Physical therapy is frequently recommended by doctors when a person is wounded or has a long-term ailment. However, in the case of older persons, this is sometimes considered as merely something to “attempt.” This could hardly be more untrue. Physical therapy is an “A-quality” treatment for a variety of illnesses that affect the elderly, including Alzheimer’s disease and urine incontinence. In fact, one researcher conducted a study in which participants had to be at least 100 years old!
One of the main things that attract older persons to the physical therapist, according to Jennifer M. Bottomley, Ph.D., MS, PT, president of the American Physical Therapy Association’s (APTA) geriatrics section and adviser to the surgeon general, is a fall. “They want and need to keep their autonomy,” she argues.
“It’s critical to look at each individual,” says Tim Kauffman, PT, Ph.D., a physical therapy professor at Drexel University’s Hahnemann campus in Philadelphia. “Every person, regardless of age, has a unique history, such as a car accident, a football injury, or genetic predispositions. There are no two ‘old’ persons alike.”
Physical therapy, according to the American Physical Therapy Association (APTA), can improve or restore strength, range of motion, flexibility, coordination, and endurance, as well as relieve pain. Retraining the patient to perform everyday duties is another crucial duty.
Guy Davidson of Tempe, Arizona, was 70 years old when he suffered a stroke after bypass surgery. The once-bustling preacher was unable to talk, his right leg refused to support him, and his right arm hung straight down. He spent three months in rehab. He could only sing at first, which involves a different part of the brain than speaking, but he eventually learned to speak. He regained substantial use of both his arm and leg after many strenuous sessions (“I would be sweating,” he admits) and can now dress, drive (he took lessons), and work full-time. Now he spends every day at the hospital, visiting sick parishioners.
Physical Therapy Can Help with a Variety of Ailments
Physical therapy referrals are suitable and beneficial for a variety of issues that are commonly associated with the elderly.
Take, for example, arthritis. According to Kauffman, practically everyone has it in their spine by the age of 65; however, not everyone experiences symptoms. Aside from taking a medication, patients can benefit from a variety of physical therapies, including swimming, hot packs, electrical stimulation, and cold to reduce swelling, to name a few. “Strength, range of motion, balance, and coordination are all important,” explains Kauffman.
Bottomley observes, “We receive a lot of referrals for osteoporosis.” “We strive to keep people’s posture erect by practicing extension exercises to make them more stable in relation to gravity. Falls can occur as a result of osteoporosis, and bones can be broken.” (Studies demonstrate that weight-bearing exercise early in life can help prevent osteoporosis.)
Physical therapy can also aid in the relief of some cancer-related discomfort. “We want to keep the highest level of functioning,” says Bottomley. “After a mastectomy, the right workouts can help reduce swelling and enhance range of motion,” explains Kauffman. “Rather than patients moving around as much as they can stand at home, the therapist must establish the appropriate activity and amount based on clinical judgment.”
What about incontinence, an old favorite? “This is an exercise in locating and controlling the muscles that govern that,” Kauffman adds. Knowing how soon after consuming something you will need to use the restroom and arranging for that is also vital. Such patterns can be established with the assistance of a physical therapist.
Strokes, as Davidson’s case demonstrates, necessitate physical treatment. Bottomley explains, “We employ something called proprioceptive neuromuscular facilitation,” which is a deliberate movement pattern that can excite and retrain the brain. Constraint therapy, in which the stroke victim’s “good” leg is bound and the weak or paralyzed one is utilized 85 percent of the time, is another approach that Davidson believes benefited him a lot. Speech retraining can also be a problem. “We can treat pain electrically if the person is in pain,” Kauffman explains.
Parkinson’s disease is an “exciting” field, according to Kauffman. “We’ve discovered that early physical assistance — before stage 4, when the therapist is frequently called — almost invariably prevents stage 4’s severe symptoms.” The idea, he continues, is to keep the Parkinson’s patient’s trunk flexible so that “robotic” movements are avoided. (Parkinson’s disease is a chronic nervous system disorder that causes a gradual loss of muscle control.) He has them lie down on the floor and move their head and trunk in different directions every now and again. He even rides his patients on horseback to improve their trunk strength and flexibility.
What role does physical therapy play in the treatment of dementia and Alzheimer’s disease? “We attempt to retain function,” says Bottomley, who adds that the forms of movement the patient remembers from the past, such as dancing or gardening, are the most successful. “It also keeps you from falling.”
Another challenge that older individuals face is balance. “Balance is extremely difficult,” Kauffman explains. “It necessitates a number of biological systems, including nutrition, blood oxygenation, muscle strength, joint receptors, eyesight, and the inner ear. All of these regions can benefit from physical therapy. Patients are instructed to toss and catch a weighted beachball that curves and wobbles through the air unpredictably, similar to a knuckleball, in one example.
Hip fracture and replacement patients, amputees, and individuals with joint aches and pains are virtually often prescribed therapy. “I refer to the latter as ‘grandparenting injuries,'” says Bottomley with a smile. “When the grandchildren visit, the grandparents go on longer walks or climb on the playground equipment. Oh, the agony of Monday morning.”
Even if an elderly person has been in the hospital or requires special care, Kauffman advises that family members should be pleasant and supportive of future journeys, this time to therapy. The loss of mobility and independence must also be understood by relatives. “It was terrifying to go home and be completely reliant,” Davidson adds. “They installed grab bars, but I was unable to assist myself.
Family members should never be authoritarian or anticipate a certain degree of improvement, according to Kauffman. Davidson does add, though, that you should seek out a therapist who has goals in mind, rather than one who is letting your insurance run out “in the hopes” that you will improve.
Bottomley believes that rather than nagging, families should participate. “Say, ‘Mom, are you up for a walk?’ when you come over.” It’s also crucial to ensure that the patient is eating well — bring microwaveable meals, or your loved one can end up surviving on crackers and cheese.
Above all, physical therapy is a journey, not a one-time event. There will be ups and downs, as with any journey. Expectations that are realistic and have a sense of humor are beneficial.
If you are in the Asheville, NC area and are considering the benefits of physical therapy for seniors, reach out to us here at 1on1 Physical Therapy we’d love to connect with you! (828) 785-8388
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