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OT 401: OP & Context for Older Adults > Final Exam: Week 7 Musculoskeletal > Flashcards

Final Exam: Week 7 Musculoskeletal Flashcards

1
Q

Neuromuscular changes with age

A

↓ muscle strength & power
↓ skeletal muscle mass
↓ number of functional motor units
Changes in postural alignment
Bone and cartilage changes
Changes in balance and gait
↓ max speed of movement and initiation in response to stimuli
↑ threshold for vibration sensation (decreased sensitivity)
↓ proprioception

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2
Q

Physically elite

A

Train on a regular basis in sports competitions, continue to work in demanding occupation

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3
Q

Physically fit

A

May still work, may participate in activities with folks younger than them, continue to exercise regularly

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4
Q

Physically independent

A

Participates in IADLs and is still active in leisure and hobbies. May have one+ chronic conditions, function independently

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5
Q

Physically frail

A

Lives independently with some assist, may be unable to engage in some IADLs

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6
Q

Physically dependent

A

Cannot perform some ADL/IADL, requires institutional care or full-time assistance

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7
Q

Strength

A

Force of muscle contractions and ability to generate force quickly

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8
Q

Power

A

Timing and coordination

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9
Q

Why do strength and power decrease with aging?

A
  • Decrease in number and diameter in myofibrils and certain types of muscle fibers
  • Neurological changes that control muscle contraction
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10
Q

What changes occur in strength?

A
  • Minor until age 60, then becomes more rapid
  • Isometric & Concentric strength in UE declines less than LE
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11
Q

What changes occur in power?

A
  • Decreases more quickly than strength
  • Example of functional activity that requires power is walking or standing up from a chair – timing and coordination of that muscle contraction
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12
Q

Sarcopenia

A

Progressive muscle wasting and decrease in strength with aging

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13
Q

Changes in muscle

A

Less elasticity, more fat, neurological changes, atrophy of some fibers, hypertrophy of others, number of myofibrils

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14
Q

Difference between muscle atrophy and sarcopenia?

A

Sarcopenia is AGE RELATED
Atrophy is muscle SHRINKING

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15
Q

Elements of physical function

A

Strength+power+endurance+coordination+balance+flexibility

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16
Q

Ways loss of strength affects physical function in older adults

A
  • Many ADLs and IADLs take power and strength (raking, stairs, exit a car)
  • Reduced ability to balance with decreased base of support
  • Walking speed slowed, stride length decreased
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17
Q

Why are impairments in muscle power more influential than decreased strength on an older adult’s ADL function and mobility?

A

Decreases more quickly, standing up or getting up from a chair requires muscle power…lose ability to do simple movements

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18
Q

Decreased LE muscle power correlates with…

A

Stairs and getting out of chairs

19
Q

Impaired balance leads to…

A

More disability

20
Q

Age-related changes to the bones

A
  • Loss of bone density
  • More susceptible to fracture
21
Q

Age-related changes to cartilage, joints, and tendons

A
  • Cartilage is more dense, stiff, thins out, deteriorates
  • Joints and tendons: tighter and less flexible
  • Matrices of collagen become denser, the collagen structures become stiffer, and the cellular movement of nutrients and wastes becomes impaired
  • ROM decreases 20-30% between ages of 30-70
22
Q

Osteocytes

A

Bone maintenance

23
Q

Osteoblasts

A

Bone formation

24
Q

Osteoclasts

A

Bone resorption

25
Q

Non-modifiable factors contributing to bone health

A
  • Age
  • Cellular regulation
  • Gender
  • Ethnicity
26
Q

Modifiable factors contributing to bone health

A
  • Nutrition
  • Exercise
  • Body weight
  • Hormones
    Help reduce the rate at which bone is lost
27
Q

As elastin decreases…

A

Elasticity of the tissues is decreased

28
Q

What kind of joints experience the most thinning and deterioration of cartilage?

A

Weight bearing joints

29
Q

What contributes to joint stiffness?

A

Decreased…
- Water content
- Hydration
- Elasticity of the joint capsule
Increased…
- Fibrous growth

30
Q

Functional consequences of connective tissue changes

A
  • Loss of flexibility
  • Loss of ROM
  • Loss of IADL, ADL, and mobility
  • Increased fall risk
31
Q

Postural changes with age

A
  • Flexed posture is MORE common
  • Forward head position is typical
  • Altered lordotic curve (flattened or exaggerated)
  • Rounded shoulders
  • Flexed hips and knees
32
Q

What is thoracic hyperkyphosis?

A

Forward head position

33
Q

Causes for postural alignment changes

A
  • Muscle weakness
  • Decreased ROM
  • Loss of spinal flexibility
  • Vertebral compression fractures
34
Q

Age related changes to the nervous system

A
  • Cerebral atrophy
  • Increased CSF space
  • Specific neuronal loss
  • Reduced dendritic branching
  • Increased lipofuscin granules
  • Decreased effectiveness of neurotransmitter systens
  • Reduced cerebral blood flow
  • Diminished glucose utilization
  • Alterations in EEG
35
Q

Lipofuscin granules definition

A

Considered to be one of the aging or “wear-and-tear” pigments

36
Q

Causes of age related changes to the nervous system

A
  • Changes in neurons and receptors
  • Loss of neurons
  • Decrease in myelin
  • Decrease in nerve conduction
  • Defects in protein synthesis
  • Cumulative trauma
  • Vascular changes
37
Q

Functional consequences of age-related changes to the nervous system

A
  • Altered gait
  • Increased fall risk
  • Impaired sensation
38
Q

Postural control

A

The ability to control the body’s position in space

39
Q

Typical changes in gait

A
  • Decreased step length and stride length
  • Slower walking velocity
  • Decreased cadence
  • Decreased ankle range of motion
  • Decreased push-off with the toes
  • Increased double-stance time
  • Decreased vertical displacement of center of mass
40
Q

Assessments for ROM, flexibility, strength, and power

A
  • Goniometry
  • Observation
  • Sit and reach test
  • MMT
  • Break test
  • Dynamometer
41
Q

Precautions for assessing elders

A
  • Caution with osteoporosis (fracture potential)
  • Concern about standing endurance/balance
42
Q

Management of neuromusculoskeletal impairments

A
  • Exercise (tailer to individual goals and needs)
  • Facilitators (self-efficacy and outcome expectation)
43
Q

Barriers to Tx plans

A
  • Fear of falling
  • Lack of time
  • Lack of social support
  • Lack of physical space to exercise
  • Insufficient resources $
44
Q

What to include in an exercise plan

A
  • Strength and resistance: walking, different isometric and isotonic movements
  • Flexibility and balance: static and dynamic stretching

OT 401: OP & Context for Older Adults (12 decks)

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