The document discusses physiological changes that occur with aging and the benefits of exercise for the elderly. It outlines a geriatric assessment involving screening for mobility, vision, hearing, incontinence, nutrition, memory, and depression. The assessment is used to establish individualized goals and plan therapeutic interventions including range of motion, stretching, strengthening, aerobic, and gait exercises. The main goals of intervention are to improve functional independence and quality of life by addressing common age-related declines in physical function.
This document provides an overview of physiotherapy for geriatric patients. It discusses assessing patients, setting goals, and therapeutic interventions. The assessment involves a full history, physical exam, and evaluation of functional status. Goals aim to improve mobility, strength, and quality of life. Therapeutic interventions may include range of motion, stretching, strengthening, aerobic exercise, and gait training exercises. Orthotics and reassessment are also discussed.
This document provides a care protocol for well elderly individuals. It begins with definitions and an overview of typical age-related changes to body systems. It then outlines the scope, objectives, and components of assessment including history, observation, functional tests, and goal-setting. The main interventions are described as exercise therapy, pain management, patient education, and promoting general fitness. Exercise recommendations include aerobic, strength, balance, and flexibility exercises. Safety guidelines are provided along with fall prevention tips. The protocol concludes with an algorithm outlining the referral, assessment, treatment, re-evaluation, and discharge process for well elderly individuals.
Exercising elderly: An overview of the debilitative factorsjesmy jose
As a result of ageing, one must experience changes in his/her body. The changes attributed to the physiological, psychological and functional systems of human body. As we grow older, an active lifestyle is more important than ever before. Regular exercise can help boost your energy and manage symptoms of illness or pain.
This document discusses physical rehabilitation for cancer survivors. Physical rehabilitation can help survivors regain independence and adjust to physical changes from cancer or its treatment. It may include exercises to improve strength and mobility, learning new ways to do daily activities, and working with therapists like physical therapists, occupational therapists, and speech therapists. Physical rehabilitation is generally recommended for survivors who have difficulty with mobility, balance, energy levels, or major physical changes that interfere with daily life after primary cancer treatment ends. The goal is to help survivors physically recover and adapt to life after a cancer diagnosis.
This document discusses physical rehabilitation for cancer survivors. Physical rehabilitation can help survivors regain independence and adjust to physical changes from cancer or its treatment. It may include exercises to improve strength, mobility and energy levels. Therapists like physical therapists, occupational therapists and speech therapists can help with issues like weakness, balance problems, difficulty with daily tasks or communication. Physical rehabilitation benefits survivors experiencing either temporary or long-term effects and may last throughout someone's cancer survivorship.
Physiotherapy Management of Rheumatoid ArthritisNilofarRasheed1
Rheumatoid Arthritis An autoimmune disorder, occurs when your immune system mistakenly attacks your own body's tissues.
occurs when your immune system mistakenly attacks your own body's tissues. Physiotherapy play a critical component of the overall management for patients with RA
The document provides guidelines for treating rheumatoid arthritis, including general principles, exercises, managing daily activities, assistive devices, joint protection, and work simplification. The main objectives of treatment are to reduce pain and swelling, improve function, stop disease progression, and prevent disability. Exercise, assistive devices, joint protection techniques, pacing activities, and simplifying tasks can help patients manage symptoms and maintain independence.
2. Special consideration in cardiac rehabilitation program for older adults.ShagufaAmber
An increasing number of cardiac patients are above the age of 65 years . They are susceptible to the adverse effect of bed rest . So early mobilization is especially important to return them to active and independent lifestyle.
- Most of the patients with heart failure, are elderly patients, shooting up to 80% in both incidence and prevalence.This is due to improved and better survival after cardiac insults, such as myocardial infarction, especially in developed countries.(AHA,2013).
-The safety and efficacy of cardiac rehabilitation have been demonstrated in the elderly (age >65 years) .(Pasquali ,et al.,2001)
-CR has a class IA recommendation by the AHA and ACSM for secondary prevention after any coronary heart disease
This document provides an overview of physiotherapy for geriatric patients. It discusses assessing patients, setting goals, and therapeutic interventions. The assessment involves a full history, physical exam, and evaluation of functional status. Goals aim to improve mobility, strength, and quality of life. Therapeutic interventions may include range of motion, stretching, strengthening, aerobic exercise, and gait training exercises. Orthotics and reassessment are also discussed.
