Ankle Dorsiflexion: A Case Study

The evidence included in this summary is from Franco, J. R., Jacobs, K., Inzerillo, C., & Kluzik, J. (2012). The effect of the Nintendo Wii Fit and exercise in improving balance and quality of life in community dwelling elders. Technology & Health Care, 20(2), 95-115. The study addressed whether or not improving balance through exercise decreased the risk of falls. The study compared two types of exercise programs for improving balance; the Nintendo Wii Fit and the Matter of Balance program. The methodology included dividing residents of an independent living senior facility into three groups. The Wii Fit group and the Matter of Balance group consisted of 11 participants and the third group, the Control group, consisted of 10 participants. Results were determined based on one-way ANOVAS in which variation within each sample was compared to the variation between the samples to test whether there is greater variation between the groups. Assessments from the outcome measurements were not statistically significant according to the study. The Berg Balance Scale tool measured the pre and post balance of the participants resulting in little change with the strength of this assessment evidenced by (p=0.837). The Tinetti Gait and Balance Assessment of mobility, balance, gait, and fall risk of participants registered minimal pre and post change with the

Falls in the elderly is a significant health problem, which can lead to severe issues such as morbidity and mortality. The topic of falls within the elderly was chosen so that the many interventions, risks, and awareness strategies can be further explored within this paper. Throughout clinical practice I was

The Lower Extremity Functional Scale (LEFS) is a tool that is administered, and scored due to its’ simple applicability to a vast variety of disability levels and conditions and all lower-extremity sites. This particular scale is easy to read when it comes to understanding error-associated measurements and for verifying the least clinically important score changes and is adequate enough to measure of reliability, validity, and sensitivity to change, at a position that is proportionate with application at an individual patient level (1). The LEFS scale abstract framework is based on the World Health Organization’s model of the handicap and disabled. It was developed to be competent to manage, score, and record in the medical record with

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

In 2015, researchers conducted a study on 79 adults (mean age 68.7) to determine the validity of the BESTest, Mini-BESTest and Brief BESTest. Activities-Specific Balance Confidence Scale, The Physical Activity Scale for the Elderly, The Timed Up and GO Test, and The Single Leg Stance test were used to assess the

Among a wide array of risk factors for falls among older client with type 2 diabetes are the use of multiple medications, excess muscle weakness, especially at the ankle, and a host of environmental factors. Specific factors that significantly heighten risk among many with type2 diabetes are the presence of motor and/or sensory neuropathy, which increases the displacement of the center of pressure recordings during static balance tests in a dose dependent manner, the use of insulin, vision impairments, and the level of glycated hemoglobin. Others include lower levels of physical activity, and poor postural control or balance. As well, people with type 2 diabetes tend to be older rather than younger, and in addition to poor levels of neuromuscular control, may have diabetic foot ulcers, and high rates of body pain as well as foot pain that lead to the use of psychotropic medications and polypharmacology.

Increased Risk of Falls in Long-Term Stroke Survivors Mr. A is a 74-year-old male who presented to the emergency department with a chief complaint of leg pain after he fell at home. He states he got up around 1 am to use the restroom, he then felt unsteady, lost his balance

On 09/08/2017, the claimant presented with a left ankle pain which has been present for 1 week. It was noted that the symptoms occurred on the left side. It was described as sharp and intermittent. The claimant sustained a left ankle injury on 08/28/2017 while running. The pain was relieved with braces and was not relieved by heat and ice. Her weight was 135 pounds and her BMI was 21.22. The left foot/ankle examination revealed tenderness to palpation over the medial malleolus. The x-ray of the left ankle revealed a non-displaced transverse fracture at the distal portion of the medial malleolus. She was diagnosed with a left ankle stress fracture medial malleolus. An outside DME bone stimulator and the use of a boot were recommended.

I discovered preventive strategies could be used as a theory to minimise falls in older people using different literature reviews. A fall however can be defined as an unexpected, involuntary loss of balance by which a person comes to rest at lower or ground level (Commodove, 1995). The older population is growing in number, and falling is common in this group up to one-third of people over the age of 65 falls each year, with half reporting multiple falling episodes (Bludau and Lipsitz, 1997). Savage and Matheisk-Kraft, (2001) states that fall-related injury is the sixth highest cause of in older people.

The ankle-brachial index is a test used to find peripheral vascular disease (PVD). PVD is also known as peripheral arterial disease (PAD). PVD is blocking or hardening of the arteries anywhere within the circulatory system beyond the heart. PVD is caused by cholesterol deposits in your blood vessels (atherosclerosis). These deposits cause arteries to narrow. The delivery of oxygen to your tissues is impaired as a result. This can cause muscle pain and fatigue. This is called claudication.

The FGA compared closely with these other assessments from moderate to strong compatibility (.57 to .85). The comparative values of the FGA with the BBS, FAC, fast walking speed, ABC, Modified Hoehn and Yahr scale, BI, and MDS-UPDRS-03 ranged from .85,.78, .73, .72, .70, .69, .and 66. These correlations show a positive trend for the FGA being a reliable assessment for balance and gait of PD patients. The TUG and FGA did not correlate as closely with a .57, but this difference is assumed to be due to the fact that TUG measures one characteristic while the FGA measures provides more in depth views of gait and balance. Overall, the FGA concurrent validity still resulted as an efficient assessment to use.

What increases the risk? You are more likely to develop this condition if: You have an unsteady walking pattern (gait) and you have conditions that contribute to poor balance, such as Parkinson's disease or dementia.

In the case of Anne Morrell there are several normal physiologically changes that impact her quality of life. Anne is experiencing normal aging related changes to her musculoskeletal system. Changes in musculoskeletal tissue occur through the loss of muscle mass and strength which replace lean body mass which fat and fibrous tissue. These changes in tissue cause a decrease in contractile muscle force with increased weakness and fatigue (Boltz, Capezuti, Fulmer, & Zwicker, 2012). As discussed in her case study she reports back pain when standing or walking for longer than 15 minutes, needs assistance with steps, ambulates with a cane since she fell last year which affects her mobility and ability to perform her activities of daily living. This loss in Anne’s muscle function greatly increases her chance of falls and she also has an increased risk for disability.

Gait is the most important function of daily living activities for all human beings. As physical therapists and researchers we are particularly interested in evaluation of gait. There is a distinct necessity for objective measurement of gait because without it the excellence of treatment decisions is condensed, due to subjective and often unreliable nature of the assessment. Objective measures must be employed to validate efficacy of the treatment protocol, a function that has become imperative since health care resources are becoming more strained and health care providers are held more accountable1. Gait assessment is an everyday responsibility of the therapist, and visual assessment seems unreliable and erratic for the most part. Measurement

This paper will discuss the impacts that physiological changes have on mobility in older adults. Mobility is the individual’s ability to carry out activities of daily living by moving the body or parts of the body (Nursing Program Guide, 2016) For the purpose of this paper the term older adult will be referring to individuals chronologically aged 65 and older. The impacts of physiological changes can be drastic on an older adult, however it is important to note no two people age the same and it is critical to view elderly as individuals. This paper will allow the reader to gain insight into the age related physiological changes which impact an older persons mobility, the underlying diseases which impact mobility, as well as the potential consequences of impaired mobility on the older adult. Furthermore, this paper will discuss nursing interventions to address the care needs of the older adult.