Physical Therapy a Boon for Seniors
Would you believe in a nondrug treatment that works for arthritis, cancer pain, Parkinson's, and incontinence and improves your strength and endurance? There is one -- physical therapy.
Strokes, as Davidson's experience illustrates, definitely
require physical therapy. "We use something called proprioceptive
neuromuscular facilitation," Bottomley says, explaining that this is a
purposeful movement pattern that can stimulate and retrain the brain. Another
technique -- which Davidson says greatly helped him -- is constraint therapy,
in which the stroke sufferer's "good" limb is restrained and the weak
or paralyzed one used 85% of the day. Speech retraining also can be an issue.
"If the person is in pain, we can treat that electrically," Kauffman
Parkinson's is an "exciting" area, Kauffman says.
"We have learned that physical intervention early -- before stage 4, when
the therapist is often summoned -- can almost always prevent the severe
symptoms of stage 4." He explains that the goal is to keep the Parkinson's
patient's trunk flexible to avoid "robotic" movements. (Parkinson's
disease is a chronic disease of the nervous system that results in a gradual
decrease of muscle control.) Sometimes he has people lie on the floor and move
their head and trunk in opposite directions. He even puts patients on horseback
sometimes, which increases trunk strength and flexibility.
How can physical therapy help dementia and Alzheimer's
patients? "We try to maintain function," Bottomley says, adding that
the types of movement the patient remembers from the past is most effective,
such as dancing or gardening. "This also prevents falls."
Balance is another issue with older people. "Balance is
very complicated," Kauffman says. "It requires many systems in the body
-- nutrition, oxygenation of blood, muscle strength, joint receptors, vision,
inner ear. Physical therapy can tune up all of these areas. In one case,
peripheral vision, patients are asked to throw and catch a weighted beachball
that curves and wobbles through the air unpredictably, like a knuckleball.
Therapy is almost always prescribed for hip fracture and
replacement patients, amputees, and those with joint aches and pains. "I
call the latter 'grandparenting injuries,'" smiles Bottomley. "The
grandkids come over and the grandparents take extra walks or climb on the
playground equipment. Come Monday morning, ouch."
Role of Family
Even though an older person may have had a hospital stay or
required extra attention, family members should be positive and supportive of
more trips -- this time to therapy, Kauffman says. Relatives also need to
understand the loss of mobility and independence. "It was a frightening
experience to go home and be dependent," Davidson says. "They put up
some grab bars, but I could not do things for myself.
Kauffman urges that family members never be dictatorial or
expect a certain level of progress. Davidson adds, however, that you should
find a therapist with goals and not one who is letting the insurance run out
"hoping" you will improve.
Families should participate rather than nag, according to
Bottomley. "When you come over, say, 'Mom, are you up to a walk?'" It
is also important to be sure the patient is eating correctly -- bring
microwaveable meals, or else your loved one may be living on crackers and