Geriatric Physiotherapy Assessment

Question 1

Role of Physio for Older Adults (4)

Answer 1

1. Educate patient, family and health care professionals to prevent and limit impairments, activity limitations and participation restrictions.
2. Promote prevention activities, health education and a healthy lifestyle.
3. Prescribing appropriate adaptive or assistive equipment.
4. Assessment of living environment to minimize risk of falls.

Question 2

Principals of Subjective Examination (6)

Answer 2

Based on the ICF.
- Physical health: OA, hearing, vision, urinary incontinence.
- Mental health: depression, cognition.
- Social factors: Family around?, living alone.
- Environment: stairs, lighting.
- Expectations
- Function: ADLs.

Question 3

Principals of Objective Examination (4)

Answer 3

Physical examination
Functional assessment
Fall risk assessment
Cognitive assessment

Question 4

Components of Subjective Examination (11)

Answer 4

• HOPC: fall, ↓ function, family want assessment?
• PMH: acute/chronic conditions, surgery?
• Physical/mental impairments: vision, hearing, dementia.
• Nutrition: need protein to counteract muscle mass loss.
• Mobility: walking aid, falls, balance.
• ADLs: KATZ, Barthel, transfers!
• IADLs: taking meds, shopping, cooking…
• Social history: Past and present, isolation?
• Cognitive impairments: mini COG
• Depression: Yale 1 question, geriatric depression scale.
• Meds: How many?! ↑ nr of meds -> ↑ risk of fall.

Question 5

Components of Objective Examination (3)

Answer 5

• Physical examination: physical function, balance and strength + flexibility.
• Functional assessment: mobility and gait, ADLs, stairs Ax, STS. (TUG)
• Fall risk assessment!: Balance/gait, recovery from loss of balance.

Question 6

Comprehensive Geriatric Assessment - What is it?

Answer 6

Multidimensional and holistic assessment, that leads to formation of a care plan, interventions and regular reviews to manage frail older adults.

Question 7

When to do Comprehensive Geriatric Assessment? (5)

Answer 7

When patient presents with frailty syndrome.
- GP visits, falls, confusion, ↓ mobility.
- Upon hospital discharge.
- In care homes.
- Clinical frailty score > 5

Question 8

Benefits of CGA? (5)

Answer 8

• Reduced mortality rate
• ↑ independence (for geriatrics living at home)
• ↓ hospital admissions and readmissions
• Management strategy for frail older adults
• Frailty progression can be reversed

Question 9

CGA - Elements of Assessment (4)

Answer 9

• Physical: sensory, footwear, gait and balance, BP, function, posture, pain/joints, weight/nutrition…
• Functional, social and environmental: Mobility and ADLs
• Psychological: mood & cognition
• Medication review

Question 10

Frailty Syndrome - 5 Main Criteria

Answer 10

Weakness
Slowness
Low level of physical activity
Self-reported exhaustion
Unintentional weight loss > 5 kg per year

Question 11

Interventions for Older Adults (5)

Answer 11

• Therapeutic exercise
• Functional training in self-care and home management.
• Manual therapy techniques
• Patient education + motivation!
• Exercise groups? -> social interaction

Question 12

What are the 5 domains of the CGA Framework?

Answer 12

Physical
Environmental
Social
Mental
Medication

Question 13

What is the difference between CGA and normal physiotherapy assessment?

Answer 13

Same domains but CGA is more extensive, patient has to have signs of frailty and > 65 y.o. Good for patients with multiple disorders.

Question 14

Minimum Frailty Score to do CGA?

Answer 14

> 5

Question 15

What outcome measures can be used in CGA? (5)

Answer 15

TUG
Barthel
KATZ
MOCA
Sit to Stand