This chapter addresses the fundamental nursing role in the management of mobility. Every nurse should possess the knowledge and skills to assess mobility needs, to select and implement evidence-based strategies to maintain mobility or assist mobility, and to review the effectiveness of these to inform any necessary changes in care. Mobility is the ability to move around independently. The most readily recognizable component of mobility is locomotion—the ability to walk. It includes transition from one position to another, which is necessary to allow walking to be incorporated into functional activities. Examples of transitions are moving from sitting to standing and from standing to lying down. Virtually all bodily systems are required for safe and effective mobility. Maintaining higher levels of physical activity has been associated with reduced mortality and morbidity from many common diseases (Gregg et al., 2003). People with higher levels of physical activity are less likely to suffer or die from cardiovascular disease (Kesaniemi et al., 2001), have reduced risk of all types of stroke (Wendel-Vos et al., 2004a; 2004b), gain less weight, are less likely to develop type 2 diabetes, breast or colon cancer, osteoarthritis, osteoporosis, falls, and depression (Kesaniemi et al., 2001; Thune and Furberg, 2001). Beneficial effects on cognition have also been documented, the most physically active having 20% lower risk of cognitive decline (Weuve et al., 2004; Yaffe et al., 2001). Maintaining good physical activity levels is associated with generalized well-being, and improved physical function, ability to perform activities of daily living, and walking distance. An active person is less likely to be disabled and is more likely to be independent. There is a lower incidence of depression in people who remain active, and physical activity is known to reduce the symptoms of clinical depression (Kesaniemi et al., 2001). For these reasons, it is important for nurses to promote the benefits of appropriate physical activity as part of their health promotion role. The American College of Sports Medicine and the American Heart Association recommends levels of physical activity required to maintain good health (Box 23.1).
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