Geriatric physiotherapy became a specialized field in physical therapy in 1989. This helps elderly people to perform basic functions and daily living activities at their best abilities without relying on others for assistance leading them to live an independent life.Physiotherapist assists elderly people in treatment of Accidents, Age-related disorders, Illnesses, Post-operative rehabilitation, Disuse conditions etc.
• As people become old, the patient may simply does not completely move their limbs/ don’t exercise leading to painful movements/no movement.
• Cardiovascular disease, Pulmonary disease, Stroke, Incontinence
• Skeletal disease affecting bones and muscles of the body (e.g. Osteoarthritis, Rheumatoid arthritis, Osteoporosis, Joint replacements)
• Cancer, Alzheimer’s disease, Balance disorders, Co-ordination disorders etc.
Note: Before starting exercise program, get check up from your doctor and seek advice. Well balance nutritional diet is also important.
Benefits of Exercise:
• Improve sleeping: Regular exercise by elderly people induces sleep more easily and deeply.
• Exercise regimen: Joining an exercise class improves social interaction and meeting new people which causes stress and depression relief.
• Exercise improves functionality of brain and helps fight diseases, depression reducing risk of Alzheimer disease and dementia.
• Regular exercise helps in reducing weight, induces building muscles which in turn decreases wear and tear of muscles and ligaments.
Precautions while exercising:
• Start the exercise gradually and slowly increase exercises completing all movements in a controlled fashion.
• Warm up should be done properly. Lack of proper stretching may lead to injuries.
• While exercising, don’t hold your breath and stop the particular exercise immediately if it causes pain.
• Drinking plenty of water helps you keeping your body hydrated and is good for health. Drink water in intervals while exercising.
• Qualitative exercise program is important than quantity.
Exercises to be done:
• Regular walking: Helps in improving circulation to calf muscles, well for heart, relieves fatigue, maintains blood pressure, improves posture etc.
• Aquatic exercises: Shoulder movements, Arm movements, Hand movements, Hip movements, Knee and leg movements in water provides resistance and protects your body parts from impact making movements painless and harmless.
• Range of movement exercises:
-These movements are done by physiotherapist on the patient’s body without voluntary action of the patient by manipulation of joints.
-Passive movements are done to elderly people who cannot actively move their limbs/body parts.
-Passive movements should be performed gently and slowly.
2. Active assisted movements:
Here movements are done by the patient itself with minimum assistance from physiotherapist.
3. Active movements:
Exercise is completely done by the patient.
• Muscle strengthening exercise or Normal range of movements to be done.
- All the shoulder movements, arm, hand, wrist, back, hip, knee, ankle exercises are to be done slowly and gently for 2-3 repetitions each.
• Co-ordination exercises:
These are task oriented exercises involving repeated slow and gentle movements which work on many groups of muscles and joints.
Balance training exercises:
1.Knee raise: Stand at back of chair to its left and hold the back of chair with your left hand and lift the right knee towards your chest shifting weight completely to your right side. While doing the exercise focus your eyes straight in front of you.
2.Heel to toe walking: Walk along the wall or in open area by completely touching your heel and toe to the ground.
3. Sit and stand exercise: Sit on a chair to its edge. Slowly taking deep breathe lift your body off the chair using your leg muscles. Stand straight and make sure that your back of legs are touching the chair and return to sitting position.
4. Sitting straight leg raise
5. Hip extension
Complete body stretching is to be done depending on the comfort level and pain free range of the person.
• Ambulation exercise:
1.These exercises are trained to improve the patient’s ability to walk independently without assistance of a person/device.
2. Weak muscles are also to be trained. Range of motion of all the muscles is to be checked. Spastic and weak muscles are to be supported. (E.g. braces, corsets, splints are to be used).
3. First start ambulation exercises on parallel bars as this may have balance and decrease the risk of falling. Then train with walkers, crutches, canes etc.
4. When patient starts walking normally on flat surfaces, train him to step up and step down the stairs.