Immobility and Movement

Definition:

The state of being unable to move about and tend to daily activities without adverse effects. The adverse effects are commonly caused by tumors of the nervous system, effects of chemotherapy, chronic illness, infection, metabolic problems, or effects from radiation. The pain, fatigue, and weakness of chemotherapy also adds to immobility. It is important to exercise and move as your condition allows to keep muscles functioning as well as possible.

The effects of immobility to watch for:

• Decreased range of motion and contractures; stiff joints
• Blood clots
• Bed sores
• Constipation
• Indigestion / poor appetite
• Depression
• Change in quality of life

What to look for:

• Pain and fatigue upon movement
• Numbness in legs or arms
• Loss of motor strength in legs or arms
• Weakness that is increasing
• Loss of bowel and bladder control
• Pain upon movement that is increasing
• Sense that you cannot place your hand or foot where you want to
• Decrease or loss of sensation in legs or arms

What you can do to alleviate or prevent immobility:

• Identify limitations and strengths
• Alternate rest periods with activity
• Take care of you skin; keep it clean and moisturized
• Keep environment safe by removing hazards in each room
• Drink plenty of fluids (2-3 liters per day)
• Engage in pleasurable activities
• Perform exercises to keep your limbs flexible and promote circulation (check with your health care provider before beginning)
• Recognize that fatigue is a normal part of treatment
• Participate in regular physical activity every day - take a daily walk
• Do range of motion exercises on a daily basis
• Do not stay in bed with little movement
• Do not let others do for you what you can do for yourself
• Take pain medications as directed to maintain relief of pain, rather than only taking then when you feel very badly
• Ensure that you do not get sores on legs and feet that you can't feel.

Call your Physician or Nurse:

• You become progressively weaker
• You have limited ability to move
• You have blurred vision, numbness, or tingling sensations

References:

1. Dufault, K., and Birenbaum, L.K. (1996). "Immobility" in McCorkle, R., Grant, M., Frank-Stromborg, M., Baird, S. Cancer Nursing: A Comprehensive Textbook, 2nd ed. Philadelphia: WB Saunders Company, P. 1120-1144.
2. Meehan, J.L. (1994) "Mobility and Neurologic Function" in Gross J. and Johnson, B.L. (eds.). Handbook of Oncology Nursing, 2nd ed. Boston: Jones and Bartlett, p.465-496.