March 25, 2019

The Balancing Act of Aging

By Ryan Batdorf, PT, DPT, CMTPT, CVRS

The statistics on falls for the elderly are stark: Every 11 seconds, an older adult is treated in the emergency room for a fall.  Every 19 minutes, an older adult dies from a fall.

Gait and balance require freely moving joints, proper muscle function and strength, and accurate visual and proprioceptive input.  As we age, we lose strength and flexibility and develop impaired neurologic feedback, posture and balance.  Early detection of these changes and deficits can help reduce the fall risk of the elderly population.  These changes, in combination with other risk factors, increase the likelihood of falls.

What’s the best way to identify deficits in the elderly? One is the functional evaluation for seniors, which consists of a series of 15 functional movement tests that compare one’s level of physical ability to benchmark norms for age groups 60-90 years old.  These tests are backed by specific, published research.  The test results are compared to the “norms” in balance, strength, ROM, endurance and posture to identify deficits.  I believe that all individuals over the age of 60 should undergo the functional evaluation for seniors annually to monitor changes from year to year.

Following a functional evaluation for seniors, a physical therapist will review the results of the tests and evaluation findings with the individual and their family or caretaker.  Next, a treatment plan will be recommended.  If the deficits are minimal and the senior is an active individual, they may be encouraged to continue their normal exercise program and active lifestyle to maintain function.  If there are significant deficits, it may be recommended that the individual undergo physical therapy treatment.  Physical therapy will include a prescription of exercises and treatment techniques designed to address balance, strength, ROM, endurance and postural issues.

Dr. Carole B. Lewis, DPT, GCS, GTC, MSG, PhD, FAPTA, is a private practitioner and creator of the functional evaluation for seniors. She stated in the Atlas of Science: “I foresee a future in which physical therapists use their knowledge and skill to assess and fix functional problems with appropriately prescribed and monitored exercise and their arsenal of treatment options. Functional assessment and exercise are not one size fits all quick fixes. They are part of a timed, incremental, and long-term approach perfected through expertise and skilled patient motivation…Everyone, but especially middle aged and older persons will benefit significantly from annual screenings conducted by physical therapists, much like annual dental checkups. A tweaking or prescription for a more detailed intervention can help prevent disability in the future.”

Physicians and physical therapists can work together to help prevent falls and decrease the functional effects of the aging process.

Ryan Batdorf, PT, DPT, CMTPT, CVRS is the Clinic Director and Director of Senior Functional Evaluation Program at the Lewes, DE clinic at Pivot Physical Therapy.