Hi there, and welcome back to Aging Together! October is Physical Therapy Month! As an occupational therapist, I wouldn’t be half the provider I am today if it weren’t for my physical therapy counterparts. From the hospital to the clinic to the home, OT and PT work side by side for most patients and families. In this week’s article, I provide a recap of interviewing my long-time colleague and dear friend, Dr. Colleen Marie McShane, PT, DPT, GCS. Colleen is an acute care physical therapist specialized in geriatric care. Together, we dove into physical therapy’s role in aging well.

Background

Did you know that by the year 2030, an estimated 22% of the U.S. population will be over the age of 65? With an aging demographic on the rise, the role of physical therapy in promoting healthier and more active lives for older adults has never been more crucial.

The Interview

The following conversation has been summarized for clarity. You can listen to the full conversation on the podcast!

Pooja: For OT Month back in April, I did an entire episode on OT’s role in aging. So let’s start with a brief overview on PT’s role in aging. How does physical therapy play a crucial role in the aging process? What are some common challenges that older adults face in terms of physical health and mobility?

Colleen: Although the ultimate goal is for elders to avoid disease and disease-related disability, the reality is the majority of older adults do have chronic health conditions and will live with functional disabilities. Therefore, physical therapists play a crucial role in the aging process to optimize functional capacity and prevent any downward spiral of increasing disability over time. We work with patients to promote restorative and compensatory strategies to prevent injury, falls, and worsening mobility. This may involve assistive device training such as how to use a walker or a cane, balance training, and generalized strength training to allow for safe mobility. 

I would also mention that some of the common challenges for older adults include:

• Reduced muscle mass, strength, and endurance (muscle gain/protein, appetite)
• Reduced coordination and balance (increases risk of falls)
• Reduced joint flexibility (arthritis/pain)
• Reduced heart and lung function (shortness of breath with walking, leg swelling, increased fatigue)
• Reduced bone strength (fragile bones = bad for falls/injury)

So PTs will work with patients to keep them active, prevent deconditioning, prevent muscle atrophy/wasting, decrease risk for falls, and maintaining independence.

If you had to provide a 360* view of everything PT addresses for aging, what are the top 3-5 areas?

• Gait/walking: assistive device training
• Strengthening: weak hips, core, concentric muscles (calves, quads)
• Balance training: think about how many times you stand on one leg (walking, curbs, stepping in/out of a tub, reaching into a cabinet)
• Endurance training: building activity tolerance to decrease fatigue (increased fatigue can lead to increased risk of falls)
• Posture: bone/joint integrity with positioning as it relates to range of motion

What are the most common or highly recommended interventions you see or provide for older adults for aging safely?

My most highly recommended intervention is definitely balance training. I’ve worked with so many patients who are so fearful of falling and it causes them to limit their mobility, decrease their independence, and affect their social life. We want nothing more than to keep you safe and help you prevent falls but if you do not train your balance the same way to train your body to stay strong through exercise, then you put yourself at risk for falling or for being afraid of falling.

I want to note that the fear of falling can be as impactful as falling. This fear of falling may come from a close instance where you lost your balance but didn’t fall or injure yourself or it may even come from hearing about a friend injuring themselves from a fall. The fear of fall results in decreased mobility and stiffness/guarding with mobility which can then lead to additional impairments (joint stiffness, weakness).

So if you are above the age of let’s say 70, you should consider meeting with a physical therapist who can assess your balance and train you in how to safely challenge your balance. This SAFELY part is important though, this is not me telling you to go out and start brushing your teeth on one leg or walking without your cane – NO. I am telling you to seek help on how to start a supervised balance program through a physical therapist.

Do you provide older adults with exercises they can do at home to complement their in-clinic sessions? How important is self-care and consistent exercise for maintaining the benefits of physical therapy as individuals age?

Certainly! If PT only needed to be in person once a week, we would be the healthiest society ever. However, as with anything, it is not that easy. We are going to give you a lot of education and tips/tricks on how to be successful and part of that is likely going to be a home exercise program. If you cut corners, your rehabilitation journey will not be successful. We can not rely on 1-2x/wk to see improvements and to benefit. We need to put in the work and remain consistent in order to see the benefits of PT. So do your exercises!

Key Takeaway

It’s never too late to start.

There are so many physical therapists out there that are eager to help you! We want to share all of the knowledge we have learned from school, patient care, and mostly from patient experience. You are the ones consistently teaching us new things like new equipment that might be on the market, creative solutions to keep you safe, and what you have been experiencing during your journey. Physical therapists strive to continue learning and to be open-minded on how to provide you the best individualized care that we possibly can.

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At Caregiver Consulting & Healthy Solutions, we are dedicated to helping you navigate aging together. This blog page is for everyone: whether you are an older adult looking to age in place, a caregiver seeking support and guidance, a young or middle-aged adult planning for the future, or simply someone interested in learning more about the aging process. I hope you’ll join me on this journey. Let’s navigate aging together.