ISSN: 2754-4745

Journal of Physical Medicine

Rehabilitation Studies & Reports

Review Article Open Access

The Role of Physical Therapy in Enhancing the Well-being of Elderly

Patients
Maheshkumar Baladaniya1* and Shraddha Baldania2

Physical Therapist Neighborhood Physical Therapy PC. Brooklyn, NY, USA

1

Exercise Physiologist Enjoy Rehab PT, PC. Syosset, NY, USA

2

ABSTRACT
The elderly population is growing, and with it, the demand for healthcare services that cater to their unique needs. Physiotherapists have traditionally
worked with older persons after an injury (e.g., a fall-related hip fracture) or event (e.g., a stroke). However, in order for our profession to make a substantial
contribution to the healthy aging agenda, we must use our knowledge in movement and exercise prescription, as well as our counseling skills, to encourage
our clients throughout the health continuum to be physically active in their daily lives. To summarize, we must incorporate physical activity promotion into
our work with older people in order to prevent chronic illnesses that impair their functional capacity, quality of life, and well-being.

*Corresponding author
Maheshkumar Baladaniya, Physical Therapist Neighborhood Physical therapy PC. Brooklyn, NY, USA.

Received: July 04, 2023; Accepted: July 11, 2023; Published: July 19, 2023

Keywords: Elderly Population, Movement and Exercise and vision loss, as well as a drop in immunological function.
Prescription, Stroke Prevention, Health Continuum, Chronic Cardiovascular disease, osteoporosis, and dementia are all frequent
Illnesses chronic illnesses in those over the age of 85. As the population
ages and grows more overweight, the prevalence of osteoarthritis,
Introduction diabetes, and related mobility disabilities will rise [8]. Osteoarthritis
Physical activity is a widely believed and supported method is the second most frequent chronic illness, causing chronic pain
for aging healthily. It specifically increases cognitive health and disability in elderly Americans. In one study, 52 percent of
and mobility, two fundamental qualities that are critical for 85-year-olds were diagnosed with osteoarthritis [9, 10]. According
functional capacity and strong indications of overall health to US Census research, 73% of Americans over the age of 85
[1]. Physical activity on a regular basis is the most effective had some difficulty walking. Mobility impairment is linked to
behavioral technique for improving health span and promoting social isolation, falls, and sadness. One-third of disabled adults
healthy aging [2]. Physical activity is an important technique over the age of 85 live alone [11]. Falls are a major cause of
for extending life expectancy since it successfully prevents morbidity and disability among older adults, with 30-40adults
chronic noncommunicable diseases like diabetes, cardiovascular over the age of 70 falling each year, and rates are especially
disease, and dementia [3, 4]. Falls prevention is an area where high for older adults in long-term care facilities. Falls account
physiotherapists have been instrumental in promoting healthy for more than half of injuries among older adults, with adults
aging [5]. Because many older persons who fall have several over the age of 85 having a higher rate of death [12]. A holistic
comorbidities, physiotherapists are most qualified to conduct approach to elder care emphasizes the importance of considering
this program, and physiotherapists have the expertise to tailor the all aspects of an individual’s well-being, including their physical,
program to individual needs [2]. mental, emotional, social, and spiritual health. This approach has
many benefits, including improved quality of life, personalized
Understanding the Elderly Population care plans, preventive and proactive care, empowerment and
In 2022, there will be 771 million persons aged 65+ worldwide, independence, and the involvement of family and friends.
accounting for about 10population. This category has been rising
at a rapid pace, and it is predicted to reach 16States alone, the The Role of a Physical Therapist
percentage of people 65 and older has more than tripled over the Older adult care is complicated since it involves several
last century, rising from 4.112.9Falls, cardiovascular disease, and conditions that require the expertise of numerous specializations.
trouble with everyday tasks are all prevalent, but not universal. Musculoskeletal, cardiovascular, and neurological diseases are
physiological changes of normal aging, diseases, and syndromes common among the elderly [13]. These categories may overlap
frequent in persons over the age of 85, cognitive and psychological since older persons frequently have multiple medical conditions.
changes, social and environmental changes, and then addresses Because of the aging influence on older adults’ health status
common discussions that clinicians engage with these patients and illness pattern of presentation, it is recommended that
and their families regularly. Normal aging includes some hearing physiotherapy in older adults be trained in musculoskeletal,

