Physical therapy is rehabilitation concerned with restoration of function and prevention of disability following disease, injury, or other calamity. The therapeutic properties of exercise, heat, cold, electricity, ultraviolet radiation, and massage are used to improve circulation, strengthen muscles, encourage return of motion, and retrain individuals to perform their tasks.
Modern physical therapy began during World War I, when we desperately needed to rehabilitate the wounded. The Surgeon General’s Office hired 2000 “reconstruction aides,” now known as physical therapists. Practicing in army hospitals, and later in veterans’ hospitals, reconstruction aides helped to restore the wounded using the therapeutic properties available.
Having successfully handled the initial role, the demand for physical therapy in the private sector grew. A professional organization, The American Physical Therapy Association (APTA) was formed and educational training programs were developed. This met the demand for therapy brought on by World War II and a nationwide polio epidemic during the 1940s and 1950s.
The Geriatrics Section is one of 19 specialized divisions of the APTA. Geriatric physical therapists are getting high acclaim for their innovative work with the aged. Coinciding with the latest health care practices, many physical therapists are practicing preventive health care with their geriatric patients. A few of the individuals making a difference are:
Terry Holley, PT, MHS, founder of the Medical Legal Corporation in Portland, Oregon, provides strength training and frailty prevention information to his geriatric patients. “Physical therapists are well positioned to design programs to increase strength and prevent greater loss of bone mineral density that may lead to fractures,” Holly stated. “There is a growing opportunity for geriatric physical therapists in developing preventive programs in nursing homes, long-term facilities and retirement communities.”
At Pennswood Village, a retirement community in Pennsylvania, residents are feeling the positive effects of fitness training. Ken Van Demark, PT, President of SteVan Physical Therapy and Rehabilitation, Inc., launched a comprehensive fitness program including a fully equipped fitness room at Pennswood. It has recorded positive results, and there is continuous growth in the enthusiasm and the number of participants. “There is an opportunity for geriatric physical therapists to set up these programs in senior centers, health clubs, and retirement communities,” said Van Demark. “There is a great need for fitness training for senior citizens.”
Nancy Prickett, MPT, has discovered a mind-set change that older adults are experiencing about exercise. In the 1980s a suggestion to older patients at her practice (Aspen Physical Therapy in New Jersey) to start an exercise program was met with amusement. “Our societal focus on health promotion and awareness has reached the geriatric population. They are becoming more exercise-oriented and less medication-oriented. They want to find ways to prevent illness, injury, and dependence,” says Prickett.
Once patients are discharged from their physical therapy program, Prickett doesn’t close the file. “We want to move them into an exercise program to maintain and improve upon the gains we made in physical therapy, so the follow-through is important,” added Prickett.
Studies show that losing independence is our greatest fear of aging. Tim Kauffman, MS, PT, co-owner of Kauffman-Gamber Physical Therapy in Lancaster, Pa. works with his patients to alleviate that fear. Kauffman, well known for his masters degree thesis in the area of strength training, applies basic fitness training and overload principles to geriatric patients. He has seen significant increases in strength when patients perform intensive exercise routines. “We as therapists need to help our geriatric patients gain strength, improve in function, and stay independent. We should be focusing on adding life to their years more than adding years to their life,” says Kauffman.
Maintaining function used to be the goal in geriatric physical therapy. LaDora Thompson, Ph.D. PT, says “research clearly shows that older patients can increase function. We should be looking at increasing absolute strength, walking speed, and quality of movement in geriatric patients,” Thompson’s research and teaching at the University of Minnesota centers around this theme. “We need to stop teaching ‘maintenance’ and teach appropriate exercises in the geriatric population,” added Thompson.
Much of society believes that after an injury or illness, aged people are rendered functionless. Geriatric physical therapy is helping to dispel this notion. Patients, who once were labeled dependent, are now exercising and strength training. Many not only regain their function but because of the increase in strength, perform at a higher level than before the injury or illness.
Another benefit of these programs is an improved mental condition. Exercise has been shown to improve our state of mind. We tend to feel better about ourselves when we make improvements in our lives. Also, exercise training, especially if done in water, will improve the patient’s balance. This, along with stronger bones from weight training, means fewer broken bones.
Older adults taking part in preventive programs such as these directly equate to a happy and healthy society. Not only is it good for the participant, but it decreases the drain on our health care systems.