PHYSIOLOGICAL CHANGES ASSOCIATED

WITH AGEING AND PHYSIOTHERAPY

INTERVENTION IN GERIATRIC CARE

ORIGBEMISOYE A.O (B.PT UNIMED)

Department Of Physiotherapy,

Federal Medical Centre, Abeokuta.

12th April, 2023

OUTLINE
• Introduction

• Physiological changes associated with ageing

• Conditions in geriatric

• Multidisciplinary team in geriatric care

• Physiotherapy intervention in geriatric care

• Conclusion

• References
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INTRODUCTION

• Ageing can be defined as the time-related deterioration of physiological

functions necessary for survival.

• It is an inevitable process that results in decline of biological functions

(tissues and systems), and are accompanied by psychological,
behavioral, and other changes.

(Lemoine et al.,2020)
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INTRODUCTION CONTD
• Geriatric is coined from the Greek word “geras”, meaning “old age”.

• It is concerned with the illnesses of old age and their care.

• Geriatric chronological age is 65 years and above [National institute of

Health (NIH)]

• It’s further classified into ;

- Young-old (65 – 74 years)

- Middle-old (75 – 84 years)

- Old-old (above 85 years) 3

PHYSIOLOGICAL CHANGES ASSOCIATED WITH
AGEING

• This changes occurs across all systems.

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CONDITIONS IN GERIATRIC

Common conditions in geriatrics includes;

 Musculoskeletal
- Arthritis
- Spondylosis
- Osteoporosis

 Neurological
- Alzheimer’s disease
- Parkinson’s disease
- Stroke
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CONDITIONS IN GERIATRIC CONTD

 Cardiovascular
- Chronic Obstructive Pulmonary Disease
- Congestive Heart Disease
- Peripheral arterial disease

 Cancerous conditions
- Prostate cancer
- Breast cancer
- Lung cancer
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 MULTIDISCIPLINARY TEAM IN GERIATRIC CARE
Geriatric care requires team work among multidisciplinary team which
includes;
• Doctor
• Nurse
• Dietitian.
• Occupational therapist.
• Pharmacist.
• Physiotherapist.
• Psychologist.
• Social worker.
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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE

The major goals of physiotherapists in geriatric care are ;

• To relieve pain

• Prevention of fall

• To improve quality of life and promote functional independence

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE

Pain management

Physical modalities

- Hot/cold therapy.

Electrotherapy

-TENS, infrared etc.

Manual therapy
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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

Exercise therapy

- Exercises are prescribed depending on the patient’s condition and

how well the patient can tolerate.

Patient education

- Advice on posture ,ergonomics and lifestyle changes such as

weight loss. 12
PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

 Outcome measures used in pain management are ;

• Numerical Pain Rating Scale (NPRS)

• Visual Analogue Scale (VAS)

• Verbal Rating Scale (VRS)

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD
Prevention of fall in the elderly

1. Assessment ;

• A detailed fall history, environmental assessment

• Physical examination

- Gait and balance,

- Neurological and cognitive function,

- Muscle strength, feet and footwear

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE
CONTD

• Outcome measures such as;

- Berg balance

- Time up and go test

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

2. Exercise; Exercises for strength, balance, coordination and mobility has

been shown to have the most effective outcomes in reduction of falls rates.
( Papilia et al., 2020)

The exercises includes ;

• Strength/resistance exercise ;

- Squatting, bridging, use of theraband/resistance bands , dumb bells,

sandbag etc.
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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

• Balance and mobility exercise;

- Free active exercise - Tandem walking

- ROM exercise - wobble board exercises

- Single leg stance

- Match and hold

- Otago exercise program

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD
3. Prescription on right ambulatory assistive devices and ambulation training

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

4. Patient education ;

• Complications that may arise from fall

• Home program exercises.

• Safety measures.

• Regular medical check up

• Fear of falling
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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

Quality of life and functional independence

• Physiotherapists improves this through geriatric rehabilitation .

Rehabilitation of the older adult involves:

• Improvement of balance, strength and mobility through exercises.

• Patient education and psychotherapy

• Emphasize on physical activities (aerobic exercises and group therapy activities)

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PHYSIOTHERAPY INTERVENTION IN GERIATRIC CARE CONTD

Physical activity ;

• Improves functional abilities in ADL,

• Slows the aging process,

• Lowers the risk of development of cardiovascular and cancer diseases.

Lack of physical activity result in a substantially accelerated rate of aging.

(Andrieieva et al.2019)

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Group therapy activities in geriatric patients 25
CONCLUSION

• Physiotherapists play a crucial role in ageing process to improve good

quality of living and promotion of functional independence amongst
the elderly.

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RECOMMENDATION

• I recommend that group therapy exercise should be implemented in

this facility for geriatric patients.

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 REFERENCES
• Aman, Y., Pitcher, T., Ballard, C., & Malcangio, M. (2019). Impaired chronic pain‐
like behaviour and altered opioidergic system in the TASTPM mouse model of
Alzheimer's disease. European Journal of Pain, 23(1), 91-106.
• Andrieieva, O., Hakman, A., Kashuba, V., Vasylenko, M., Patsaliuk, K., Koshura, A.,
& Istyniuk, I. (2019). Effects of physical activity on aging processes in elderly
persons.
• Anami K, Murata S, Nakano H, Nonaka K, Iwase H, Shiraiwa K, Abiko T, Goda A,
Horie J. The Association between Health Literacy and Gait Speed in Community-
Dwelling Older Adults. InHealthcare 2020 Dec (Vol. 8, No. 4, p. 369).
Multidisciplinary Digital Publishing Institute.

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REFERENCES CONTD
• Hoenig H, Kortebein PM. Overview of geriatric rehabilitation: Program
components and settings for rehabilitation. UpToDate, Waltham, MA. Accessed.
2019;3(24):20.

• Khan SS, Singer BD, Vaughan DE. Molecular and physiological manifestations and
measurement of aging in humans. Aging cell. 2017 Aug;16(4):624-33.

• Kotsani M, Kravvariti E, Avgerinou C, Panagiotakis S, Bograkou Tzanetakou K,

Antoniadou E, Karamanof G, Karampeazis A, Koutsouri A, Panagiotopoulou K,
Soulis G. The Relevance and Added Value of Geriatric Medicine (GM): Introducing
GM to Non-Geriatricians. Journal of Clinical Medicine. 2021 Jan;10(14):3018 .
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REFERENCES CONTD

• Lemoine, M. (2020). Defining aging. Biology & Philosophy, 35(5), 46.

• Migliarese S, White E. Review of forward-head posture and vestibular deficits in

older adults. Current Geriatrics Reports. 2019 Sep;8(3):194-201.

• Papalia, G. F., Papalia, R., Diaz Balzani, L. A., Torre, G., Zampogna, B., Vasta, S., ...
& Denaro, V. (2020). The effects of physical exercise on balance and prevention of
falls in older people: A systematic review and meta-analysis. Journal of clinical
medicine, 9(8), 2595.

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REFERENCE CONTD

• Savvas, S. M., & Gibson, S. J. (2016). Overview of pain management in older

adults. Clinics in geriatric medicine, 32(4), 635-650

• Wagner AR, Akinsola O, Chaudhari AM, Bigelow KE, Merfeld DM. Measuring
vestibular contributions to age-related balance impairment: a review. Frontiers in
neurology. 2021 Feb 9;12:635305.

• Waldron N, Hill A, Barker A. Falls prevention in older adults: assessment and

management. Aust Fam Physician. 2018; 41(12): 930-935

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• Is ageing a disease ?

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