The Geriatrics is the medical specialty devoted to the study of prevention, diagnosis, treatment and rehabilitation of diseases in old age or elderly, starting at 60-65 years.
The geriatric physiotherapy is a particular discipline of physiotherapy , not by the techniques employed but their modes of application and adaptation to the elderly.
The increase in the life index makes this type of patients more and more numerous and thus the adaptations of physiotherapy are increasingly important, to facilitate the achievement or improvement of their functional, psychological and psychomotor skills.
Factors and principles of application:
Need for early and often preventive treatment :
- Any motor deficiency, of nervous or articular origin, should receive a re-education treatment.
- The persistence of a physical activity willconsist of the best life hygiene.
The general principles of rehabilitation in the elderly , whatever the process in question, should be applied as a general measure and then apply the specific techniques corresponding to the process.
- Maintain maximum joint mobility.
- Maintain or restore independence in activities of daily living (AVD) .
- Maintain or increase muscle strength.
- Achieve a good gait and balance pattern.
- Rate posture.
- History of falls suffered.
- Achieve patient confidence and cooperation from the beginning.
Adaptation of the individual psychology of the elderly to assimilate the elements of reeducation.
Use of a maximum of active methods and a minimum of devices and accessories, if not for occupational purposes (ergoterapia).
Creation of a favorable psychological environment together with the necessary patience by the physiotherapist.
Strengthen the habit of performing daily exercises without fatigue .
The objectives must often be modest and one of the main goals will be the reacquisition of real independence as complete as possible, taking into account the patient’s residual abilities.
Criteria that may determine the degree of autonomy of the elderly:
- Mobility (possibilities of displacement).
- Functional physical independence.
- Occupation (prepare food, perform small cleanings).
- Orientation in relation to the environment.
- Economic independence.
The domain of the application of geriatric physiotherapy can be applied to elderly patients affected by disabling diseases that concern the musculoskeletal , cardiorespiratory and circulatory system ; as well as to patients with psychological or psychological problems .
The conditions related to the musculoskeletal system are mainly:
- Degenerative rheumatic conditions( osteoarthritis , osteoporosis ) or inflammatory ( arthritis ).
- Fractures(humerus neck, hip).
The objectives will aim at the prevention of an accelerated or inharmonious aging of a too rapid degradation of the functional aptitudes, having to act on:
- Exercises of control and regularization of breathing: Wide and controlled ventilation.
- Avoid abdominal contents that increase pressure, fight against defective positions, obesity and prolonged stay in bed.
- Locomotor system:The possibilities of locomotion condition the relationship and communication life of the elderly, numerous factors influence the locomotion of the elderly:
a. Articular state
- Degree of bone mineralization (Osteoporosis).
- Associated neurological damage
- Cardiovascular and pulmonary state.
- Trauma sequelae
Among the measures available to improve the locomotor system are:
General circulatory and / or lymphatic massage (do not return to the patient dependent on this treatment).
- Active mobilizations++, self-assisted exercises, individual and collective gymnastics.
- Functional exercisesthat insist on lateral and oblique movements in association with a stimulation of visual control (use of moving objects and colored and luminous references).
- Stimulation of balance: importance of the oculomotor system and cervical mobility.
Muscle activity , especially static, with resistance equal to 50% of maximum resistance (RM).
- Physical means ( thermotherapy, hydrotherapy).
- Teaching a correct regime of life.
- Fight the fear of falling(balance ++) and learning to “get up from the ground”.
- Practice of an adapted sport or functional gymnasticsthat pursues:
- Simple movements.
- Diversity of exercises.
- Functional and utilitarian character.
- Progressive adaptation to an always tolerable effort.
- Frequent periods of recovery and relaxation.
Help the patient preserve and even develop a better psychic concept.
Aging and its impact on the musculoskeletal system can cause difficulties during activities of daily living, simple advice and the use of technical aids (cane, crutches, walker) can support the elderly in their desire for conservation or recovery of autonomy These technical aids can solve numerous problems due to joint mobility deficit, lack of strength and coordination and visual disturbances.