scholarly journals DYNAMICS OF PHYSICAL FUNCTIONING PARAMETERS IN THE ELDERLY ADULTS WITH FRAILTY AND INSULIN RESISTANCE UNDER THE INFLUENCE OF THE PHYSICAL THERAPY PROGRAM

2020 ◽  
Vol 4 (14) ◽  
pp. 79-87
Author(s):  
N.P. Koval
Keyword(s):  
Insulin Resistance ◽  
Older Adults ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Physical Functioning ◽  
Fall Risk ◽  
Physical Therapist ◽  
Frailty Syndrome ◽  
Therapy Program ◽  
Physical Therapy Program

Aim: to determine the effectiveness of physical therapy program according to the parameters of physical functioning in older adults with frailty syndrome and insulin resistance. Material and methods. Ninety six older adults were examined. The control group consisted of individuals without signs of insulin resistance and frailty syndrome. The main group 1 (MG 1) consisted of persons with insulin resistance and frailty syndrome who did not want to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations according to the WHO CINDI program (modification of nutrition, expansion of household and training physical activity). The main group 2 (МG2) included patients who agreed to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). A program of physical therapy with the using of kinesіоtherapy, massage, nutritional correction, education of the patients and their families, elements of cognitive training and occupational therapy for 1 year was developed for them. The dynamics of the condition was evaluated by the results of wrist dynamometry, Timed Up and Go test, a 6-minute test, Functional Mobility Assessmetn in Eldery Patients, Bartel index. Results. Older adults with frailty and insulin resistance demonstrated a statistically significant deterioration in physical function compared to peers (coordination, balance, strength, flexibility, endurance, agility skills according to the results of tests), which increases the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in МG1 led to a statistically significant improvement in the parameters of physical functioning, reducing the intensity of signs of frailty and the fall-risk, reducing the degree of dependence in domestic functioning, indicating the biopsychosocial effect of the program. The low level of therapeutic alliance of МG2 individuals led to unsatisfactory implementation or non-implementation of the provided recommendations and was associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology – frailty and metabolic syndrome.

scholarly journals Effect of Physical Therapy on Fall-Risk and Physical Status in Older Adults with Frailty and Metabolic Syndrome

2020 ◽  
Vol 5 (6) ◽  
pp. 282-291
Author(s):  
N. P. Koval ◽  
◽  
M. G. Aravitska
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Metabolic Syndrome ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Fall Risk ◽  
Physical Therapist ◽  
Main Group ◽  
Frailty Syndrome ◽  
Physical Status

The constant increase in the proportion of the disabled or partially disabled elderly population and, accordingly, patients of this age contingent, leads to the need for rehabilitation and physical therapy of persons with geriatric syndromes and various comorbid pathologies. The purpose of the study was to determine the effectiveness of a physical therapy program based on the dynamics of indicators of the fall-risk and physical status in older adults with frailty syndrome and metabolic syndrome. Material and methods. 96 older adults were examined. The control group consisted of persons without metabolic syndrome and without frailty syndrome. The main group 1 consisted of persons with metabolic syndrome and frailty syndrome who did not express a desire to cooperate with a physical therapist and / or actively improve their health on their own (low level of therapeutic alliance). They were provided with recommendations on the WHO CINDI program (diet modification, extension of household and training physical activity). Main group 2 included patients who showed consent to take active steps to improve their own health under the supervision of a physical therapist (high level of therapeutic alliance). We developed a physical therapy program for them using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for one year. The dynamics of the state was assessed according to the results of the Short Physical Performance Battery, hand dynamometry, Senior Fitness Test, the Berg Balance Scale. Results and discussion. Older adults with metabolic syndrome and frailty syndrome demonstrated a high fall-risk (according to the results of a Short battery of physical activity tests and the Berg scale) and a statistically significant lag in physical status parameters (coordination, balance, strength, flexibility, endurance, agility) according to the parameters of the Senior Fitness Test, hand dynamometry, Short battery of physical activity tests) from their peers. These results increase the risk of adverse health effects, loss of autonomy and death. The use of physical therapy in main group 1 subjects led to a statistically significant (р<0.05) improvement in physical qualities, a decrease in the intensity of frailty signs; leveling the fall-risk in them. The low level of therapeutic alliance of persons in the main group 2 led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided and is associated with a lack of improvement in their physical status and a high fall-risk. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology of frailty and metabolic syndrome

scholarly journals A Demonstration of Physical Therapy

1977 ◽  
Author(s):  
Jerry Weissman ◽  
Carolyn Zottoli
Keyword(s):  
Physical Therapy ◽  
Physical Fitness ◽  
Physical Therapist ◽  
Exercise Programs ◽  
Home Program ◽  
Therapy Program ◽  
Orthopedic Procedure ◽  
Physical Therapy Program

It has been generally accepted that physical therapy has a role to play in the total habilitation and rehabilitation of the hemophillic patient. These types of services are readily provided within the framework of a comprehensive hemophilia clinic.All patients are advised as to physical fitness and recreational type activities. In addition, most patients are on a home program of specific exercises directed at specific orthopedic problems. Physical therapy is also available through our out-patient clinic when it is felt that the assistance and supervision of a physical therapist is required. An evening clinic is held to accommodate those working or attending school. In-patient physical therapy is most commonly reserved for those patients who have undergone an orthopedic procedure though, on occasion, patients have been admitted solely for an intensive physical therapy program.The concepts underlying the exercise programs are similar to the ones used in managing arthropathies of other etiologies. Special exercise techniques will be demonstrated.

