Performance‐Oriented Assessment of Mobility Problems in Elderly Patients

M any people experience a decline in mobility with aging. The multiple chronic diseases and disabilities responsible for this decline also may predispose to falling. This decline is well recognized by clinicians caring for elderly patients. The Canadian Task Force on the Periodic Health Examination not only recognized the problem, but concluded that assessing physical, social, and psychologic functions as they impact on “Progressive Incapacity with Aging” was the most important assessment for patients over age 75.’ Prominent among their list of potentially preventable impairments were locomotory, sensory, and cognitive functions, each of which is intricately related to mobility. The Canadian Task Force further stated that protection of abilities should be emphasized over diagnosis. They believed that establishing the optimal content of the assessment was a high research priority. The purpose of the following discussion is to address the question of content of a functional mobility assessment appropriate for elderly patients. The limitations of relying solely on either a disease-oriented or a gait analytic approach are outlined. A practical performance-oriented assessment of mobility is described that incorporates useful features of both approaches. The recommended evaluation centers on the more effective use of readily (and frequently) obtained clinical data. Although limited to a discussion of ambulation as the expected mode of mobility (necessary because of space limitations), many of the concepts apply to other modes as well (eg, wheelchair).

[1]  A. B. Drought,et al.  WALKING PATTERNS OF NORMAL MEN. , 1964, The Journal of bone and joint surgery. American volume.

[2]  F. Finley,et al.  Locomotion patterns in elderly women. , 1969, Archives of physical medicine and rehabilitation.

[3]  Finley Fr,et al.  Locomotion patterns in elderly women. , 1969 .

[4]  A J Nelson,et al.  Functional ambulation profile. , 1974, Physical therapy.

[5]  J T Scales,et al.  Clinical assessment of gait using load measuring footwear. , 1975, Acta orthopaedica Scandinavica.

[6]  B. Wyke CONFERENCE ON THE AGEING BRAIN CERVICAL ARTICULAR CONTRIBUTIONS TO POSTURE AND GAIT: THEIR RELATION TO SENILE DISEQUILIBRIUM , 1979 .

[7]  Vestibular stimulation to improve ambulation after a cerebral vascular accident. , 1979, Physical therapy.

[8]  O. Edholm,et al.  The assessment of gait and mobility in the elderly. , 1979, Age and ageing.

[9]  F. Kottke From reflex to skill: the training of coordination. , 1980, Archives of physical medicine and rehabilitation.

[10]  P. Overstall,et al.  Prevention of Falls in the Elderly , 1980, Journal of the American Geriatrics Society.

[11]  A. Reeves,et al.  Neurologic Signs in Uncomplicated Aging (Senescence) , 1981 .

[12]  R P Bhala,et al.  Ptophobia. Phobic fear of falling and its clinical management. , 1982, Physical therapy.

[13]  B. Roberts,et al.  Improving balance. Therapy of movement. , 1983, Journal of gerontological nursing.

[14]  E. Campion,et al.  Motivating the Geriatric Patient for Rehabilitation , 1983, Journal of the American Geriatrics Society.

[15]  Exercises to promote independent living in older patients. , 1984, Geriatrics.

[16]  M. Tinetti,et al.  Fall risk index for elderly patients based on number of chronic disabilities. , 1986, The American journal of medicine.