Physical functioning and mobility

1.12.5 Include strategies to maintain and prevent deterioration of physical functioning and mobility in the care and support plans of people with ME/CFS. These strategies may need to be carried out in small amounts and spread out throughout the day. Think about including the following:

• joint mobility
• muscle flexibility
• balance
• postural and positional support
• muscle function
• bone health
• cardiovascular health.

1.12.6 Assess at every contact people with severe or very severe ME/CFS or those with prolonged periods of immobility for:

• areas at risk of pressure ulcers (see the NICE guideline on pressure ulcers)
• deep vein thrombosis (see the NICE guideline on venous thromboembolic diseases)
• risk of contractures.

1.12.7 Give people with ME/CFS and their family or carers (as appropriate) information, advice and support on how to recognise and prevent possible complications of long-term immobility.

1.12.8 Give families and carers information, advice and support on how to help people with ME/CFS follow their care and support plan in relation to physical functioning and mobility. This may include:

• bed mobility
• moving from lying to sitting to standing
• transferring from bed to chair
• using mobility aids
• walking
• joint mobility
• muscle stretching
• muscle strength
• balance
• going up and down stairs.
  
  For training to provide care and support, see NICE's guideline on supporting adult carers.