J PhyMed Rehab Stud Rep, 2023 Volume 5(4): 1-7

Citation: Maheshkumar Baladaniya, Shraddha Baldania (2023) The Role of Physical Therapy in Enhancing the Well-being of Elderly Patients. Journal of Physical
Medicine Rehabilitation Studies & Reports. SRC/JPMRS-217. DOI: doi.org/10.47363/JPMRS/2023(5)192

neurological, and cardiovascular assessment and management year, more than one-third of people 65 and older fall, and half
of older persons. A physiotherapist specializing in geriatric of these falls are recurring [20, 21]. A serious injury, such as a
care should consequently have a thorough understanding of hip fracture, other fracture, subdural hematoma, other serious
physiotherapy methods in all three areas, focusing on the care soft tissue injury, or brain injury, occurs in approximately one
of older persons [14]. Physiotherapy is a key component of the out of every ten falls [22, 23]. Fall-related admissions have not
complete geriatric assessment (CGA), which has been shown decreased over the last ten years, and there is an urgent need to
to enhance outcomes for older persons, especially those who create effective fall prevention methods that are acceptable and
are frail. A CGA strategy is used in successful orthogeriatric sustainable in the long run for older individuals [18]. Balance
treatment as well as in the new field of perioperative surgical improving activity and lower-limb resistance training have been
care for the elderly. [14] Assessments and treatment concepts for identified as the best exercise modality for fall prevention in
older people should follow national protocols and guidelines. older individuals [19]. Physical activity has thus been shown to
The assessment of older persons differs from that of younger prevent this effect.
people in that it takes into account the physical changes that occur
with age. The World Health Organization’s (WHO) International However, it is yet unclear which sort of exercise will be most
Classification of Functioning, Disability, and Health [15] is effective for this goal [19, 25, 26]. Increased physical activity
the most global and inclusive approach to rehabilitation. The reduces overall morbidity and mortality, as well as the chance of
International Classification of Functioning, or ICF, is a model that falling by 30% to 50% [27, 28]. Leg strength training and balance
allows healthcare practitioners to analyze different impairments training, in particular, have been identified as appropriate strategies
and relate them to the important domains of an individual’s life for reducing the risk of falls. However, because balance is the
to guide assessment, goal setting, and treatment planning. The foundation of being able to remain erect and move around, balance
ICF is useful to physicians because it can help them conduct a training should also play an essential part in fall prevention [29].
complete examination of the elderly. The ICF assists physicians in Almost all research on the risk of falling among the elderly agree
determining how impairments frequently affect everyday activities that physical activity, especially leisure exercises, are excellent
and how a person can engage in social responsibilities in later way to maintain a healthy balance and prevent falls [30, 31, 32].
life [16]. Various research has looked into various types of exercise, such as
Pilates, stair climbing, vibration training, and dancing [33, 34-39].
Medical History: It is critical to obtain a full medical/surgical All of these studies demonstrated significant increases in balance
history as well as a supportive medication history. ability and give evidence that physical activity can minimize the
• Medication Impact on Mobility: Medication, particularly chance of falling. Tai-Chi training is another typical exercise
in older adults, can significantly affect mobility and increase intervention that has been reported to improve balance and was
the risk of falls. included as a comparator intervention in the study of Zhao et al.
• Underreported Major Medical Issues: Individuals may fail Several systematic reviews and meta-analyses have examined
to report significant medical issues, such as cardio- vascular the effects of Tai-Chi on balance in elderly populations, with all
conditions, posing a potential risk to their health. concluding that such exercise is effective in increasing balance
and functional measures related to quality of life in the elderly,
Social History: Vital, older adults frequently rely on formal or such as flexibility or strength, and is also capable of reducing the
informal (family and friends) support. For example, how can risk of falls [40, 41, 43].
a physiotherapist (and other allied health professionals) assist
rehabilitation in the instance of an elderly person who is to be Pain Management and Mobility Improvement
discharged home alone but is unable to stand comfortably to Chronic pain is one of the most frequent health problems among
prepare a meal or walk to the grocery store? The ICF can guide older persons (those over the age of 65), and it is connected with
clinicians through the assessment process and serve as a checklist severe disability. Chronic pain limits mobility in the elderly is
to ensure that all essential history and evaluations are included connected with melancholy and anxiety, and can impair familial
[16]. and social connections [44, 45].

