Immobility and rehabilitation Flashcards
What happens to the prevelance of immobility/disability as age increases ?
It increases
What is the commonest type of disability ?
Problems with locomotion
What is the commonest cause of disability ?
MSK conditions
Appreciate this pic of some of the causes of functional limitations
Define what sarcopenia is
It is age related loss of muscle mass and function
What is the criteria for defining sarcopenia ?
You need to have criteria 1 + 2 or 3 or both:
- Low muscle mass
- Low muscle strength
- Low physical performance
when does muscle mass start to usually decline ?
Around 30yrs old and then accelarates at 60yrs old
Define what is meant by sarcopenic obesity ?
A condition defined as the presence of sarcopenia and obesity i.e. loss of muscle mass accompanied with increased fat
What does sarcopenic obesity increase the risk of?
Cardiometabolic disorders – insulin resistance, metabolic syndrome, cardiovascular disease
What are some of the consequences of sarcopenia ?
Muscle wasting causes decreased exercise capacity ==> decreased activity ==> increased risk of diabetes and increased bone loss ==> dependance on others
Increased bone loss ==> increased risk of fractures
Decreased energy used ==> increased fat deposition/obesity
Muscle weakness causes increased risk of falls
Appreicate the viscious cycle of immobility
What are some of the causes for the development of sarcopenia ?
Note cachexia = weakness and wasting of the body due to severe chronic illness
Define primary sarcopenia ?
Sarcopenia purley due to age
Define seconday sarcopenia
Sarcopenia due to one or more causes
What are the proven immobility treatments to reduce chances of sarcopenia development? (imagine these are are good for treating it too)
Excerise:
- Progressive resistance training to increase strength and endurance and functional measures e.g. gait speed, chair stands
- Aerobic training to increase endurance
Reduce sedentary time
What are the recommended physical activity levels for older people (>65) ?
Its the same as for other adults (18-64 years).
- 150 minutes a week of moderate intensity activity in bouts of 10 minutes or more. OR
- 30 minutes of brisk walking or equivalent activity 5x week OR
- 75 minutes of vigorous activity spread across the week or a combination of moderate and vigorous activity.
- Strength and balance work should also be carried out at least 2x week.
What are some of the other interventions which have some degree of evidence behind their use ?
- Nutrition – Calcium & Vitamin D, Protein supplementation
- Creatine
- ACE inhibitors
How can the effectiveness of immobility intervetions be measured ?
Physical activity monitors e.g. activPAL, stepwatch 3 etc
Define rehabilitation
A personalised, interactive and collaborative process, reflecting the whole person. It enables an individual to maximise their potential to live a full and active life within their family, social networks, education/training and the workplace where appropriate.
What may rehabilitation include (note this is not just for old people rehabilitation can occur at any point in someones life)
habilitation, reablement and recovery
What are the aims of rehabilitation ?
- Maximise the participation of the patient in his or her social setting;
- Minimise the pain and distress experienced by the patient;
- Minimise the distress of, and stress on, the patient’s family and carers.
Define reablement/recovery
The active process of an individual regaining the skills, confidence and independence to enable them to do the things for themselves, rather than having things done for them.
Define habilitation
The process of assisting an individual with achieving developmental skills when impairments have caused a delay or blocking of initial acquisition of these skills,
e.g. congitive, emotional/social, fine motor, gross motor or other skills that contribute to mobility, communication, socialisation, performance of activities of daily living and quality of life
Who may need rehabilitation ?
People with long-term conditions, illness, ageing people with general deterioration
What are the principles of rehabilitation/reablemnet ?
- Person centred e.g. find out what matters to them most
- Goal –directed
- Co-ordinated
- Improve outcomes
What are the principles of goals used in rehabilitation ?
- Used to Measure progress
- Evaluate intervention
- Realistic to motivate individual
- Adaptable
How is rehabilitation often measured?
- Impairment / activity specific assessments
- Activities of Daily Living (ADL) Scales
