ConditionBones, joints & muscles
Mobility Impairment
Mobility impairment is a reduced ability to move around independently, such as walking, standing, climbing stairs, getting in and out of bed, or using the arms. It can be temporary, after surgery or injury, or long-term, from conditions such as arthritis, stroke, multiple sclerosis, spinal cord injury, Parkinson's disease, amputation or frailty in older age. Rehabilitation, the right mobility aids, home adaptations and treatment of the underlying condition help people stay as active and independent as possible.
Also called: Impaired mobility, reduced mobility, limited mobility, physical disability affecting movement
At a glance
- What it is
- Difficulty moving the body or getting around independently.
- How common
- Mobility disability is the most common type of disability in US adults, affecting about 1 in 8.
- Common causes
- Arthritis, stroke, nerve and muscle diseases, spinal cord injury, amputation, frailty, obesity and heart or lung disease.
- Assessment
- Medical review, physical and occupational therapy evaluation, and home assessment.
- Support
- Exercise and rehabilitation, mobility aids, home adaptations, pain control.
- Complications to prevent
- Falls, pressure sores, blood clots, muscle loss and isolation.
When to get help
Call 911 or go to the ER
- Sudden loss of the ability to walk or move a limb, with face drooping or speech problems (possible stroke)
- Sudden leg weakness with back pain and loss of bladder or bowel control (possible spinal cord compression)
- A calf that becomes swollen and painful, or sudden breathlessness, in someone who is largely immobile (possible blood clot)
See a doctor within a day or two
- Mobility getting noticeably worse over days to weeks
- A fall with injury, or being unable to get up after a fall
- A new red, broken or black area of skin over the hips, heels or tailbone (possible pressure sore)
Book a routine appointment
- Gradually increasing difficulty with walking, stairs or getting out of a chair
- Needing help with daily activities that you could previously do alone
- Pain limiting movement
- A mobility aid that no longer fits or works well
What mobility impairment means
Mobility covers a range of everyday activities:
- walking indoors and outdoors
- standing and balancing
- getting in and out of bed, chairs, cars and the bath
- climbing stairs
- using the hands and arms to reach, grip and carry
Impairment ranges from mild (slower walking, using a cane outdoors) to severe (needing a wheelchair or help to transfer). The way it affects a person depends not only on their body but also on their environment, such as stairs, transport and workplace access.
Causes
Joint and bone conditions
- Osteoarthritis of the hips, knees and spine
- Rheumatoid and other inflammatory arthritis
- Fractures, especially hip fractures in older adults
- Osteoporosis with spine fractures
- Amputation
Brain and nerve conditions
- Stroke
- Multiple sclerosis
- Parkinson's disease
- Spinal cord injury
- Cerebral palsy
- Peripheral neuropathy
- Brain injury
- Motor neuron disease
Muscle conditions
- Muscular dystrophies
- Inflammatory myopathies
- Sarcopenia (age-related muscle loss)
Other conditions
- Heart failure and COPD, which limit exercise tolerance
- Obesity
- Chronic pain conditions
- Frailty in older age
- Vision loss
- Mental health conditions, such as severe depression, and fear of falling
Assessment
A primary care doctor, physical therapist or occupational therapist will typically assess:
- Medical causes: diagnosis and treatment of the underlying condition, medicines that cause dizziness or weakness, pain control, vision
- Strength, balance and gait: tests such as the Timed Up and Go, chair stand and walking speed
- Daily activities: dressing, bathing, cooking and shopping
- Home environment: stairs, bathroom layout, rugs and lighting
- Equipment needs: which mobility aids would help and fitting them correctly
- Mood, cognition and social support
Treatment and support
Rehabilitation and exercise
- Physical therapy to build strength, balance, endurance and walking technique
- Occupational therapy to adapt how daily tasks are done and recommend equipment
- Regular activity: even people with significant impairment benefit from exercise suited to their ability, such as seated exercises, water exercise or walking programs
- Balance training such as tai chi to reduce falls
Mobility aids
| Aid | Helps with |
|---|---|
| Cane | Mild balance problems or one-sided pain |
| Crutches | Temporary non-weight-bearing after injury |
| Walker or rollator | Greater balance support, frailty |
| Manual wheelchair | Longer distances or inability to walk |
| Power wheelchair or scooter | Limited arm strength or endurance |
| Orthoses (braces) | Foot drop, joint instability |
| Prostheses | Amputation |
A therapist should fit aids, because the wrong height or type can cause falls or strain.
Home adaptations
- Grab bars, raised toilet seats and shower chairs
- Stair lifts, ramps and handrails
- Removing trip hazards and improving lighting
- Moving essential rooms to one floor
- Accessible kitchen layouts
Treating the underlying condition
- Joint replacement for severe arthritis
- Medicines for Parkinson's disease and multiple sclerosis
- Pain management
- Weight management
Complications to prevent
- Falls and fractures
- Pressure ulcers: change position regularly, inspect skin daily and use pressure-relieving cushions or mattresses
- Blood clots in the legs
- Muscle loss and joint stiffness (contractures)
- Constipation and urinary infections
- Loss of bone density
- Weight gain or malnutrition
- Isolation and depression
Rights and access
In the US, the Americans with Disabilities Act requires reasonable accommodations at work and accessible public spaces. Disability parking permits, paratransit services and home health services may be available. A social worker or occupational therapist can help with access to equipment funding and services.
Frequently asked questions
What is mobility impairment?
Mobility impairment is a reduced ability to move independently, including walking, standing, transferring or using the arms. It may be temporary or permanent and has many causes, from arthritis and stroke to spinal cord injury and frailty.
What causes reduced mobility in older adults?
Common causes include osteoarthritis, muscle loss with age, previous falls or fractures, stroke, Parkinson's disease, heart and lung disease, vision problems, medicines that cause dizziness, and fear of falling, which leads to less activity and weakness.
How can mobility be improved?
Physical therapy, regular exercise that includes strength and balance training, treating pain and underlying conditions, losing weight if needed, and using the right mobility aids can all improve mobility. Small, consistent increases in activity make a difference.
Which mobility aid is right for me?
It depends on your balance, strength, endurance and environment. A cane suits mild balance problems, a walker or rollator gives more support, and wheelchairs or scooters help for longer distances. A physical or occupational therapist can assess and fit the right aid.
What are the complications of limited mobility?
Limited mobility increases the risk of falls, pressure sores, blood clots, muscle weakness, joint stiffness, constipation, urinary infections, bone loss, weight changes, loneliness and depression. Staying as active as possible and regular skin checks help prevent them.
Sources
This guide was written from current patient and clinical guidance, including:
- CDC: Disability and Health, mobility
- World Health Organization: Assistive technology fact sheet; Rehabilitation
- American Physical Therapy Association: ChoosePT, mobility and fall prevention
- NIA: Exercise and physical activity for older adults
- Americans with Disabilities Act (ADA.gov): Guide to disability rights laws