This document provides a care protocol for well elderly individuals. It begins with definitions and an overview of typical age-related changes to body systems. It then outlines the scope, objectives, and components of assessment including history, observation, functional tests, and goal-setting. The main interventions are described as exercise therapy, pain management, patient education, and promoting general fitness. Exercise recommendations include aerobic, strength, balance, and flexibility exercises. Safety guidelines are provided along with fall prevention tips. The protocol concludes with an algorithm outlining the referral, assessment, treatment, re-evaluation, and discharge process for well elderly individuals.
Exercising elderly: An overview of the debilitative factorsjesmy jose
As a result of ageing, one must experience changes in his/her body. The changes attributed to the physiological, psychological and functional systems of human body. As we grow older, an active lifestyle is more important than ever before. Regular exercise can help boost your energy and manage symptoms of illness or pain.
This document discusses physical rehabilitation for cancer survivors. Physical rehabilitation can help survivors regain independence and adjust to physical changes from cancer or its treatment. It may include exercises to improve strength and mobility, learning new ways to do daily activities, and working with therapists like physical therapists, occupational therapists, and speech therapists. Physical rehabilitation is generally recommended for survivors who have difficulty with mobility, balance, energy levels, or major physical changes that interfere with daily life after primary cancer treatment ends. The goal is to help survivors physically recover and adapt to life after a cancer diagnosis.
This document discusses physical rehabilitation for cancer survivors. Physical rehabilitation can help survivors regain independence and adjust to physical changes from cancer or its treatment. It may include exercises to improve strength, mobility and energy levels. Therapists like physical therapists, occupational therapists and speech therapists can help with issues like weakness, balance problems, difficulty with daily tasks or communication. Physical rehabilitation benefits survivors experiencing either temporary or long-term effects and may last throughout someone's cancer survivorship.
Physiotherapy Management of Rheumatoid ArthritisNilofarRasheed1
Rheumatoid Arthritis An autoimmune disorder, occurs when your immune system mistakenly attacks your own body's tissues.
occurs when your immune system mistakenly attacks your own body's tissues. Physiotherapy play a critical component of the overall management for patients with RA
The document provides guidelines for treating rheumatoid arthritis, including general principles, exercises, managing daily activities, assistive devices, joint protection, and work simplification. The main objectives of treatment are to reduce pain and swelling, improve function, stop disease progression, and prevent disability. Exercise, assistive devices, joint protection techniques, pacing activities, and simplifying tasks can help patients manage symptoms and maintain independence.
2. Special consideration in cardiac rehabilitation program for older adults.ShagufaAmber
An increasing number of cardiac patients are above the age of 65 years . They are susceptible to the adverse effect of bed rest . So early mobilization is especially important to return them to active and independent lifestyle.
- Most of the patients with heart failure, are elderly patients, shooting up to 80% in both incidence and prevalence.This is due to improved and better survival after cardiac insults, such as myocardial infarction, especially in developed countries.(AHA,2013).
-The safety and efficacy of cardiac rehabilitation have been demonstrated in the elderly (age >65 years) .(Pasquali ,et al.,2001)
-CR has a class IA recommendation by the AHA and ACSM for secondary prevention after any coronary heart disease
Stroke is the third leading cause of death in the US and the leading cause of severe disability. Rehabilitation after a stroke aims to prevent complications, maximize functional independence, and facilitate a return to normal life roles and community integration. Post-stroke rehabilitation includes physiotherapy, medication management, and psychological support. The goals are to address impairments, prevent issues like contractures, and train new skills to manage daily living. A variety of rehabilitation techniques and technologies are used depending on individual needs and impairments. Outcomes vary based on neurological deficits and rehabilitation received, though many patients achieve significant functional gains.
Therapeutic exercises are planned physical movements intended to remediate or prevent impairments, enhance function, reduce risk, and optimize health and well-being. They involve movement prescribed to correct impairments and restore function. The most common therapeutic exercises fall into four groups: strengthening exercises, endurance exercises, flexibility exercises, and balance/coordination exercises. Therapeutic exercise is a core skill of physiotherapy and includes aerobic conditioning, agility training, coordination exercises, range of motion exercises, and more. Factors like a patient's health status, goals, motivation, and support system influence the expected outcomes of therapeutic exercise.
This document summarizes age-related physiological changes in different body systems, including the cardiovascular, respiratory, nervous, musculoskeletal, and sensory systems. It discusses how aging affects the structure and function of organs in each system, such as decreasing heart muscle contraction, stiffening of the rib cage, loss of brain volume and neurons, loss of bone density and muscle mass, and declining vision and hearing. It also outlines common age-related medical conditions and how physiotherapy can help address issues like pain, impaired mobility, balance problems, and risk of falls in older patients.