A Comprehensive Physical Therapy Program for Seniors When caring for elderly people, it is critical to consider the overall
Should Include therapeutic goal of treatment. Rehabilitation’s primary goal is to
• Evaluation: Assessment of the patient’s strength, balance, improve impairment (loss of physiologic or anatomical structure
range of motion, and functional abilities. or function), which is typically accomplished through modalities
• Manual Therapy: Techniques to increase range of motion, that address the underlying pathophysiologic etiology (e.g., core
alleviate discomfort, and promote recovery. strengthening and stabilization exercises for degenerative lumbar
• Modalities: Application of methods like heat, ice, and spondylosis). When improving impairment seems unlikely,
electrical stimulation to relieve pain and inflammation. rehabilitation should instead focus on improving patient disability
• Balance Training: Exercises designed to improve balance (restricted in ability to perform an activity due to impairment) [44].
and prevent falls.
• Home Exercise Program: Tailored exercises for the patient’s Multiple modalities of therapy have been found to improve
individual needs and abilities to be performed at home. musculoskeletal function and results when the impairment is
• Functional Training: Activities focused on enhancing amenable to improvement. Physical therapy programs that
seniors’ ability to perform everyday tasks. emphasize strength training are very beneficial in increasing
overall mobility, balance, and physical function in the aged
Falls Prevention and Balance Enhancement population [46-49]. Resistance-based strengthening interventions,
Falls and unbalance are widespread among the elderly, and fall/ for example, have dramatically improved patient- reported pain
instability is one of the ’giants’ in geriatric medicine [17]. Falls can outcomes in older people with hip or knee osteoarthritis [50-52].
trigger a downward spiral of immobility, diminished confidence, Similar functional improvements in the aged population have
and incapacity, eventually leading to institutionalization. Every been found across a wide range of active therapy methods. In
J PhyMed Rehab Stud Rep, 2023 Volume 5(4): 2-7
Citation: Maheshkumar Baladaniya, Shraddha Baldania (2023) The Role of Physical Therapy in Enhancing the Well-being of Elderly Patients. Journal of Physical
Medicine Rehabilitation Studies & Reports. SRC/JPMRS-217. DOI: doi.org/10.47363/JPMRS/2023(5)192

