M4 · Difficulty walking
Actual Movement and self-care
Definition
Walking is slow, unsteady, painful, or not possible without help.- Weak legs
- pain
- stroke
- poor balance
- arthritis
- Shuffling
- limping
- needs support
- slow pace
📋 Scenario
A patient with arthritis walks very slowly and winces.
Subjective (S): "My knees hurt and walking is slow."
Objective (O): Arthritis; shuffling walk; limping; pain 6/10 on walking; uses a stick.
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:** Difficulty walking related to weak legs, as evidenced by shuffling and limping.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Assess walking. | Assessing the walk shows what is wrong, such as pain, weakness or poor balance, so the plan can target the real problem. |
| Use a walking aid. | A suitable aid takes weight off painful joints and improves balance, which makes walking safer and less painful for him. |
| Physiotherapy. | Physiotherapy builds leg strength and teaches better walking patterns, which helps his long-term mobility and independence. |
| Give pain relief. | Pain relief lets him move with less pain, so he can walk further and take part in exercises. |
| Ensure safe footwear. | Supportive footwear with good grip improves stability and lowers the risk of slipping or falling. |
| Assist. | Help close by prevents falls while his walking is slow and unsteady, and it gives him confidence to keep moving. |
**Expected outcomes**
- Within 1 week: walks 30 meters with aid and pain 4/10 or lower.
- Safe footwear.
- Stable walk.
**Linking the data to the diagnosis**
A patient with arthritis says, "My knees hurt and walking is slow." He has a shuffling, limping walk, pain of 6/10 on walking and uses a stick. The difficulty is already present, so this is an actual diagnosis and not a risk. The plan aims to improve his walking through pain relief, a suitable aid, physiotherapy and safe footwear. Within 1 week the expected outcomes are walking 30 meters with an aid, pain of 4/10 or lower, safe footwear and a stable walk.
CarePath diagnosis
Difficulty walking related to weak legs, as evidenced by shuffling and limping.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Assess walking. | Assessing the walk shows what is wrong, such as pain, weakness or poor balance, so the plan can target the real problem. |
| 2. Use a walking aid. | A suitable aid takes weight off painful joints and improves balance, which makes walking safer and less painful for him. |
| 3. Physiotherapy. | Physiotherapy builds leg strength and teaches better walking patterns, which helps his long-term mobility and independence. |
| 4. Give pain relief. | Pain relief lets him move with less pain, so he can walk further and take part in exercises. |
| 5. Ensure safe footwear. | Supportive footwear with good grip improves stability and lowers the risk of slipping or falling. |
| 6. Assist. | Help close by prevents falls while his walking is slow and unsteady, and it gives him confidence to keep moving. |
Expected outcomes
- Within 1 week: walks 30 meters with aid and pain 4/10 or lower.
- Safe footwear.
- Stable walk.
Linking the data to the diagnosis
A patient with arthritis says, "My knees hurt and walking is slow." He has a shuffling, limping walk, pain of 6/10 on walking and uses a stick. The difficulty is already present, so this is an actual diagnosis and not a risk. The plan aims to improve his walking through pain relief, a suitable aid, physiotherapy and safe footwear. Within 1 week the expected outcomes are walking 30 meters with an aid, pain of 4/10 or lower, safe footwear and a stable walk.