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Mobility Impairments

Mobility impairments include a broad range of disabilities that affect a person’s independent movement and cause limited mobility. Mobility impairments may result from cerebral palsy, spinal cord injury, stroke, arthritis, muscular dystrophy, amputation, polio or other conditions. According to the National Center for Medical Rehabilitation Research, an estimated 25 million people have mobility impairments, which may take the form of paralysis, muscle weakness, nerve damage, stiffness of the joints, or lack of balance or coordination. Only people whose mobility impairments substantially limit a major life activity are covered by the ADA.

The conditions that cause mobility impairments each have their own distinct characteristics. Some mobility impairments are acquired at birth, others are caused by accidents, illnesses or the natural process of aging.

For example, amputation is the removal of all or part of a limb. An amputation may occur as the result of an accident or as a surgical intervention for a medical condition. Prior to this century, amputation was commonly performed to prevent gangrene in a limb. When antibiotics came into use, wounds could be more effectively treated and many limbs were spared. Today, most amputations are for patients who have wounds that do not heal properly due to vascular disease, atherosclerosis and blood clots. Amputation may also be carried out to prevent the spread of cancer in the lower end of a limb. Current statistics regarding amputation are difficult to calculate, but the Handbook of Severe Disability states that “the National Health Service for Health Statistics of The U.S. Public Health Service estimated a prevalence of 311,000 amputees in 1970. An incidence of approximately 43,000 per year is estimated, of which 77 percent occur in males and 90 percent involve the legs.”

Phantom pain is a sensation felt by a person who has had a limb amputated. According to information collected by the National Amputation Foundation, the sensation may be one of a crushing, cramping or twisted feeling in the absent body part. Some individuals may also feel an aching or burning pain where the extremity was. The sensation is caused by a stimulation along a nerve pathway, where the sensory ending has been severed in the amputated body part. The pain generally lasts between 2 and 3 months after the amputation, although some individuals have been noted to have sensation for years.

A definition provided by the Muscular Dystrophy Family Foundation describes Muscular Dystrophy (MD) as the common name for many progressive hereditary diseases that cause muscles to weaken and degenerate. MD is caused by altered genes, which prevent the body from manufacturing essential substances in adequate amounts to maintain and fuel the muscles. There are 40 different kinds of MD, and each type has its own hereditary pattern, age of onset and rate of muscle loss. In cases where heredity does not seem to be a factor, MD occurs because of a new gene mutation in the affected person or the parent(s) of that person.

Multiple Sclerosis Central, a web site dedicated to providing information on MS, defines Multiple Sclerosis as a disease of the brain and spinal cord (Central Nervous System) in which the covering of the nerves is destroyed. This situation causes messages from the brain and spinal cord to interpret signals ineffectively, creating a multitude of different symptoms. Although each case of MS is unique, typical symptoms include problems with balance and coordination, bowel and bladder problems, fatigue, tremors and spasms, pain, weakness, cognitive problems, numbness and tingling and communication disorders related to vision, speech and hearing.

The Polio Society defines polio, short for poliomyelitis, as a disease that can damage the nervous system and cause paralysis. The polio virus lives in the throat and intestinal tract of infected persons. The virus attacks the nerve cells that control muscle movements. Many people infected with the virus have few or no symptoms, and others have only short-term symptoms, such as headache, tiredness, fever, stiff neck and back, and muscle pain. More serious problems occur when the virus invades nerves in the brain and causes paralysis of the muscles used in swallowing and breathing. Invasion of the nerves in the spinal cord can cause paralysis of the arms, legs or trunk. Polio is most common in infants and young children, but complications occur most often in older persons. Post-polio is a name given to new symptoms of increased weakness, fatigue and muscle deterioration that occur in former polio victims after many years of relatively stable physical condition. This syndrome typically shows up in middle age or later.

Spina Bifida is the most common neural tube defect (NTD) — a serious birth defect that involves incomplete development of the brain, spinal cord and/or protective coverings for these organs. According to the Spina Bifida Association of America, this condition affects approximately one out of every 1,000 newborns in the United States. It results from the failure of the spine to close properly during the first month of pregnancy. In severe cases, the spinal cord protrudes through the back and may be covered by skin or a thin membrane. Surgery to close a newborn’s back is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord. Because of the paralysis resulting from the damage to the spinal cord, people born with spina bifida may need surgeries and other extensive medical care.

Spinal Cord Injury is damage to the spinal cord that results in a loss of function such as mobility. Causes include motor vehicle accidents, falls, sports injuries (including diving accidents), and diseases such as polio and spina bifida. According to the National Spinal Cord Association, approximately 450,000 Americans are living with spinal cord injuries, with 8,000 new injuries occurring each year.

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