Hi All!
Working with seniors is enjoyable and truly rewarding too especially as they do show remarkable improvements with mild to moderate exercise activities. We, as a team, look forward to this part of our daily work very much.
Seniors have an increased risk of falls, owing to declines in muscle strength and mass with age, reduced perception of height, and impaired balance. As such, a major part of our programme consists of supervised strength training exercises, balance and coordination activities and gait retraining to improve strength and function.
To gauge their performance and for regular evaluation of functional status and muscle strength and power differences, we use several outcome measures. Assessment scales include the Berg Balance, Functional reach, timed walk over 6 meters, the TUG (Timed Up and Go) and self-paced stair ascent tests and muscle strength tests.The PAR-Q is also used in certain cases and for physician follow-up.
Our program incorporates:
- A warm-up routine
- Overall stretching and strengthening exercises
- Strenghening specific to muscles that are predominantly affected by aging, especially hip abductors, hip extensors and knee extensors (view blog date 10 May 2012)
- Specific exercises to retrain balance
- Core stabilization
- Coordination exercises
- Cardiovascular endurance training
- Functional balance training
- Circuit training activities in which seniors participate by doing activities that are targeted at different muscle groups and carried out in a specified time
Exercises are customized to individual ability level at baseline assessment.Patients are provided with an activity log, in which they keep track of their activity and are able to monitor their own progress.
Physiotherapists Deshi and Jing Yi working at balance retraining activities on the therapy ball.
The seniors get used to sitting on an ''unstable" base and recruit their core muscles and multifidus, which is essential to maintaining balance. Displacing them a little helps in recruiting multiple muscles as well.
Stretch left hand out, right leg out.
Come on, have confidence, You can do it!
Getting a bit more confident with her ball now, our Madam Ng!
Balance on The Wobble Board!
Standing on a wobble board helps the senior to learn to control their center of gravity and maintain a standing posture on unstable surface conditions.
Try placing your feet slightly apart, so that you can balance better :)
The Wobble board also helps train proprioception, which is the ability of the body to sense movement and coordination. A record is kept of the duration of standing.
Physiotherapists Lava and Jing Yi with Mdm Ng on wobble board balancing and weight shifting training activities.
Moving on to dynamic perturbations on the board : Anterior-posterior weight shifts
Lateral-to-Medial weight Shifts in Balance training.
Bilateral stance with and without support
Mobilising hips and knees in sitting with therapy Ball.
Bilateral stance with and without support
Mobilising hips and knees in sitting with therapy Ball.
Training being done by one senior for the other senior, supervised by physiotherapist Kaan.
"Patience, my dear, keep in control of the Ball", seems to be what Mr Pook is saying to his partner.
"Patience, my dear, keep in control of the Ball", seems to be what Mr Pook is saying to his partner.
Jing Yi is explaining the sequence of the next exercise.
Ok, Lets have a go at this!
A Time to Relax....and exchange views.
Can I do this exercise by bending and pulling with my hand?
Ok, Lets have a go at this!
A Time to Relax....and exchange views.
Can I do this exercise by bending and pulling with my hand?
Actually, I am quite comfortable like this!
Strengthening abdominals is an essential to strengthening the spine and maintaining an erect posture.
You can do this!
You can do this!
Enough of therapy, I wanna go home! Time to teach gait outdoors!
Sitting to standing, using gluteals and trunk muscle activation techniques. Initially done with prompting, and slowly, progressing to doing the motion as quickly as she can.
Single-task condition: Narrow walking task where the patient was asked to walk between 2 strips of tape secured to the floor that ran parallel the length of the walkway. Here , we used a 6-meter walkway.
(Ref: Training of Balance Under Single- and Dual-Task Conditions in Older Adults With Balance Impairment - Patima Silsupadol, Ka-Chun Siu1, Anne Shumway-Cook and Marjorie H Woollacott, Journal of the American Physical Therapy Association, 2005)
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