one study of adults 60 years or older, regimens focused on high- dislocated joints have immediate pain, which subsides once a
intensity strengthening (8 repetitions at 80% of single repetition physician assists in repositioning the joint. Many orthopedic
maximum) and low- intensity strengthening (13 repetitions at 50% conditions commonly require physical therapy which we will
of single repetition maximum) revealed equivalent improvement discuss in detail in the chronic disease management section [63].
in endurance and function.[53] Low-impact modalities, such as
Tai Chi and Aqua-aerobic regimens, may also improve balance Benefits of Early Mobilization and Rehabilitation
and musculoskeletal function when done on a regular, consistent Early mobilization interventions benefit patients with critical
basis [54]. illnesses by reducing muscle weakness acquired in the intensive
care unit (ICU). Adequate awareness of the population at risk of
Encouragement of older patients to attend sessions at an exercise developing muscle problems is critical, and the two most obvious
facility or community facility with a trained and attentive instructor dangers are prolonged mechanical breathing and immobility. [64]
may reduce these undesirable effects while also improving mood As a result, the physiotherapy team must assess the potential risks
through the development of positive social contacts [54]. of adverse consequences associated with mechanical ventilation
and immobility of critically sick patients in the ICU, such as
Older adults should maintain an active lifestyle for a multitude of loss of strength and muscle mass [69]. There are various early
benefits, including improved physical and mental health, enhanced mobilization programs available in the literature, with differences
cognitive function, reduced risk of chronic diseases, and increased in the development of activities and even their start time. Other
social interaction. Engage in enjoyable activities gradually and instruments, such as neuro-muscular electrical stimulation
seek support to stay motivated. (NMES), the cycle ergometer, and the orthostatic board, have
been integrated into the early mobilization regimens. Early
Rehabilitation after Surgery or Injury mobilization and electrostimulation are suggested as the most
Hospitalizations for cardiac events, infections, fall-related effective solutions for short-term outcomes by Conolly et al.
injuries, stroke, cancer, or surgical or medical procedures are [65-68]. The benefits of various early mobilization strategies are
widespread among the elderly population [56]. Physiotherapy associated with the prevention and reduction of critical patient
is a crucial component of post-surgery recovery. It can assist polyneuropathy and myopathy, improvement of patient’s quality
patients in regaining strength, mobility, and independence while of life, reduction of ICU stay and hospitalization, and mortality
also lowering the chance of re-injury. Physiotherapy can help you during hospitalization. Other results include reduced mechanical
achieve your goals safely and effectively, whether you have had a breathing time and weaning, as well as preservation of peripheral
simple surgery or a large operation. If you are going for surgery or and respiratory muscle strength [69]. Significant research has
have recently had one, you should talk to your doctor or surgeon recently been dedicated to understanding the effects of physical
about the importance of physiotherapy in your rehabilitation exercise training on cognitive performance and brain plasticity
process. You can reach your rehabilitation goals and return to your in older people [70]. Findings support the concept that executive
daily activities as soon as possible with the correct physiotherapy cognitive skills, which are important for controlling goal-oriented
program [57]. Geriatric Rehabilitation (GR) attempts to improve actions and adaptive behaviors, are severely reduced by aging
the quality of life and restore function in older adults, particularly but also positively and specifically sensitive to aerobic exercise
those with debilitating impairments and/or frailty [58]. The current training [71, 72]. Physical training research aimed at improving
rehabilitation approach emphasizes function and well-being rather cognitive functioning has primarily focused on modifying
than sickness [59]. Rehabilitation for older individuals aids in the exercise’s quantitative characteristics (intensity, duration, and
preservation of functional independence and the enhancement frequency) to find a dose-response link between physical activity
of quality of life.[60] 11% of elderly patients are referred to and cognitive performance [73]. In contrast, not much attention
rehabilitation centers after being admitted to the hospital [62]. has been made to analyzing the nonphysical components of
Older adult rehabilitation should focus on functional activity to exercise (i.e., the complexity of the cognitive or coordinative
maintain functional mobility and capability [61]. demands inherent in movement tasks), which might contribute to
its cognitive effects [71, 74, 75]. The lack of long-term exercise
Some Examples of Orthopedic Conditions that Commonly interventions that challenge neuro-muscular coordination is
Require Physical Therapy surprising, given that research on motor training clearly shows
Osteoarthritis that movement task complexity and the associated involvement
This is a degenerative condition that primarily affects the hands, of executive function have a strong impact on neuro-plasticity
ankles, and fingers, as well as the spine and knees. Osteoarthritis and thus cognitive function [76]. There is some evidence that
makes it harder to carry out daily tasks, particularly those that cognitive gains can be acquired through training programs that
involve flexibility, movement, or fine motor ability. focus on neuro-muscular coordination and balance rather than
endurance and resistance [77].
Fractures
This is yet another important issue for the elderly. People’s Neuro-Muscular Re-Education Training
bone mineral density diminishes as they age. This is especially Manual techniques (e.g., PNF-proprioceptive neuromuscular
troublesome in postmenopausal women. Mineral deficiency causes facilitation), activities for balance and core control (e.g., Bosu
weaker, more brittle bones. It worsens as people age because they exercises and Therapeutic Ball exercises), and other therapeutic
have more unsteady balance and vision problems, increasing their exercises are used in neuromuscular re-education to re-
risk of fractures. Strength training exercises can help build bone develop normal, controlled movement patterns. The purpose of
strength and reduce the probability of fracture. neuromuscular re-education activities in the outpatient orthopedic
context is the same as it is in any other situation: to re-train a body
Dislocations component to do a previously capable job [79].
When a joint dislocates, the bones that make up that joint move
from their original position. This is frequent following a fall, 1) Balance and Proprioception Exercises: Balance: and
when the jolt knocks bones out of the joint. Older persons with proprioception exercises: By challenging stability, balance
J PhyMed Rehab Stud Rep, 2023 Volume 5(4): 3-7
Citation: Maheshkumar Baladaniya, Shraddha Baldania (2023) The Role of Physical Therapy in Enhancing the Well-being of Elderly Patients. Journal of Physical
Medicine Rehabilitation Studies & Reports. SRC/JPMRS-217. DOI: doi.org/10.47363/JPMRS/2023(5)192

