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Movement and Mobility

Overview

There are five primary categories of limitations that represent the most prevalent limitations experienced by people related to movement and mobility.  

1. Limited Use of Lower Limbs
2. Limited Use of Upper Limbs
3. Difficulty Moving Head
4. Difficulty with Joint Functions
5. Risk of Fracture and Pain

In the sub-sections that follow, we have organized the information presented by these categories.

Movement and Mobility Related Limitations

Limited Use of Lower Limbs

• Difficulty in using legs and feet: People who walk with difficulty and who may use mobility aids (canes, walkers, crutches); people who have prosthetics; people who shuffle, limp, drag feet; people who have difficulty sitting, bending, kneeling.
• Inability to use legs and feet: People who use wheelchairs; may often include limitations of upper extremities and trunk coordination, difficulty handling and fingering, limitations of stamina, sensory loss, etc. Limitations also include physiological dysfunction due to sitting down such as needing a lot of fluids (to keep kidneys flushed), bladder problems, sores, and burns.

Limited Use of Upper Limbs

• Difficulty Lifting and Reaching, and Inability to Use Arms and Shoulders (Upper Extremity Impairment): People who have difficulty lifting and/or reaching, and people who have limited use of their arms and shoulders; may be either ambulatory or use a wheelchair; people with loss of mobility as in paraplegia or quadriplegia; people whose use of upper extremities or reach is limited by some other factor such as using crutches, loss of balance, shortness, or being in a wheelchair; people who may have frequent spasms.
• Difficulty Handling or Fingering: People who cannot grasp, pinch, twist, or those who have other functional limitations such as a lack of coordination.

Difficulty Moving Head

People with limited head movement cannot move their heads up and down and/or side to side.

Difficulty with Joint Functions

People who have limited range of movement or lack of stability in one or more joints such as vertebrae, shoulders, elbows, wrists, hips, knees, ankles, small joints of hands or feet or who have frozen joints that don’t move at all or excessive mobility in the joints, a rare condition in which you have excessively mobile joints.

Risk of Fracture or Risk of Pain

• People who have brittle bones or who are recovering from injury will restrict movement for reasons of personal bodily safety. Conditions such as severe osteoporosis or the disease osteogenesis imperfecta (OI), a condition that results in short stature, are characterized by fragile bones that fracture easily.
• People with conditions that produce pain associated with specific movements will also restrict movement and mobility in order to reduce the energy expended dealing with pain. Pain also impairs movement. Involuntary actions can occur as a result of bodily pain, such as the involuntary release of the grip, when the hand is in pain. There are an enormous range of conditions from injury, to chronic disease, to deformity that can create levels of pain that either impair movement or lead a person to make choices that will reduce the intensity and frequency of pain.

Who Is Affected

Limited Use of Lower Limbs

According to the U.S. Census Bureau,

• 27 million Americans report some difficulty walking.
• Between 1.7 and 2.3 million Americans use ‘wheeled mobility’ – either a manual or power wheelchair or a scooter. The number is climbing due to the population aging and is expected to be 4.3 million by 2010. ¹ 

Canes are the most common mobility aid.

There are a large number of reasons that people develop difficulty with movement or mobility related to their lower limbs.

• Arthritis-related diseases
• Autoimmune diseases, diabetes, or cancers
• Pain, inflammation, or broken bones
• Congenital deformities
• Extreme obesity
• Paralysis and stroke

Limited Use of Upper Limbs

Limitation of the upper limbs is increasingly common as an acquired condition because of repetitive motions using tools and computers and the related job stress. Repetitive injuries lead to pain, discomfort, or tingling in the upper extremity.

Difficulty Moving Head

Causes of difficulty in moving the head are:

• Arthritis in the neck
• Muscular weakness related to diseases like muscular dystrophy
• Stroke and paralysis
• Bone fusion

Difficulty with Joint Functions

Causes of difficulty with joint functions are:

• Many forms of arthritis
• Back problems due to injury
• Problems related to some congenital neuromusculoskeletal disorders
• Locked spines
• Other connective tissue diseases such as scleroderma and lupus

Risks of Fracture or Risks of Pain

Causes of increased risks are:

• Osteoporosis
• “Brittle-bone syndrome” or osteogenesis imperfecta (OI)
• Injury
• Any of the prior mentioned conditions and diseases

Looking at the Impacts

People with some combination of limited abilities to walk, reach, shift position and/or use their hands may require a combination of assistive devices and accessibly-designed environments to maintain independence. As in every other type of functional limitation, the range of severity varies from sporadically inconvenient to substantial and sustained reduction in function. People with movement and mobility-related functional limitations also may use caregivers or personal care attendants to replace functions of transferring to a chair or reaching and using hands.

A broad range of the activities of daily living can be affected. They may include getting out of bed, dressing, cooking and eating, washing, and other personal tasks as well as going to school or work. However, with assistive technology, accessible environments, assistive animals and, for some, the use of personal care assistants to fulfill the tasks that the person with a limitation directs and guides, she can have a full life including working and raising children.  Technology has spurred dramatic expansion in the options for tools and devices that can be used to maintain independence.

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