The document discusses statistics related to strokes in Tennessee and the benefits of outpatient rehabilitation and exercise programs. It notes that Tennessee has high rates of obesity, diabetes, and hypertension, which increases healthcare costs and risk of strokes. Outpatient rehabilitation can improve functional ability, independence, and quality of life through physical, occupational and speech therapy. Regular exercise provides additional benefits like improved strength, balance, and reduced risk of falls and disease. Proper assessment and individualized programs are important for safety and achieving results.
2. Special consideration in cardiac rehabilitation program for older adults.
Stroke Care Health Fair
1. The Continuum of Care From Rehabilitation to Fitness: Improving the Quality of Life Trent Nessler, PT, DPT, MPT Area Vice President – Physiotherapy Associates CEO - Accelerated Conditioning and Learning
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Notas del editor
2 groups: exercisers and non-exercisers 105 adults, age 68 – 85 exercisers attended 1 hour session, 3x/week, 24-26 weeks n = 25 for strength training using weight machines n = 25 for endurance training using bicycles n = 25 for strength and endurance training Follow up for 25 months tracked self reported falls use of outpatient medical services admission to hospital Non exercisers fell more often used more outpatient services were more likely to sustain hospital costs >$5000 were more likely to have acute hospital stay of over 3 days
Study participants had positive fall hx (2 or more falls/last 6 months) community dwellers, over 65 years of age (avg. age 78-80) control plus 2 exercise groups partially adherent ( < 75% sessions attended) Exercise programs not standardized. Addressed balance training other strength/ROM issues that arose from evaluation home exercise program not standardized Outcomes support value of individually designed program adherence to exercise program carryover to functional issues: fall prevention
Also called “Tufts University Study” Long Term Care Residents Conventional Resistance Training Equipment Week 1 - 50% of 1RM Subsequent weeks – 80% of 1RM 3 sets of 8 reps 3x weekly sessions Prior studies did not examine effect of tng on 90 year olds.
2 consecutive years 42 weeks year one 10 week testing break 42 weeks year two 85% mean attendance in exercise group Average gains 32% in leg press 90% in military press Cycling – 6.2% (+/-0.8%) Treadmill walking – 29.2% (+/- 7.3%) Stair climbing – 57% (+/-12%)
Emphasis is on eccentric slow movement Raised platform allows introduction to movement without armrests Progress to lower platform Add resistance Note position: hip/knee strategy for balance loss hip/knee strategy is essentially a high speed eccentric squat
Theraband side steps resisted Progression First strength Add speed and increased resistance later Remove dependence on bar Note similarity to stepping strategy
Heel raises Progression holding bar, 2 feet holding bar with 1 hand, 2 feet holding bar with 1 hand, 1 foot Strengthens gastrocnemius/soleus and also adds active stretching
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