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Inpatient Rehabilitation Acute, Subacute, and in Community Settings
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Older patients are transitioned to rehabilitation settings for the management of disabilities caused by illness, injury, and/or hospitalization. A care transition is the movement of the patient from one healthcare setting to another. Older adults are at an increased risk of suboptimal care during care transitions. Rehabilitation professionals play a critical role in efficient and safe care transitions by determining the appropriate level of care based upon the intensity of services that older patients need. Medical and geriatric rehabilitation addresses the patient’s current functional status and rehabilitation goals with the intent to optimize the individual’s function, and facilitate independent living. The process involves addressing diseases, particularly multiple medically complex conditions in the context of disability. Based upon the intensity of services (including medical management and rehabilitation) required by the individual, the level of care setting is determined. Transitions of care may also be appropriate for older adults living independently in communities, when they require inpatient and outpatient rehabilitation.
Introduction
Published in Ann Burkhardt, Jodi Carlson, Complementary Therapies in Geriatric Practice, 2014
This volume describes several topics in complementary care which are important in geriatric rehabilitation. Therapist involvement in spirituality is of growing interest, and this topic reaches across all boundaries of complementary care. Mental Rehearsal, Tai Chi Chuan, and Energy Therapies are all examples of specific modalities or methods which can be used to enhance outcomes in rehabilitation treatment. And, finally, Well Elderly approaches to treatment are useful both in rehabilitation and prevention of the problems of aging. By providing information about these topics, we hope to expand possibilities in geriatric rehabilitation and prevention to enhance patient outcomes.
The Geriatrician
Published in Stefano Federici, Marcia J. Scherer, Assistive Technology Assessment Handbook, 2017
Martina Pigliautile, Lorenza Tiberio, Patrizia Mecocci, Stefano Federici
Geriatric rehabilitation can be provided in a rehabilitation clinic, subacute rehabilitation unit, skilled nursing facility, or via home health assistance. The basic team consists of different subspecialty professionals, such as a physical therapist, who will assess a wide array of abilities, including strength, balance, transfer (rising from a chair), and walking. An occupational therapist evaluates the following: self-care skills, ADL, and the home environment. The occupational therapist can also provide training on how to use assistive technologies, incorporating meaningful activities to promote participation in everyday life. The occupational therapist assesses the patient's ability to perform his or her daily activities, whereas the physical therapist focuses on improving mobility. In addition, other professional members of the rehabilitation team are the speech therapist, nurse, social worker, dietician, psychologist, physiatrist, and pharmacist (Brown and Peel, 2009; Tsukuda, 1990). Rehabilitation treatment requires collaboration between team members, the patient, and his/her family. On the one hand, the patient should play an active part in the care and decision-making process, and, on the other, the family should ideally receive training in how to assist the older patient at home. This involvement influences not only rehabilitation outcomes but also the quality of life of the patient in all aspects: functional, physical, social, and emotional. A patient's satisfaction with care tends to be greater when there is such involvement (Toseland et al., 1996). This approach is in line with the biopsychosocial model, where the functioning of an older patient is not only observed in association with health condition but is also linked to personal and environmental factors. In order to prescribe an appropriate rehabilitation treatment, the health-care team should have a common understanding of health and functioning in a disability context. The International Classification of Functioning, Disability, and Health (ICF) model provides a helpful framework that illustrates why geriatric rehabilitation must be an interdisciplinary activity (WHO, 2001).
Use of surface electromyography to evaluate effects of whole-body vibration exercises on neuromuscular activation and muscle strength in the elderly: a systematic review
Published in Disability and Rehabilitation, 2022
Bruno Bessa Monteiro-Oliveira, Ana Carolina Coelho-Oliveira, Laisa Liane Paineiras-Domingos, Anelise Sonza, Danúbia da Cunha de Sá-Caputo, Mario Bernardo-Filho
The Elderly has movement, physical and environmental restrictions and because of these restrictions, they choose to remain sedentary and inactive. In consequence, it is extremely desired to encourage them to perform physical exercise [26]. Physical exercise is a very effective non-pharmacological intervention to prevent effects of the aging [14,15]. Physical exercise decreases or reverses muscle weakness leading to muscle hypertrophy in healthy elderly people [27]. Authors demonstrated positive effects of exercise on the individual components of sarcopenia, such as muscle strength [27], muscle quality and quantity [28], and physical performance [28]. Nevertheless, it is relevant to identify alternative modalities of useful and suitable exercises, such as the whole-body vibration (WBV) exercise for the elderly. This type of exercise seems to have high relevance in geriatric rehabilitation as a form of physical exercise [29–31].
Physiotherapists’ experiences and views of older peoples’ exercise adherence with respect to falls prevention in Singapore: a qualitative study
Published in Disability and Rehabilitation, 2022
Bernadine Teng, Ingrid C. M. Rosbergen, Sjaan Gomersall, Anna Hatton, Sandra G. Brauer
In September and October 2019, 21 physiotherapists were invited to participate and 16 provided written informed consent (2 males; 14 females). Five did not participate (one was not eligible, two were not well on the day and two were not available on the dates/time of focus groups). The mean working experience of all participants was 10.5 years (SD = 5.9). The physiotherapists had an average of 6 years (SD = 4.5) working in geriatric rehabilitation. Most participants were Chinese (n = 13), two Malay and one of Indian ethnicity. The majority of physiotherapists (n = 12) completed their undergraduate training in Singapore. Focus groups ranged from 50 to 60 min in duration. Data saturation was reached after three focus group discussions. After analysis, three main- and nine sub-themes emerged which are summarised in Table 2.
The Relationship Between Performance of Sit-To-Stand From a Chair and Getting Down and Up From the Floor in Community-Dwelling Older Adults
Published in Physiotherapy Theory and Practice, 2022
Gunay Ardali, Rebecca A. States, Lori T. Brody, Ellen M. Godwin
Functional assessment is the cornerstone of geriatric rehabilitation. There is a growing body of convincing evidence that supports the use of simple, functional performance tests of transitional maneuvers such as “getting down and up from the floor” and “sit-to-stand (STS) from the chair” in the assessment of geriatric patients (Ardali, Brody, States, and Godwin, 2019; Bergland and Laake, 2005; Jordre et al., 2013; Silva, Quintino, Franco, and Faria, 2014; Vaidya, Chambellan, and de Bisschop, 2017). These fundamental, transitional mobility maneuvers are required for safe and independent living (Bergland and Laake, 2005; Bohannon, 2012; Corrigan and Bohannon, 2001; Klima et al., 2016). Effective functional levels of muscle strength/power, coordination, body composition, balance, and flexibility are necessary for the body to successfully transition from a standing to a supine or a sitting position, and similarly to rise from either the chair or floor (Bohannon, 2012; Bohannon and Lusardi, 2004: Brito et al., 2014; Murphy, Olson, Protas, and Overby, 2003). Unfortunately, the performance of these essential activities can become challenging for many older adults for reasons such as advanced age, limited lower extremity range of motion, reduced lower extremity strength, and decreased standing balance (Bohannon, 2012; Bohannon and Lusardi, 2004; Tatum, Bradley, and Igel, 2011