Role of Physiotherapy in Geriatric People | Physiotherapist for Elderly care

Aging or getting old makes our body go through many physical changes. These changes usually cause a decrease in muscle strength, bone density, body coordination, and even make the joints stiffer, which sometimes can lead to falls and fractures. For elderly citizens, exercising may be the key for bringing back and sustaining the physical function required in daily living. Exercise programs set by a physiotherapist can help in reducing body pain, enhancing the movement of joints, facilitating coordination, and boosting respiratory function.  Elderly people suffering from chronic diseases can also obtain benefits from physiotherapy. Though physiotherapy cannot stop the process of aging it can help to reduce the impact that it has on our bodies. Physiotherapists are trained professionals who can identify the factors that prevent elderly people from being active and independent. Exercising on regular basis can also help to reduce the risk and impact of illnesses that are more likely to affect older people. In this blog, we will discuss the various conditions suffered by elderly people who require physiotherapy.

 

Conditions treated by Geriatric Physiotherapists

• Geriatric conditions are susceptible to various illnesses usually including musculoskeletal, neurological, and cardiopulmonary problems, mental illness, balance problems, and chronic pain. Physiotherapy treatment has been successful in managing each of these ailments.

 

Pain from chronic conditions:

• Physiotherapy can help to decrease discomfort due to conditions like arthritis or osteoporosis. Usually, joint pain is caused by inflammation of the joints, injuries, arthritis, gout, etc. It can restrict mobility and lead to weakness or instability to perform normal activities if left untreated for a longer time. The goal of the physiotherapist is to restore the function of the muscles, bones, joints, tendons, and ligaments.

 

Improve strength and flexibility:

• Due to aging decreased strength and flexibility is one of the most common issues that almost every individual faces. Further, the condition can be worsened by the presence of other chronic conditions related to neurological issues, endocrine problems, and musculoskeletal issues. As a result of degenerative changes that occur due to old age, there is poor muscle tone and stiff joints, etc. A physiotherapist helps to alleviate pain and helps return to mobility. Some of the common causes of decreased strength are thyroid disease, anemia, and depression, lack of sleep, diabetes, congestive heart failure, and medication side effects. Physiotherapy helps to bring back strength and flexibility, and also improves patients' quality of life.

 

Postural Instability and Balance Impairment:

• Balance impairment in the elderly is due to the loss of normal functioning of muscles and bones. It is most commonly caused due to arthritis and numbness in feet and legs, eye problems, blood circulation problems, and intake of multiple medicines. Physiotherapy treatment includes balance exercises to help improve the function of muscles & bones in individuals having neurological conditions such as Alzheimer's disease, ALS, Parkinson's disease, or suffered a brain injury.

 

Risk of injury:

• Physical therapy helps to maintain stability. The physiotherapist teaches the patient to adapt to visual, mobility, balance, and muscle loss impairments to easily complete the activities of daily living. This awareness helps to reduce the risk of injuries and re-injury. Patients who have had a heart attack, or have other cardiovascular or pulmonary conditions such as pulmonary fibrosis or Chronic Obstructive Pulmonary Disease can benefit from physiotherapy by following a treatment regime that helps them to increase endurance and gain functional independence.

 

Prevention of risk of a fall:

• Falls are the leading cause of accidents among aged individuals, resulting in bone fractures and other injuries. A physiotherapist can train the individual in techniques to prevent a fall.

 

Maintaining an independent lifestyle:

• Recovery from pain due to an illness or injury allows the individual to lead an active and independent life for a longer period of time. Stretching and strengthening exercises are proven to be effective for older people. Patients with foot drop, spinal injury, and stroke are provided with walking aids to facilitate independent living. The therapist works with the patient to ensure that he/she can remain as independent as possible.

 

Physiotherapy treatment:

Physiotherapist aims to help and address the areas which require treatment. The therapist uses his/ her information to design a tailor-made program. The program includes strengthening exercises, range of movement (ROM), balance, and walking exercises.

• Physiotherapy includes exercises, workouts, and the use of electric modalities such as Ultrasound, TENS, Shockwave therapy, Laser, etc
• Muscle-strengthening exercises are done twice a week, one of the best treatments for osteoarthritis and bone health.
• Moderate intensity activity like brisk walking is recommended.
• Strengthening exercises for muscles can be done against resistance, by using stretchy bands.
• Combination of moderate cardio, endurance, and balance exercises.