This document discusses the benefits of exercise for older adults. It finds that exercise can help prevent diseases and disabilities, and even moderate activity like washing dishes can provide health benefits. While many older adults are inactive, regular exercise can help maintain strength, balance, flexibility and endurance as people age. The document provides guidelines for aerobic exercise, strength training, flexibility and balance exercises that are appropriate for older adults.
This document discusses age-related problems in geriatrics. It begins with definitions of aging, geriatrics, and gerontology. It then covers theories of aging and normal physical, psychosocial, cognitive, and pharmacological changes that occur with aging. Common health problems in older adults are also discussed, including depression, substance abuse, delirium, dementia, geriatric syndromes, and increased susceptibility to infection. The document concludes with sections on the medical and nursing management of various aging-related conditions.
The document provides information about rehabilitation of patients with Parkinson's disease. It discusses the epidemiology, etiology, pathophysiology, clinical features, investigations, differential diagnosis, management including pharmacological, surgical and rehabilitative approaches. The rehabilitative management involves physical therapy, occupational therapy and speech therapy. Physical therapy focuses on improving mobility, gait, balance and preventing contractures through exercises. Occupational therapy aims to improve activities of daily living and adaptive equipment usage. Speech therapy helps with vocal training, breathing exercises and swallowing difficulties.
1) Exercise programming for older adults aims to maintain independence through activities of daily living and should focus on what older adults are capable of rather than limitations.
2) The older adult population is growing rapidly and will continue to do so, increasing the need for exercise programs tailored to seniors.
3) Strength training provides significant benefits to older adults by increasing strength and lean mass, improving mobility and independence, reducing bone loss, and preventing chronic disease. Programs should focus on functional exercises and progress slowly.
The document discusses the musculo-skeletal system including its main components and functions. It describes the three types of muscles, tendons, ligaments, bones, joints, and cartilages. It then discusses the assessment of the musculo-skeletal system including history taking, physical examination, common tests like bone marrow aspiration and arthroscopy, and common musculoskeletal problems and their nursing management.
Rheumatoid arthritis is a chronic inflammatory disease that causes pain, stiffness, swelling and loss of function in the joints. It is characterized by symmetrical inflammation of peripheral joints. Treatment involves rest, splinting, medications and physical therapy exercises to relieve pain, improve range of motion and function. The goal of rehabilitation is to reduce inflammation, prevent deformities and help patients maintain independence with daily activities. The prognosis can vary from partial remission to slow or rapid progression resulting in joint damage and disability.
This document provides information on physical fitness and exercise. It defines key terms like physical activity, exercise, and physical fitness. It recommends that adults get at least 30 minutes of moderate physical activity most days of the week to promote health. It also discusses the health benefits of exercise and lists the components of physical fitness like cardiorespiratory endurance and muscular strength. Finally, it provides guidelines for developing an effective exercise program and training safely and gradually over time.
Physical activity and Successful agingSMVDCoN ,J&K
The single most effective means by which older adults can influence their own health and functional abilities and therefore, maintain a high quality in the old age.
This document discusses geriatric management at both the individual and community level. At the individual level, management includes acute care, functional restoration, and prevention. Acute care focuses on education, pain relief, and healing. Functional restoration maintains and improves range of motion, strength, flexibility, and balance. Prevention maintains previous exercises and identifies risk factors. At the community level, a multidisciplinary team provides primary, secondary, and tertiary prevention. This includes health promotion, early diagnosis and treatment, and rehabilitation. The document also outlines exercise recommendations for older adults, including aerobic, strength, flexibility, endurance, and neuromotor exercises.
The document discusses the musculoskeletal system, including its main components like muscles, bones, tendons, and joints. It describes the three main types of muscles and functions of bones and joints. Assessment of the musculoskeletal system includes inspection, palpation, range of motion testing, and evaluation of gait and posture. Common musculoskeletal problems like pain, impaired mobility, and self-care deficits are discussed along with relevant nursing management.
Physical activity in people with disabilities and elderly peopleKarel Van Isacker
This document discusses physical activity for disabled and elderly people. It defines physical activity and exercise, and explains the health benefits of physical activity, including reduced risk of heart disease, diabetes, obesity, and hip fractures. It recommends that physical activity programs for the elderly and disabled include aerobic exercise, strength training, and flexibility training, along with guidelines for frequency, duration and intensity. Barriers to physical activity for these groups are addressed, as well as ways to motivate participation through social support, alternative activities, and tracking progress. Environmental and medical factors to consider with exercise programs are also outlined.
Advantages of Sports in our Kids Life | David OvistDavid Ovist
Soccer Coach of Lake Oswego David Ovist offers training and will provide you with drills and games to help you develop your players. He provides children an affordable place to develop soccer skills within their own community.