scholarly journals The results of the analysis of the criteria of therapeutic alliance of patients orthopedic profile of outpatient physical therapy program

2019 ◽  
Vol 5 (3) ◽  
pp. 15
Author(s):  
S.M. Fedorenko ◽  
V.V. Vitomskyi ◽  
О.B. Lazarіeva ◽  
M.V. Vitomskа
Keyword(s):  
Statistical Analysis ◽  
Physical Therapy ◽  
Therapeutic Alliance ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Medical Center ◽  
Scientific Information ◽  
International Classification Of Functioning ◽  
Therapy Program ◽  
Literary Sources

<p><strong>Objective:</strong> to determine the peculiarities of forming a therapeutic alliance in outpatients with disorders of orthopedic profile after completing a course of physical therapy and their physical therapists depending on the psychotype of patients.</p><p><strong>Methods of research:</strong> theoretical analysis and generalization of literary sources, method of systematization of scientific information; Working Alliance Inventory questionnaire Form SF Hatcher (WAI). Patients were grouped using the International Classification of Functioning and Disease Types. The obtained results were processed by adequate methods of mathematical statistics. The study involved 113 patients who underwent a course of physical therapy at FESCO Medical Center during 2013-2015.</p><p><strong>Results.</strong> According to the results of the statistical analysis, patients with irrational attitude to the disease (irrational psychotypes) had significantly lower scores on the eight items of the WAI questionnaire out of twelve, as well as on all three totals. In particular, the «goal» score was significantly better in patients with rational psychotypes: Me (25; 75) scores were 14 (12.75; 15) points, versus 12 (11; 14) scores among patients with irrational psychotypes (p&lt;0,01). Similarly, the score of the "task" was 15 (13; 15) points against 12 (11; 15) points (p &lt;0.01), and the total score of the "bond" points 16 (16; 17) points against 14 (13; 15) points (p &lt;0.01). Thus, it can be stated that the evaluation of the “goal” items showed the lowest results, which were the farthest from the maximum values.</p><p><strong>Conclusion.</strong> The results obtained and the statistical analysis made it possible to evaluate the different sides of the level of formation of the therapeutic alliance, to identify the strengths and weaknesses and, thus, necessitated the development of ways to improve the union of the patient and the physical therapist.</p>

scholarly journals When More Than Exercise Is Needed to Increase Chances of Aging in Place: Qualitative Analysis of a Telehealth Physical Activity Program to Improve Mobility in Low-Income Older Adults (Preprint)

2018 ◽  
Author(s):  
Kathy VanRavenstein ◽  
Boyd H Davis
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Physical Therapy ◽  
Social Isolation ◽  
Low Income ◽  
Qualitative Interviews ◽  
Aging In Place ◽  
Exercise Program ◽  
Therapy Program ◽  
Physical Therapy Program

BACKGROUND A telehealth-delivered physical activity program was implemented within two low-income older adult housing properties utilizing the Otago exercise program, a physical therapy program endorsed by the Centers for Disease Control and Prevention to improve balance and strengthening in community dwelling older adults and by the National Council on Aging as the highest level of evidence for fall prevention programs. Participants were also given Fitbit activity monitors to help track their activity. OBJECTIVE The goal of this project was to increase older adults’ daily physical activity in hopes of decreasing chronic disease morbidity, disability, and falls, and decrease social isolation. METHODS The Otago exercise program was conducted via telehealth twice weekly for 12 weeks. Participants also wore Fitbit activity trackers to encourage physical activity outside of the group classes. Postintervention qualitative interviews were conducted, recorded, transcribed, and analyzed using discourse analysis. RESULTS Twenty-one older adult participants from two low-income properties in Charleston, SC, participated in the 12-week telehealth physical therapy program. Postintervention qualitative interviews revealed that the two sites were very different in their participation in the program and their main concerns surrounding aging in place. One site had a community-oriented outlook and enjoyed participating in physical activity together; whereas, the other site had very few participants and referenced depression and social isolation as main concerns. CONCLUSIONS A telehealth physical therapy-led intervention to increase physical activity in low-income older adults aging in place was successfully implemented and attended; however, it became clear in postintervention qualitative interviews that social isolation and depression were prevalent and mental health needs to be addressed along with physical health to encourage successful aging in place.

Low frequency transcranial magnetic stimulation in subacute ischemic stroke: Number of sessions that altered cortical excitability

2020 ◽  
Vol 47 (4) ◽  
pp. 427-434
Author(s):  
Mohammed S. El-Tamawy ◽  
Moshera H. Darwish ◽  
Saly H. Elkholy ◽  
Engy BadrEldin S. Moustafa ◽  
Shimaa T. Abulkassem ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Magnetic Stimulation ◽  
Physical Therapy ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Low Frequency ◽  
Cortical Reorganization ◽  
Therapy Program ◽  
Physical Therapy Program

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.

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