Most people who are not injured can move about freely in their environment with no limitation. After a period of immobilization or after injury or illness, however, you may notice limitations in your ability to move around. You may need the assistance of another person to move in bed and get out of bed; to move into and out of a chair; or even to walk. You may also require a cane, walker or other assistive device to help you maintain your balance and walking ability.
If you are hospitalized, a physical therapist who works at the hospital may come to evaluate your mobility to ensure that it is safe for you to return home. If injury or illness prevents you from leaving the house, a physical therapist may come to your home to assess your functional mobility. While at your house, the therapist can also provide ideas to help make your home environment safe for mobility.
The three main areas of functional mobility that your physical therapist may evaluate include: bed mobility, transfers and ambulation.
- Bed Mobility. Bed mobility describes your ability to move around in bed. This includes activities like scooting, rolling or moving from lying to sitting and sitting to lying. Depending on your condition or illness, your ability to move around in bed may be limited and you may require assistance to move.
- Transfers. Transfer refers to the act of moving from one surface to another. You may need assistance when moving from a bed to a chair or when moving from one chair to another.
- Ambulation. Your ability to walk is referred to as ambulation. When the body is weakened due to illness or injury, walking may be impaired and you may require assistance from another person or an assistive device, such as a cane, to walk. Your physical therapist may also perform a gait evaluation to analyze the way you walk and to provide strategies to improve ambulation.
Depending on the severity of your injury, you may need varying levels of assistance to help with functional mobility. Your physical therapist may need to help you when moving around in bed, when sitting or when walking. He or she may also help educate a family member or friend on how to provide assistance with functional mobility. The various levels of assistance that can be provided are described below.
- Maximal Assist: Maximal assist means that the physical therapist performs about 75% of the work during mobility and you are perform 25%.
- Moderate Assist: Moderate assist is a level of assist where you perform about 50% of the work necessary to move and the physical therapist performs about 50% as well.
- Minimal Assist: Minimal assist means that you perform 75% of the work to move and the physical therapist provides about 25% of the work.
- Contact Guard Assist: With contact guard assist, the physical therapist needs to merely have one or two hands on your body, but provides no other assistance to perform the functional task. The contact is made to help steady your body or help with balance.
- Stand-by Assist: During stand-by assist, the physical therapist does not touch you or provide any assistance, but he or she may need to be close by for safety in case you lose your balance or need help to maintain safety during the task being performed.
- Independent: This situation is one that every physical therapist hopes their patients achieve. This means that you can perform the functional task with no help and you are safe during the task.
Functional mobility may become impaired when you suffer injury or illness. Muscles may become weak, balance may be impaired or muscular spasm and pain may limit your ability to move. By understanding various levels of assistance, you can help improve your mobility and functional independence.