The document discusses guidelines for exercise during pregnancy. It recommends cardiorespiratory exercise 3-4 days per week at a moderate intensity for at least 15 minutes, increasing up to 30 minutes per day. Resistance training 2-3 days per week focusing on large muscle groups is also recommended. Exercise should be low impact and avoid activities in a supine position. Intensity should allow for conversation and progression should occur after the first trimester.
The document discusses exercise guidelines and benefits for various medical conditions. It provides guidelines for moderate and vigorous aerobic exercise for adults, as well as reasons some people do not exercise. It then outlines strategies to motivate patients using 3M's (mentioning, modeling, motivation). The FITT principle for exercise prescription and risk stratification for exercise are also covered. Specific conditions discussed include hypertension, obesity, pregnancy, osteoporosis, and depression.
1. Exercise is essential for building and maintaining bone density throughout life. Weight-bearing and resistive exercises stimulate bone growth, especially in childhood and adolescence.
2. Therapeutic exercise programs for osteoporosis patients should be tailored based on factors like bone mineral density, fitness level, and fracture risk. Exercises should progressively build strength, balance, and flexibility to prevent falls and fractures.
3. Even gentle, non-strenuous exercises can benefit older osteoporosis patients and those with fractures by improving balance, cardiovascular health, and reducing falls. Programs combining exercise, nutrition, fall prevention and medical treatment can optimize bone health and quality of life.
Lec 8 special population ex.Physiology of Exerciseangelickhan2
This document discusses various special populations that require special consideration for exercise prescription, including the elderly, those with cardiac issues, diabetes, hypertension, osteoporosis, asthma, COPD, and pregnant women. For each population, it describes characteristics of the condition and provides guidance on exercise goals, testing, prescription parameters, and precautions. The key recommendations are to consult a physician, start low intensity and gradually progress exercise, and focus on improving functional capacity, management of risk factors, and quality of life. Chair exercises are recommended for those with limited mobility.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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Stroke is the third leading cause of death in the US and the leading cause of severe disability. Rehabilitation after a stroke aims to prevent complications, maximize functional independence, and facilitate a return to normal life roles and community integration. Post-stroke rehabilitation includes physiotherapy, medication management, and psychological support. The goals are to address impairments, prevent issues like contractures, and train new skills to manage daily living. A variety of rehabilitation techniques and technologies are used depending on individual needs and impairments. Outcomes vary based on neurological deficits and rehabilitation received, though many patients achieve significant functional gains.
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This document summarizes age-related physiological changes in different body systems, including the cardiovascular, respiratory, nervous, musculoskeletal, and sensory systems. It discusses how aging affects the structure and function of organs in each system, such as decreasing heart muscle contraction, stiffening of the rib cage, loss of brain volume and neurons, loss of bone density and muscle mass, and declining vision and hearing. It also outlines common age-related medical conditions and how physiotherapy can help address issues like pain, impaired mobility, balance problems, and risk of falls in older patients.
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This document discusses age-related problems in geriatrics. It begins with definitions of aging, geriatrics, and gerontology. It then covers theories of aging and normal physical, psychosocial, cognitive, and pharmacological changes that occur with aging. Common health problems in older adults are also discussed, including depression, substance abuse, delirium, dementia, geriatric syndromes, and increased susceptibility to infection. The document concludes with sections on the medical and nursing management of various aging-related conditions.
The document provides information about rehabilitation of patients with Parkinson's disease. It discusses the epidemiology, etiology, pathophysiology, clinical features, investigations, differential diagnosis, management including pharmacological, surgical and rehabilitative approaches. The rehabilitative management involves physical therapy, occupational therapy and speech therapy. Physical therapy focuses on improving mobility, gait, balance and preventing contractures through exercises. Occupational therapy aims to improve activities of daily living and adaptive equipment usage. Speech therapy helps with vocal training, breathing exercises and swallowing difficulties.
1) Exercise programming for older adults aims to maintain independence through activities of daily living and should focus on what older adults are capable of rather than limitations.
2) The older adult population is growing rapidly and will continue to do so, increasing the need for exercise programs tailored to seniors.
3) Strength training provides significant benefits to older adults by increasing strength and lean mass, improving mobility and independence, reducing bone loss, and preventing chronic disease. Programs should focus on functional exercises and progress slowly.
The document discusses the musculo-skeletal system including its main components and functions. It describes the three types of muscles, tendons, ligaments, bones, joints, and cartilages. It then discusses the assessment of the musculo-skeletal system including history taking, physical examination, common tests like bone marrow aspiration and arthroscopy, and common musculoskeletal problems and their nursing management.