Benefits:

• Physiotherapy is vital for restoring functionality, reducing pain, and thus improving quality of life.
• Regular exercises result in improved balance, strength, coordination, motor control, flexibility, endurance, and even memory.
• Helps to maintain cognitive function.
• Reduces the risk of heart disease.
• Helps to maintain the ability to carry out activities of daily living.
• Improves mood and self-esteem.
• Reduces the risk of falls.
• Helps to reduce the impact of illnesses that are more likely to affect older people.
• Treats and prevents joint problems, balance disorders, risk of falls, strength decline and reduces high blood pressure and obesity.
• Physiotherapy is proved to be beneficial for old people suffering from conditions like stiff joints, unbendable ligaments, and overall body movement. Parkinson's disease, arthritis, and neurological problems.
• The therapy helps maintain mobility and independence.
• The therapy is a means of attaining coordination within the body systems.
• It also improves cardio-respiratory functions.

Physiotherapists can provide advice on how the exercises can be done safely and also strongly recommends exercises for elderly patients as a part of a daily routine. While following the exercise regime elderly people are not limited to uncomfortable living conditions or insufficient physical activities. This unique therapy is a proven methodology for elderly parents to engage in exercises for as long as their health will allow it.

 

Osteoporosis: Physiotherapy Management and Prevention

Osteoporosis or low-density bone is a health problem that causes disability and various complications in the sufferers. It occurs when the normal bone becomes thin and porous due to poor nutrition or aging, which can decrease the ability of the bone to withstand the forces that are applied during daily activities.  This disease can be silent progressive with no prominent symptoms until complications like fracture occurs if left untreated or unidentified. Strategies to improve bone density and reduce the likelihood of falls are important in the prevention of osteoporosis. Physiotherapy plays an important part in treating this health problem. Certain exercises can help strengthen the bones when performed in a proper way and under the guidance of a well-trained professional. In this blog, we will discuss physiotherapy management for osteoporosis sufferers and the precaution to be taken to prevent the complications.

 

Role of Physiotherapy in the management of osteoporosis

Physiotherapists are trained professionals who treat osteoporosis by personalizing the treatment plan. There is no single exercise regimen for people suffering from Osteoporosis. Based on a medical evaluation of range of motion, muscle strength, fitness level, fracture risk, gait, and balance each regimen for the individual patient is specially tailored. They develop a specific program based on the individual’s need. The goal aims:

 

• To help manage osteoporosis with minimal risk of complications.
• To build or strengthen the bones and muscles to decrease the amount of bone loss and the risk of injury and help to stay independent.
• Teaches proper postural alignment and body movement to protect the spine from fracture during daily activities, like lifting, forward-stooping, and bending.
• Gives balance training and develops a program to help reduce the risk of falls.

Muscle grows when challenged by more than usual weight, same is the case with bone, bone grows when it is properly and sufficiently stressed.

 Physiotherapy management

Exercising for bone-building or slowing bone loss is very specific and similar for all ages.  

 

• Physiotherapist provides appropriate external devices, like bracing, to improve posture and promote healing.
• Uses different modalities which help reduce pain

 

·    Range of motion (ROM) and strengthening exercises

Physiotherapists aim to improve the overall posture through a gentle range of motion and strengthening exercises. Gradual fractures and wedging of the vertebra are due to the increased flexion through the thoracic spine. These conditions worsen with poor posture. Maintaining a good posture with the help of exercises gentle range of motion and strengthening exercises can maintain the healthy mobility of the upper back and core.

 Resistance exercises

As exercises lead to stronger bones, physiotherapist designs an appropriate exercise program, which can reduce the risk of falls and fall-related fractures. Exercise programs include the use of exercise bands, gravity resistance exercises e.g., squats, single-leg heel raises, prone trunk extension with cushion to protect lowest ribs, push-ups, lunges, sustained standing positions in neutral spine position.

 Loading exercises

To increase the overall stability and bone strength lifting weights and lower impact exercise can decrease the risk of fracture. People with osteoporosis are afraid to perform strengthening exercises and other strenuous exercises. For any physiological system to improve its function load larger than normal must be exposed for strengthening.  Bones must meet forces greater than those it sustains to improve strength on a day-to-day basis. Weight lifting in the proper spine and lower-extremity alignment can be done. Weight-bearing exercises stomping, heel drops, dancing, jogging are also done under the guidance.

 Balance and coordination exercises

Coordination and balance exercises also help in reducing fall risk. When walking on unstable surfaces or walking through narrow spaces, these exercises help to improve balance. Exercising on a bobath ball and placing challenges the whole walking can increase and maintain balance.

 As a part of an overall fitness program, exercises are performed 2 to 3 times a week.

 Things to avoid: 

• Avoid exercises that can put the greater risk for injury.
• Avoid exercises that overstrain or under strain the bone or muscle.
• Avoid exercises with any type of sit-up or crunch, and excessive spinal or hip twisting, forward or side bending.