Final: Geriatric Patient Lab

Question 1

What is the most common MSK complaint of elderly?

Answer 1

Lumbosacral pain

-loss of muscle mass->decrease strength/stamina->pain

Question 2

How do you assess for fall risk?

Answer 2

Get Up and Go Test

->12s means fall risk

Question 3

Do old people prefer direct or indirect?

Answer 3

Indirect

Question 4

Whats the first step in FPR?

Answer 4

Flatten the curve!

-then add compression and localize indirect

Question 5

Whats the first step in Stills?

Answer 5

Localize to indirect

-then compress/traction and move into RB

Question 6

LE extension=lumbar ____ E/F?

Answer 6

Extension

So LE F=Lumbar F

Question 7

Which way would you lumbar sidebend with R LE ABduction?

Answer 7

To the R

Question 8

Which way would you lumbar sidebend with R LE ADduction?

Answer 8

To the L

Question 9

Right lower extremity internal rotation rotates the lumber to the..?

Answer 9

Left

-imagine it going the same direction as your knee cap

Question 10

Right lower extremity external rotation rotates the lumbar to the..?

Answer 10

Right

-imagine it going the same direction as your knee cap

Question 11

Prone Neutral Lumbar FPR (opposite letter)

Answer 11

Pt prone, doc contra to PTP

1. Flatten the curve with pillow under stomach
2. Compress with LE
3. Slight E and IR contra leg
4. ABduct contra leg

Question 12

Prone Extended Lumbar FPR (same letter)

Answer 12

Pt prone, doc contra to PTP

1. Flatten the curve with pillow under stomach
2. Compress with LE
3. Slight E and IR contra leg
4. ADduct contra leg

Question 13

Prone Flexed Lumbar FPR

Answer 13

Pt prone, doc ipsi to PTP

1. Flatten the curve with pillow under stomach
2. Compress with LE (knee off table!)
3. Slight F and ER contra leg
4. ABduct ipsi

Question 14

Right Superior Pubic Shear Tx (FPR and Still’s)

Answer 14

Flex and compress R knee
Gentle ADduct and ER the LE
–superior motion at pubs

FPR hold for 3-5s
Stills IR to direct barrier

Question 15

Right Inferior Pubic Shear Tx (FPR and Still’s)

Answer 15

Flex and compress R knee
Gentle ADduct and IR the Right LE
–inferior motion at pubs

FPR hold for 3-5s
Stills ER to direct barrier

Question 16

Supine Innominate Shear Treatment (FPR and Still’s)

Answer 16

ER and abduct LE to gap SI Joint
-add compression through foot

FPR hold for 3-5
Stills IR while applying traction

Question 17

How do you do a simplified sacral motion exam?

Answer 17

Pt is prone, Pillow is placed under abdomen

-direct cephalad force at ILA simultaneously

Question 18

What is a positive test for the simplified sacral motion exam?

Answer 18

(+)=Diminished cephalad motion

-restriction at one side or other

Question 19

Prone Sacral FPR Tx

Answer 19

Stand Ipsi to Restricted Side

1. Flatten curve w pillow
2. Flex ipsi leg off table w knee extended until ILA moves posterior
3. Slight abduction at hip and fine tune w IR/ER
4. Compress through ILA
5. Hold 3-5s

Question 20

How does exercise benefit elderly?

Answer 20

Most efficient lymph pump
Sym/Psym balance
Proper perfusion of joints
Maintians neuroplasticity
Encourages bowel movements

Sitting is the new smoking!

Question 21

What is an attainable goal for elderly?

Answer 21

150 mins of moderate intensity per week
-start at 5-10 if needed

Swimming, walking, or other low impact

Question 22

What muscles does the trendeleburg test, test?

Answer 22

Your abductors (gluts)

Question 23

Which way does your hips dip during a trendelenberg gait?

Answer 23

Will fall away from pathologic side

Will raise toward pathologic side

Question 24

What are some great exercises to strengthen your gluts?

Answer 24

Body weight stuff with chair
Back Bridge
Clamshell

Question 25

What are some modified stretches with a chair older pts can do?

Answer 25

Modified:

• psoas (still seems kind of excessive, can’t see my grandma doing that?)
• hamstring
• gastroc

Hold for 20s

Question 26

What is another way to train older people so they don’t fall?

Answer 26

Practice balance!
-use chair, eyes open and closed

Make harder by extending knee or close eyes