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Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
2. AGEING
•Ageing is deterioration in structure and function of body cells, tissues and
organs of an organism.
•It implies loss of vitality, reduced ability to withstand environmental insults and
increased chance of dying with time.
PHYSIOLOGICAL CHANGES AND ADAPTATIONS DURING AGEING
Musculoskeletal changes:
•muscle mass and strength decrease at a rate of about 30% b/w age of 60-90
•Decrease water content in cartilage
•Reduction in bone mineral density
•Loss of height
•Decrease in speed of movement
•Reduced joint activity and ROM and incresed risk of fractures.
3. Neuromuscular changes:
•Atrophy of neuron
•Depletion of dopamine level
•Decreased reflexes
•Increased postural sway
•Reduction in transmission speed of myoneural junction
•Reduced nerve conduction velocity
•Reduced balance and co-ordination
Neurosensory changes:
•Decrease in sweating
•10-20% decrease in brain weight by age of 90.
•Reduced mechanoreceptors
•Reduced hearing capacity
•Reduced sense of smell and taste
•Reduced vision
4. Cardiopulmonary changes:
•Decrease in cardiac output by about 0.7% a year after around 30 yrs of age
•Reduced arterial elasticity
•Increased vascular resistance
•Decreased lipid metabolism which may increase risk of heart diseases
•Ventricular wall stiffness
•Diastolic abnormality
• Heart valve thickens and becomes stiff
•Reduced oxygen saturation
•Reduced elasticity in lungs and chest wall
•Reduction in vital capacity
Renal changes:
•Reduced filtration rate
•Loss of control over urinary bladder
5. BENEFIT/NEED FOR EXERCISE INTERVENTION IN ELDERLY
•Reduce risk of heart diseases, diabetes, hypertension, weight problems,
anxiety, depression.
•Increase stamina
•Maintain healthy weight
•Reduce the chance of fall
•Maintain muscle mass
•Control joint movement
•Better mental health
•better self-esteem
•Better sleep pattern
•Better QOL
7. GERIATRIC ASSESSMENT
AIMS:
Better recognize common geriatricdisorder.
Plan an effective treatmentprogram.
Improve over all health and functionaloutcomes.
Reducevulnerability tosubsequent illness.
Provide better quality oflife.
THETEAM:
many members work together to develop a single treatment plan
8. EFFICIENCY OF ASSESSMENT
Problem area Screening measure Abnorma
l
response
Mobility Note the time after asking the patient: ’RISE FROM THE
CHAIR, WALK 20FT, TURN , WALK BACK TO THE CHAIR
AND SITDOWN’
Unable to task
15 second
Physical
disability
1.Have you had any fall in last year? Yes to all six
2.Do you have trouble with the activities of personal life
like bath, dress, toilet or eat?
Questions
3.Do you have trouble with light house hold work like
cooking?
4. Do you have trouble with heavy house hold work like washing
cloths?
5.Are you able to go out for shopping or to see a
family friend?
6.Are you able to do strenuous activities such as cycling or
fast walking?
9. EFFICIENCY OF ASSESSMENT
Problem area screening measure Abnormal response
Vision Test each eye with Snellen eye chart,
with glasses if applicable
Can’t read 20 /40
Hearing Whisper short sentences at 6-12 inches Unable to hear
Urinary incontinence Do you have problem with urine
leaks?
Yes to the question
Nutrition , weight loss Have you lost weight ? If yes, how
much?
Loss of 5 per cent
Weight /BMI BMI< 21
Memory Name 3 objects ask to recall in 5 min If remember <3
Depression Have you often been bothered by
feeling sad or depressed?
Yes to the question
10. COMPONENTS OF ASSESSMENT
HISTORY TAKING: GeneralGuidelines
Remember that patient having age related changes in one or more body
system.
Keep the pace slower thanusual
Introduce yourself in start of historytaking
Address each individual as per her/his preference. Sir, Madam, Mr., Mrs.
Use rather than grandma or grandpa
Adopt the most effective way of communication such as eye contact, gentle
touch or loud voice.
11. COMPONENTS OF ASSESSMENT
- Do not discuss the case with relative to the questions
as if he is not allow to participate in discussion.
Never ignore the presence of elderly
Ensure that patient can hear what is beingsaid
Provide glasses ifneeded
Speak at eye level facing thepatient
Never treat the elderly as is achild
Respect elderly as anindividual.
12. COMPONENTS OF ASSESSMENT
Subjective information and personal history:
Age/sex
Education/occupation
Socioeconomic status etc.
