Exercises & Geriatric Rehabilitation

The natural progression of aging reduces strength, agility, flexibility and endurance. In fact, one in three adults aged 65 and older will endure a fall each year due to the decline in physical strength, mobility and balance. These falls can produce fractures, loss of independence, disability, hospitalizations, future falls or death. Progression in both medical care and rehabilitation helps to reduce the occurrence of geriatric disability.

Definition of Geriatric Rehabilitation

• Geriatric rehabilitation services are an established medical intervention for older adults from all physical capability levels to increase and regain endurance, strength and physical independence after a fall, disability or illness. Some of the most common diagnoses physical and occupational therapists treat include orthopedic injuries, neurological insufficiencies, balance issues, pain and ambulation problems.

The Initial Evaluation

• After a physician determines that a patient requires rehabilitation, an evaluation is performed by a licensed physical or occupational therapist. During the comprehensive initial evaluation, the therapist will review patient medical history, current diagnosis, medications, living conditions, current and past activity levels and recovery goals. The therapist will then assess the patient’s pain, movement, strength, endurance and flexibility levels associated with disease, illness or disability.

  Once the initial evaluation has been performed, an individualized exercise program is established based on the patient’s medical condition and goals. The exercises chosen by the therapist will work to improve muscular strength and endurance, increase joint mobility and flexibility, decrease pain, and promote appropriate movement patterns of muscles and joints affected by the medical condition.

Exercise to Increase Strength and Mobility

• Geriatric rehabilitation exercises may consist of activities such as stretching, ambulation, resistance training, tai chi, yoga, balance activities, aquatic therapy and exercises specifically designed for a particular injury or condition. Geriatric rehabilitation exercises promote an increase in strength and mobility. The goal of geriatric rehabilitation is for patients to return to their prior functional levels as quickly and safely as possible.

  Sometimes it is appropriate for the therapist to assist in the movement of a muscle or joint as a form of exercise following a stroke or other neurological disease or if active range of motion is contraindicated. The therapist may also educate patients in compensatory techniques for those who do not have full motion of a joint and/muscle due to disease, illness, neurological deficits or fracture.

Exercise to Reduce Fall Risk

• Exercise can also decrease fall risk through the improvement of balance, lower extremity strength and core strength. Exercise improves the strength of the muscles that control balance. The physical or occupational therapist may have the patient perform exercises while sitting, standing or a combination of the two to work various muscles and increase confidence in standing. Resistance activities significantly increase balance, improve bone density to assist in inhibiting osteoporosis (which can produce falls and fractures), and increase the sense of happiness and self-confidence.

After Rehabilitation

• Once goals have been met and function is restored, the therapist will give the patient exercises to be performed at home to maintain the achieved level of function, supported by appropriate printed handouts. It is important that the patient follow all of the exercises and perform them as directed by the therapist to maintain functional abilities.