exercises improve bodily awareness and control. These activities, coordination, motor control, flexibility, en- durance, and even
such as single-leg balancing or standing on unstable surfaces, memory. It also helps to maintain cognitive function, reduces
challenge the body to recruit muscles and activate brain pathways the risk of heart disease, and enables individuals to carry out
involved in balance maintenance. Proprioception exercises, which daily activities with ease.
concentrate on the body’s sense of position and movement, • Physiotherapy also enhances mood and self-esteem, re- duces
increase coordination and stability even more. the risk of falls, and minimizes the impact of illnesses that
2) Dynamic Stability and Agility Training: Dynamic: stability are more likely to affect older people.
exercises consist of movements that evaluate stability in several • It treats and prevents joint problems, balance disorders,
planes of motion. Exercises like lateral lunges and single-leg strength decline, and reduces high blood pressure and obesity.
squats provide better control and balance during strenuous tasks. • Additionally, physiotherapy has been proven to be beneficial
Agility training improves quickness, response time, and change- for seniors suffering from conditions such as stiff joints,
of-direction abilities through ladder or cone drills. unbendable ligaments and overall body movement,
3) Exercises for Core and Functional Strength: Core: exercises Parkinson’s disease, arthritis, and neurological problems [82].
target the muscles of the belly, lower back, and pelvis, providing
a stable foundation for movement and stability. Core strength Here are the most common medical conditions treated by physical
enhances general body control and lowers the chance of injury. therapists [83]:
Functional strength workouts are designed to mirror motions in A. Muscular Dystrophy
everyday tasks or sports, ensuring optimal movement patterns As we age or suffer from various diseases, our muscles and
and control. bones atrophy and weaken. Mobility exercises and the usage of
supporting frames can be beneficial in this regard.
Hand Exercises for Fine Motor Skill Improvement B. Back and Neck Pain
1) Painting Using your Fingers: This practice is especially Acute back and neck pain that appears quickly or chronic back
beneficial for seniors who have difficulty communicating and neck pain that lasts months or years limits normal functioning.
how they feel or what they desire vocally. Finger painting Physical therapy helps to reduce pain and increase mobility.
will help children to express themselves while also allowing C. Osteoporosis
them to be creative. Thin and brittle sponge-like bones with numerous holes inside
2) Playdough: Allow your older parent to stretch, shape, and them break. Similarly, debilitating fractures might be avoided
form the playdough. This is a great workout for folks who with immediate treatment.
want to strengthen their fingers. D. Chronic Fatigue Syndrome
3) Simple Hand Exercises: Simple hand exercises can be quite This complex illness produces exhaustion that is not alleviated
beneficial, but the senior must maintain consistency to see by rest. Doctors and physical therapists work together to create a
gains. They can put pegs in a pegboard, transport beans from treatment plan that incorporates endurance training assignments.
one bucket to another, exercise their fingers by wrapping E. Respiratory Issues
rubber bands around them, and squeeze a stress ball. It may Chronic bronchitis and other respiratory problems can be addressed
take hours of repetition for these exercises to be beneficial, with pulmonary rehabilitation strategies that include diaphragmatic