Chief complaints: reflecting the presence of multiple
pathologies
Present physical illness: chronic disease previous surgeries or
hospitalization
Drug history: prescribed or non-prescribed drugs, drug
allergies
Nutritional history: number of meals/day, contents of diet
Family history: major disease in family, cause of death of
family members.
13. PHYSICAL EXAMINATION
HEIGHT, WEIGHT, BMI
ORTHOSTATIC BP AND PULSE
SKIN INTEGRITY, PALLOR
RANGE OF MOTION
MUSCLE STRENGTH
SENSORY STATUS
COORDINATION
VISION AND HEARING
14. GOAL-SETTING
Functional independence is the ultimate goal.
Torelieve pain
Toimprove or maintain ROM of different joint
Toimprove or maintain strength and endurance of movement
Toimprove or maintain cardiovascular endurance
Toimprove or maintain ambulatory status
15. THERAPEUTIC INTERVENTION
RANGE OF MOTION EXERCISES
Flexibility decreases with age and joint become stiff
Development of contracture, it develop within 1 week of inactivity
1. Passive ROM: therapeutic benefits
Tomaintain range of motion
Toprevent complication of inactivity such as –
- contracture formation
- cartilage degeneration
-deep vein thrombosis etc
16. 2. Active ROM: therapeutic benefits
Topreserve joint function
Tomaintain physiological elasticity and contractility of muscle
Tomaintain and improve ROM
Toinduced muscle relaxation
Todecrease pain
Toincrease circulation and thereby preventing DVT.
Toprovide sensory feedback from the contracting muscle
Toprovide a stimulus for bone and joint tissue integrity
Toimprove neuromuscular coordination
17. STRETCHING EXERCISE
1. Static stretching: the muscle tendon unit under a slow, gentle stretch that
is maintain for a period of 20 to 60 seconds
2. proprioceptive neuromuscular facilitation stretching: the inhibition
technique that attempt to reduce muscle tone
The most popular technique is Hold-Relax
3.Ballistic stretching: it is contraindicated in
- elderly individuals
- sedentary individuals
- musculoskeletal pathology and
- chronic contracture
Because,
the high velocity, high intensity movement are difficult to control.
Tissue weakened by immobilization or disuse, can be injured easily
Dense connective tissues of chronic contracture become more brittle and tears more
readily
18. MOBILIZATION EXERCISE
Joint mobilization stretching technique: specially use for restricted capsular
tissue
Therapeutic benefits
To stimulate the mechanoreceptors that may inhibit the transmission of nociceptive
stimuli at the spinal cord or brain steam level
Tocause synovial fluid motion, this is the vehicle for bringing
nutrients to the avascular portion of the articular cartilage
Toprevent painful or degenerative stasis when a joint is swollen or painful
Toelongate hypomobile capsular and ligamentous connective tissue
Tomechanically distend the shorten tissue
19. STRENGTHENING EXERCISE
Force-generating capability is prerequisite for performing many
everyday activities.
Therapeutic benefits
The increase in muscle strength
Improve in neuromuscular co-ordination
Improve stability of joint
An increase in bone mineral density
Lessen the amount of stress placed on the joints that are mostly
affected by degenerative process in older adults
20. STRENGTHENING EXERCISE
TYPES OF RESISTANCE:
1. body weight:
Body weight offers sufficient resistant for initial training,
similar to active ROM.
Progression can be done by performing exercises in different
positions
2. manual resistance:
The main disadvantage of this exercise is that the amount of
resistance can not be measured quantitatively.
But experience therapist very well judge the amount of resistance
21. STRENGTHENING EXERCISE
3. mechanicalresistance:
Equipment ranges from simple tocomplex
Incase of old-olds(>85 years) this equipment should not be used, as it my result in to
muscle soreness or inhibition
INTENSITY OFEXERCISE
Start with base line assessment ofintensity,
Popular method is find out repetitionmaximum(RM)
FREQUENCYANDDURATION
For each level of intensity, session are 2- 3 time aweek
A single session consist of 3 set of 10RM
Resistance can be increase when 1 or 2 sets done in a smooth manner
22. STRENGTHENING EXERCISE
REST INTERVALS
Patient should rest for 1- 2minutes between sets in a same session
MODE OF EXERCISE:
Functional strength is affected not only by the absolute ability to
generate force but also by the ability to generate force across the
varying lengths of the muscle during movement.
