M1 · Limited ability to move
Actual Movement and self-care
Definition
Pain, weakness, or restrictions reduce the ability to move the body or parts of it.- Pain
- weakness
- surgery
- fear
- restrictions
- Moves slowly
- avoids movement
- needs help
- stiff
📋 Scenario
After hip replacement, a woman will not move her leg for fear of pain.
Subjective (S): "I'm afraid to move my leg."
Objective (O): Day 1 after hip replacement; will not move the leg; pain 7/10; muscle tight.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score CP-PAIN Pain & Comfort Score
Validated scales to consider: Barthel Index, Katz ADL, NRS 0–10, FLACC, PAINAD
**CarePath diagnosis:** Limited ability to move related to pain, as evidenced by moves slowly and avoids movement.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Give pain relief before activity. | Pain relief given before activity lets her move with less pain, which lowers her fear and makes movement more likely and more comfortable. |
| Assist with exercises. | Guided exercises keep the joint and muscles working safely and help prevent stiffness and weakness after the surgery. |
| Encourage safe movement. | Safe, gradual movement rebuilds strength and circulation and lowers the risk of clots and other complications of staying still. |
| Praise progress. | Praise builds confidence and motivation, which helps a frightened patient keep trying and accept each small step forward. |
| Follow the therapy plan. | The therapy plan protects the new hip by setting safe movements and limits, so progress does not harm the repair. |
**Expected outcomes**
- Sits at the bedside within 24 hours and walks a short distance with a frame by day 2.
- Pain 4/10 or lower with activity.
**Linking the data to the diagnosis**
A woman on day 1 after hip replacement says, "I'm afraid to move my leg." She will not move the leg, her pain is 7/10 and the muscle is tight, so she moves slowly and avoids movement. This is an actual problem that has already happened, not a risk, and pain is the main cause. The plan aims to reduce pain with medicine before activity and to encourage safe movement. The expected outcomes are sitting at the bedside within 24 hours, walking a short distance with a frame by day 2 and pain of 4/10 or lower during activity.
CarePath diagnosis
Limited ability to move related to pain, as evidenced by moves slowly and avoids movement.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Give pain relief before activity. | Pain relief given before activity lets her move with less pain, which lowers her fear and makes movement more likely and more comfortable. |
| 2. Assist with exercises. | Guided exercises keep the joint and muscles working safely and help prevent stiffness and weakness after the surgery. |
| 3. Encourage safe movement. | Safe, gradual movement rebuilds strength and circulation and lowers the risk of clots and other complications of staying still. |
| 4. Praise progress. | Praise builds confidence and motivation, which helps a frightened patient keep trying and accept each small step forward. |
| 5. Follow the therapy plan. | The therapy plan protects the new hip by setting safe movements and limits, so progress does not harm the repair. |
Expected outcomes
- Sits at the bedside within 24 hours and walks a short distance with a frame by day 2.
- Pain 4/10 or lower with activity.
Linking the data to the diagnosis
A woman on day 1 after hip replacement says, "I'm afraid to move my leg." She will not move the leg, her pain is 7/10 and the muscle is tight, so she moves slowly and avoids movement. This is an actual problem that has already happened, not a risk, and pain is the main cause. The plan aims to reduce pain with medicine before activity and to encourage safe movement. The expected outcomes are sitting at the bedside within 24 hours, walking a short distance with a frame by day 2 and pain of 4/10 or lower during activity.