so urge your loved one to do so. breathing exercises to strengthen the lungs.
4) Make a Fleece Blanket with Ties: Fleece blankets with ties F. Joint Replacement
on all sides are simple to construct and can help develop finger Post-operative care for surgical removal and replacement of a
muscles. They will also be proud to show off something they hip or knee joint with an artificial joint (prosthesis) will almost
created themselves to relatives and friends. probably give adequate knee pain alleviation.
5) Assist with Household Tasks: Even basic tasks like folding G. Parkinson’s Disease
clothes can help an elderly person’s fine motor abilities. Other Chronic motor impairments and tremors are caused by this
things kids can do are open jars and containers, fix hooks and neurological and progressive movement condition. Physical
buttons on garments and tidy shelves. therapy and resistance strength exercises can also be used to
treat it.
The Link Between Physical Activity and Mental Health H. Huntington’s Disease
• Physical activity enhances cognitive function by improving Huntington’s illness affects both intentional and involuntary
memory, attention, learning, and cognitive flexibility. motions. Common symptoms include spasms, slurred speech,
• Regular exercise reduces the risk of Alzheimer’s disease and and an unsteady gait, which can be treated with physical therapy.
dementia by combating inflammation and oxidative stress.
• Physical activity promotes better mood and sleep, further Psychological and Emotional Wellbeing
contributing to cognitive well-being. Mental health is described as a condition of well-being in which
each individual realizes his or her potential, can manage typical life
Chronic Disease Management stresses, can work creatively and fruitfully, and can contribute to
Physiotherapy can assist in reducing pain caused by ill-nesses his or her community [84]. Physical therapists work with patients
such as arthritis or osteoporosis. Joint inflammation, traumas, who may have mental health concerns in addition to other long-
arthritis, gout, and other factors typically cause joint pain. If term health issues, and exercise is an evidence-based treatment
left untreated for an extended period, it can limit mobility and for persons with mental health issues [85, 87]. The prevalence of
cause weakness or instability in performing typical activities. The depression, anxiety, and other mental diseases needs a coordinated,
physiotherapist aims to restore muscle, bone, joint, tendons, and multi-sectoral approach. Not only should public awareness be
ligament function [82]. raised, but treatment and prevention techniques must also be
Benefits of Physiotherapy in Geriatrics: developed to lessen this enormous and growing health problem, as
• Physiotherapy plays a vital role in restoring functionality, well as the economic losses associated with it. The links between
reducing pain, and improving quality of life. poor mental health and an increased prevalence of musculoskeletal
• Regular exercises can result in improved balance, strength, disorders, different types of pain, and chronic and avoidable
J PhyMed Rehab Stud Rep, 2023 Volume 5(4): 4-7
Citation: Maheshkumar Baladaniya, Shraddha Baldania (2023) The Role of Physical Therapy in Enhancing the Well-being of Elderly Patients. Journal of Physical
Medicine Rehabilitation Studies & Reports. SRC/JPMRS-217. DOI: doi.org/10.47363/JPMRS/2023(5)192

diseases highlight the importance of an effective and holistic and Public Health Implications for the 85 Years Old and Over
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Medicine Rehabilitation Studies & Reports. SRC/JPMRS-217. DOI: doi.org/10.47363/JPMRS/2023(5)192

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