So the strengthening exercise include dynamic exercise as well as
static exercises
23. AEROBIC EXERCISES
This endurance activities that do not require excessive speed or
strength but do have a beneficial effect on cardiovascular system
Therapeuticbenefits-
Improvement in maximal cardiovascular functiona lcapacity:
Improvement in the energy level
decrease LDL and triglyceride level increase in
HDL
Improvement in the bodycomposition
Reduction in fat mass and increase in musclemass
Reduction in disability
Psychosocial well-being
Improvement in functional status
Reduction in risk of developing age-related changes
24. AEROBIC EXERCISES
EXERCISE PROGRAM
1.warm-up:5-7 min
to reduce the chances of injury
2. Protocol:
mode-walking, stationary bicycling, jogging
intensity- 60% of MHR,
duration- 30 minute,
frequency- 5 days in a week
3.Cool down: 10 min
Toexpedite the recovery process after aerobic exercis
Toprevent injury
Protocol: slow walk for 5 minutes and slow exercises
25. GAIT TRAINING
The purpose is to make a patient walk at functional speed.
Factors contributing the physical therapy intervention
altered gait of patient
1.difficulty in rising from
sitting
2.Increased thoracic
kyphosis with flexion in
lower cervical spine and
extension in upper
cervical spine-
3.Unequal weight
distribution-
place feet close to chair by flexing knees >90d,
bend forward in sitting,
push from chair,
strengthening of triceps & latissimus dorsi,
adaptation height of chair
correction in cervical spine position in sitting,
postural control training,
visual feedback in standing,
Hold-Relax
weight in all directions- forward, Backward, side
ways- for equal distribution in standing,
decreasing the size of support, eg. alternately raising on
toes and heels,
standing on balance board,
26. GAIT TRAINING
4.Increased stiffness
and/or tightness of
soft tissues in
trunk, hip, knee and
ankle-
5. Difficulty in
maintaining weight
bearing postures-
6. Foot clearance
problems-
suitable heat modality ,
joint mobilization with precaution in case of osteoporosis, Hold-
Relax,
passive stretching or self stretching
rhythmic stabilization ,
standing on different types of surfaces like foam,
concrete to alter sensory input,
standing with eyes closed,
isometric contraction of the postural extensor muscles in
shortened range against resistance ,
assess foot wear , hard sole, well fitted , lace- up shoes with
thick, absorbent socks are preferred,
recommended walking aid according to deficits and needs of
patient
faradic stimulation to ankle dorsi flexors, hip
hiking in parallel bar,
weight shifting to forwards and backwards,
ankle mobilization to increase DF. ,
27. GAIT TRAINING
7.Difficulty with reciprocal swing of
legs-
8. Decrease strength of muscles –
9. Decrease cardiovascular endurance –
10. Decrease push-off –
trunk rotation on mat,
trunk twisting in sitting and standing,
4-point gait drills
resisted exercise with therabands or
weights, training on isokinetic device ,
PNF technique
administration of aerobic exercise in
graded manner
strengthening of planter flexors ,
ankle mobilization to increase planter
flexion, standing on toes
28. ORTHOTICS
The responsibility of physical therapist is to identify abnormal positions and
movements that are responsible for;
pain,
Misalignment of body segment,
Difficulty in maintaining weight bearing position,
Unequal weight distribution and
Gait deviation
Indications:
Toprovide mobilization or to control movement
Tosupport a weakened structure
Toprevent deformity and correct anatomical alignment
Topromote ambulation and assist motion to improve body
function
Torelieve pressure on areas andto reduced pain
29. ORTHOTICS
Principles:
There should be a practical balance between the objective that are ideally
desired and the tolerance of elderly patients
The basic principle refers to the application of force to the involved body
segments.
Comfort and tolerance are important for an elderly patient
Attempting biomechanical control is not appropriate in most of geriatrics,
Plastic orthosis is the choice in elderly patient,
AFOs are well tolerated by elderly individual
HKAFOs usually not recommended, as they are cumbersome
A hip orthosis is used to restrict the movement ofhip adduction and
flexion
30. PRECAUTIONS WHILE EXERCISING
•Vigorous exercises should be avoided.
•Always start with low intensity exercises and very gradually progress to
moderate.
•Never exercise empty stomach.
•Always keep water alongwith during exercise
•Never exercise immediately after meals
•Comfortable clothing.
•Comfortable footwear to avoid any injuries.
•Vitals should be monitored continuously while exercising.
•Decrease work load if any sign of fatigueability is there.
•Immediately terminate the exercise if any discomfort like dyspnoea, dizziness,
chest tightness or pressure, nausea, pain, etc. are seen.
31. RE-ASSESSMENT
There should be ongoing reassessment while administering
geriatric physical therapy program.
This enables to judge the effectiveness of treatment towards
the goal set, with a required modification in the treatment
strategies.
