Final Exam: Week 8 Musculoskeletal Flashcards
What is the most common type of joint disease among older adults and is one of the leading causes of disability?
Osteoarthritis
What causes osteoarthritis?
Cause is UNKNOWN→ related to wear and tear on joints
OA non-modifiable risk factors
Age and family history
OA modifiable risk factors
Obesity, physical occupations, participation in contact sports
Most common OA sites
Hip, knee, spine, big toe and thumb/finger joints
How to manage OA?
- Address modifiable risk factors→ weight and activity
- Strength training→ greater muscular support of joints decreases reliance upon bony joints
- Medication→ anti-inflammatory
- Joint replacement
When is joint replacement for OA necessary?
SEVERE disease
Osteoporosis
Comprised bone density predisposing to risk of fragility fracture
Common fracture sites with osteoporosis
Vertebrae, hip, and wrist
After an osteoporosis fracture there is increased…
Mortality risk
How to manage osteoporosis?
- Multicomponent exercise program→ resistance and balance training
- Consultation with PT→ precautions are being followed
Most common type of amputation
Lower limb
Greatest risk factor for amputation
Long-term diabetes
Other risks for amputation
Peripheral vascular disease, trauma, and cancer
Issues with prosthetics
Difficulties in many contexts, mainly psychosocial and bereavement
How to manage amputations
- Team approach
- Goals→ pain management, return to function, psychosocial issues, psychotherapy
- Interventions→ exercise, pain management, functional interventions, psychotherapy
Parkinson’s disease
Progressive, age-related neurodegenerative disease
Cause is unknown
Parkinson’s disease is characterized by…
Voluntary and involuntary movement dysfunction and resting tremor/rigidity→ especially difficulty in initiating motion
Nonmotor symptoms of Parkinson’s
- Pain
- Depression and anxiety
- Fatigue
- Memory impairment
- Sleep disturbances
- Autonomic dysfunction
Management of Parkinson’s
- Pharmacological
- Rehabilitation (PT and OT)
- Assistive devices
Definition of a fall
- Any unplanned decent
- Event that results in a person going to the ground or other lower level WITH or WITHOUT injury
About ____ of adults will fall each year
1/3
Costs of falling for older adults
Function, quality of life, cost of care
Consequences of falls
- About 1/4 of falls result in injury
- Many people never fully recover to their prior x’al status
- Death
Most common injuries resulting from falls
- Bruises, contusions, lacerations
- Sprains
- Fractures (pelvis, hip, UE, spine, skull, ankle)
Risk factors for falls
- Intrinsic→ medical conditions
- Extrinsic→ environment (slippery floor)
Both of these factors can be changed with intervention
Fear of falling
- May be present even if person has never fallen
- Results in anxiety and self-restricting activity
- May lead to deconditioning→ increase in fall risk
Interventions for falls
Fall prevention education
Exercise→ resistance and balance
Functional intervention→ assistive devices, ADLs, gait and balance
Interventions for fear of falling
- Improve balance and muscle strength
- Eliminate environmental hazards
- Education
Goal of rehabilitation
To provide people with the tools they need to attain the highest possible level of independence
Keys to successful rehab
- Broad perspective
- Identification and management of→ medical, social, psychological problems, occupational performance
- Understanding of difference between “normal aging” and pathological changes
____% of those 70 and older have some sort of disability
20%
____% of those 85 and older have some sort of disability
50%
Most common causes of disability
- Chronic diseases
- Injury
- Mental impairments
- Malnutrition
- Communicable diseases (HIV/AIDS)
Definition of loss
Irrevocable and can be any valued object (loved person, job, status, home, possession, health)
Grief is our response to…
Loss, often includes the loss of the future as we expect it
Can ve sudden, gradual, anticipated, temporary, or permanent
Impact of trauma and illness
- Loss of sense of self
- Loss of connectedness
- Loss of power
- Loss of valued roles
How OTs help in processing loss
- Dialogue and relationship
- Spend time talking about the grief
- Focus on process rather than outcome
- Process of life review
- Being present
Challenges for those with intellectual disease
- They may have had previous negative experiences with care providers.
- Their parents may have been primary care providers and are now themselves aging or dead
Issues for individuals with serious mental illness
- Shorter life expectancy
- Physical issues overlooked or not treated
Issues for individuals with long standing physical disabilities
- Musculoskeletal problems
- Declining energy and strength
- Osteoporosis
- Stress
- Higher pain levels
