerular filtration rate (GFR) as shown by the lower creatinine clearance in the IS group. Since this reduced GFR ran with a low fractional excretion of sodium, it supports the hypothesis of a prerenal state that could be explained by the reduced cardiac output and capillary leak that immobile people usually present.It was found that the IS group had a relatively higher vasopressin level regarding its serum osmolality level, enabling this hormonal excess to explain the free water retention state found in this group. It could be hypothesized that the above mentioned prerenal state could induce the documented vasopressin hormone relative excess found in the immobile old people.Symptoms:Cardiovascular Symptoms May Include:Loss of consciousness due topositional changes causingincrease in fall risk.
  • Increased heart rate placinggreater demand on the heart.
  • Decreased volume of blood to thelungs, causing less oxygen to getto all the organs and tissues.
  • Sluggish circulation.
  • Clots in the veins, can be lifethreatening.
  • Reduced efficiency of the kidneyswith increased urine output.
  • Edema (swelling) in legs, hands, oroverall.
Digestive Symptoms May Include:Decreased appetite. Muscular Symptoms May Include:Pain and irritability.
  • Decreased muscle fiber andmuscle wasting.
  • Strength can decrease by 50% assoon as 3 weeks after inactivity.
  • Muscle contractures causingdisfiguring and loss of motion andabilities.
  • Loss of muscle strength andmuscle tone.
  • Balance loss when postureschange causing an increase in fallrisks.
Anatomic Nervous System Symptoms May Include:Decreased bowel movements
  • Infections in urinary tract.
  • Urine output is reduced, andstones can develop.
Central Nervous Systems Symptoms May Include:Emotional changes such asdepression, anger, despair,feelings of helplessness.
  • Behavioral changes suchwithdrawing from friends andfavored activities, hostility, confusion, and belligerence.
  • Decreased intellectual capability.
  • Decrease in ability to cope.
  • Changes in sleeping patterns.
Peripheral Nervous Systems Symptoms May Include:Changes in sensation awareness.
  • Changes in vision.
  • Changes in pain perception.
  • Changes in coordination.
Respiratory Symptoms May Include:
  • Lungs are not used to full capability.
  • This can cause pooling of fluids inthe lungs that can cause coughing,accumulation of phlegm and canlead to pneumonia.
  • Infections in lungs.
Symptoms Related to Skin May Include:Wrinkles can increase.
  • Skin quality declines.
  • Pressure sores can occur.
Treatment:The best preventative measure is to maintain a certain level of mobility.Various studies agree that exercise and general physical activity are the main factors in warding off immobility. The benefits from exercise do not decrease with age, but increase cardiovascular functions, improve musculature and bone density, reduce anxiety, frustration and depressive symptoms and promote socialization.Statistically, elderly people who lead an independent and active life with regular exercise have a lower risk of mortality. Those who have always exercised age better and have less functional disabilities.Recommended forms of exercise may include walking, cycling, swimming, gardening, and aerobic exercise under medical supervision.Steps may include:Maintain a sufficient fluid intake. Ensure 1.5-2.0 liters fluid intake per day as possible.
  • It is important to encourage the elderly to remain active and if possible propose that they join senior citizen clubs. They should also be allowed to continue or to participate in everyday activities at their own pace.
  • Families should avoid overprotecting them.
  • Doctors should periodically evaluate the functional abilities of the elderly, as well as those who have been recently discharged from hospital.
  • Recommended exercise for the elderly should include periodic reviews of their physical state of health and individual adjustments to the type of exercise and activities they can engage in.
  • It is also important to establish certain minimum activity objectives depending on functional ability and to teach correct techniques. The motivation of the elderly should also be assessed, as well as their capacity for enjoyment, the major factor determining whether they will continue to exercise.
  • For bed-bound cases, maintain proper body alignment and change positions every few hours. Pressure padding and heel protectors may be used to provide comfort and prevent pressure sores.
Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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