an overview of general assessment for older adults in physical therapy.

1. General Assessment for
Old People in Physical
Therapy
PT. Maryam Alasfour
MSc Candidate, KSU
Sept, 2016

2. Why?
Better recognize
& list pt problems
Plan an effective
treatment
program
restore mobility, increase fitness levels,
reduce pain
maintain independence as possible.
Prevent disability
Restoring level of function to its highest
level.
Provide better QUALITY of Life

3. Component of Geriatric Assessment
Performing comprehensive assessment in the form of different components is
These components are:
A. History taking
B. Physical examination
C. Functional status
D. Social, Mental & Emotional status
E. Assistive Device Assessment

4. History Taking
Medical File
Patient
RelativeCare
giver

5. History Taking
Chief Complain
Percent Hx
Past Hx

6. History Taking
Vision Speaking Hearing Other
Associated disorders

7. Physical Examination
 Inspection:
Presence
SkinPosture

8. Physical Examination
Rest tremor

9. Physical Examination
Gait pattern

10. Gait normal findings
Possible CauseFindings
-Weak calf muscles
-Poor Balance
-Arthritis
Shorter steps
Fear of fallReduced gait velocity
ArthritisReduced motion in some joints (ankle plantar flexion)
-Weak abdominal muscle and tight hip flexor muscles
-Osteoporosis with kyphosis
greater downward pelvic rotation & leaning forward
-loss of hip internal rotation
-to increase lateral stability
slightly greater turn-out of the toes
-Arthritis
-Stroke
-Foot problem
Step length abnormalities
Parkinson’s diseaseDifficult to initiate walking

11. Physical Examination
Back View Lateral View
Posture

12. Physical Examination
Skin
Bed Ulcer RA Deformity
Varicose Vein

13. Physical Examination
 Palpation:
pain and tenderness
Spasm & Trigger points
locate particular anatomical landmarks
diagnose edema

14. Physical Examination
 Objective findings:
Height and
weight
Vital signs Pain
Muscle
strength
Range of
motion

15. Physical Examination
 Objective findings:
Muscle
Length
Muscle tone
Long & Round
measurements
Coordination
Sensory
status

16. Physical Examination
 Objective findings:
cardio-
respiratory
Microcirculation
and lymphatic
Urinary
continence
Palliative

17. Functional Status
ADLs IADLs Balance &
Fall
Gait Quality of
Life

18. Functional Status
 ADLs & IADLs
 (Instrumental Activities of Daily Living Scale (IADL)
 Activities of Daily Living Scale (IADL)
 Functional Independence Measure (FIM)
 Balance
 Berg Balance Scale
 Timed Up and Go Test
 Timed Walk Tests, Gait Speed, Balance Confidence Scales
 Single Leg Stance Test
 Multi-Sensory Polymer Insole
 Static Force Platform

19. Functional Status
 Quality of Life
 SF-36questionnaire
 Gait
 Short Physical Performance Battery (SPPB)
 Dynamic Gait Index
 Wisconsin Gait Scale (WGS)

20. Social, Mental Status & Emotional Status
 Cognition
 Mini-Mental State Examination (MMSE)
 Depression
 Geriatric Depression Scale

21. Orthotic, protective, Prosthetic requirements
and supportive devices
 Components, alignment, fit, and ability to care.
 Use during functional activities.
 Restrictions with use.
 Safety.

23. References
 Timothy Kauffman, A Comprehensive Guide to Geriatric Rehabilitation, 3rd Edition,
2014
 Katherine T Ward, David B Reuben, Comprehensive geriatric assessment, 2016
 GUIDELINES: PHYSICAL THERAPY DOCUMENTATION OF PATIENT/CLIENT MANAGEMENT,
APTA, 2009
 Narinder Kaur Multani, Satish Kumar Verma, Principles of Geriatric Physiotherapy,
JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD, 2007