Mobility History | MSK History - MedSchool
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MSK History
 

Mobility History

 
 

Overview

  • These questions are incredibly valuable for elderly patients who are poorly mobile, though are likely to be inappropriate in younger patients who are fit and active.
    • Ask About

    • Steadiness - how steady the patient feels on their feet with or without mobility aids
    • Walking aids - whether the patient requires any aids to mobilise, such as a walking stick, 4-wheel walker or rollator frame
    • Transfers - whether the patient can transfer from bed to chair or chair to toilet independently, with assistance, or if they require hoist transfers
    • Stairs - whether the patient is able to climb stairs independently
    • Modifications - whether the patient has had anything added onto their home, such as ramps or toilet / shower rails
  • Also ask about whether the patient's mobility has changed recently, and why.
    • Significance

    • Poor mobility significantly increases risk of falls, and affects the patient's ability to perform their activities of daily living.

Falls History

    • Ask About

    • Whether the patient has had any falls recently
    • What they were doing when they fell
    • Why they fell
    • Whether the hit their head or other part of the body
    • Whether they have pain in any part of their body
    • How long they were on the ground for
    • How often they fall over
    • Significance

    • Falls in the elderly significantly increase the risk of devastating injuries - especially hip fractures and intracranial bleeds.
    • Risk Factors for Falling

    • Poor vision
    • Cognitive impairment
    • Past stroke
    • Parkinson’s disease
    • Cerebellar pathology
    • Impaired proprioception
    • Pain
    • Vertigo
    • Hypotension
    • Medications - especially sedatives, antihypotensives
    • Dangerous home environment - e.g. stairs, pets, clutter
Last updated on April 19th, 2019
 
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