33. BASIC ACTIVITIES OF DAILY LIVING
(Here; I-Independent, A-Assistance requires,D- Dependent)
A. Toilet:
I- Able to get to, on and off toilet, cleans self
A-Needs help, soiling or wetting while asleep more than 1week
D- Completely unable to use toilet
B. Feeding:
I- Able to completely feed self
A- Feed self with assistance
D- Completely unable to feed self or need parenteral feeding
C. Dressing:
I- Able to select cloths, dress and undress self
A-Need assistance D-dependent
34. BASIC ACTIVITIES OF DAILY LIVING
D. Grooming: (neatness, hair, nails, face, clothing)
I- Able to groom well without help A-Needs
assistance in grooming
D-Completely unable to care for appearance
E. PhysicalAmbulation:
I-Able to get in/out of bed, roam around without help A-Needs human or
mechanical assistance
D-Completely unable to get in/out of bed/chair, walk
F. Bathing:
I- Able to bathe(tub, shower) without assistance
A-Need assistance for getting in and out of tub or washing more than one body part
D- Completely unable to bathe self
35. INSTRUMENTAL ACTIVITIES OF DAILY BY:
LIVINGM.P. LAWTON & E.M. BRODY
A. Ability to usetelephone:
I-Able to operate telephone on own initiative
A-Answered telephone but needs special phone or assistance in getting number dialing
D- Unable to use telephone at all
B. Shopping:
I-Able to take care of all shopping needs independently
A-Able to shop but needs to be accompanied on any shopping trip D- Unable to shop
C. Preparing meals:
I-Able to plan and prepare meal independently A-Unable to cook
full meal alone
D-Unable to prepare any meal
D. Housekeeping
I-Able to maintain house independently
A-Able to do light work bt need assistance with heavy task D-Unable to do any
house work
36. INSTRUMENTAL ACTIVITIES OF DAILYLIVING
E. Laundry
I-Able to launder independently
A-Launder small items such as socks, handkerchief
D-Unable to launder at all
F.Travelling
I-Able to drive own car or travel independently
A-Needs assistance for travelling
D-Unable to travel
G. Responsibility for own medication
I-Able to take medication in correct dose and time
A-Able to take medication if it is prepared in advance
D-Unable to take medication
H. Ability to manage finances
I-Able to maintain finance s independently eg. Pay bills
A-Able to manage day to day purchases but needs assistance
D-Unable to handle money
37. MINI-COG ASSESSMENT INSTRUMENT
Administration
1. Instruct the patient to listen carefully to and remember 3 unrelated words and then to repeat the words.
2. Instruct the patient to draw the face of a clock, either on a blank sheet of paper, or on a sheet with the clock
circle already drawn on the page. After the patient puts the numbers on the clock face, ask him or her
to draw the
hands of the clock to read a specific time, such as 11:20.
These instructions can be repeated, but no additional
instructions should be given. Give the patient as much time as needed to complete the task. The CDT serves
as the
recall distractor.
3. Ask the patient to repeat the 3 previously presented word.
38. MINI-COG ASSESSMENT INSTRUMENT
Scoring
Give 1 point for each recalled word after the CDT distractor. Score 1– 3.
A score of O indicates positive screen fordementia.
A score of 1 or 2 with an abnormal CDT indicates positive screen for dementia.
A score of 1 or 2 with a normal CDT indicates negative screen for
dementia.
A score of 3 indicates negative screen fordementia.
The CDT is considered normal if all numbers are present inthe
correct sequence and position, and the hands
readably display the requestedtime.
39. GERIATRIC DEPRESSION SCALE
(MOOD SCALE)
Choose the best answer for how you have felt over the past week:
1. Are you basically satisfied with your life? YES /NO
2. Have you dropped many of your activities and interests? YES / NO
3. Do you feel that your life is empty? YES / NO
4. Do you often get bored? YES / NO
5. Are you in good spirits most of the time? YES /NO
6. Are you afraid that something bad is going to happen to you? YES/
NO
7. Do you feel happy most of the time? YES / NO
8. Do you often feel helpless? YES / NO
40. GERIATRIC DEPRESSION SCALE
(MOOD SCALE)
9.Do you prefer to stay at home, rather than going out and doing new
things? YES / NO
10. Do you feel you have more problems with memory than most? YES /
NO
11. Do you think it is wonderful to be alive now? YES / NO
12. Do you feel pretty worthless the way you are now? YES / NO
13. Do you feel full of energy? YES / NO
14. Do you feel that your situation is hopeless? YES / NO
15. Do you think that most people are better off than you are? YES /NO
Answers in bold indicate depression. a score > 5 points is suggestive of
depression and should warrent a follow-up interview. Scores > 10 arealmost
always depression.