Physical Therapy for Older Adults with Arthritis: What is Recommended?

Maura Daly Iversen

Disclosures

Int J Clin Rheumatol. 2010;5(1):37-51. 

In This Article

Abstract and Introduction

Abstract

With the exponential growth of the aging segment of the population, physical therapy clinics are treating larger proportions of patients with arthritic conditions. Arthritis is a leading cause of functional restrictions and disability due to its associated pain, inflammation, cardiovascular and pulmonary involvement. These symptoms overlaid upon normal age-related declines in the musculoskeletal, neuromuscular, integumentary and cardiopulmonary systems place older adults with arthritis at higher risk of disability and loss of independence. Physical therapy interventions are recognized as an integral component of arthritis management and their benefits have been well documented. This article reviews the common findings of the physical therapy examination and evidence for physical therapy interventions for select arthritic conditions.

Introduction

Arthritis and musculoskeletal disorders are widespread and may result in joint pain, soft tissue contracture, restrictions in joint movement and activities of daily living, deformity, disability[1] and, in some instances, death.[2] Physiologic manifestations of arthritis, such as joint capsule thickening, inflammation, muscle atrophy and reduced cardiopulmonary reserve, are exacerbated with physical inactivity and may be compounded with side effects of pharmacotherapy. Unfortunately, approximately 70% of older adults in the USA report no regular exercise and among older adults with arthritis, the rates of leisure time physical activity are 7% lower than their healthy counterparts.[3]

There are more than 100 rheumatic conditions, of which the most common form is osteoarthritis (OA). Osteoporosis may be present at any age, but is more prevalent in older adults. Polymyalgia rheumatica (PMR) presents with advancing age, while ankylosing spondylitis (AS) often presents early in life. Diseases such as systematic lupus erythematosus (SLE) and rheumatoid arthritis (RA) may present early (patients aged in their 30s and 40s) or have a late onset (age of 55 years and older). The systematic and local manifestations of these conditions are compounded by the normal aging process and influence the physical therapy management of older adults with arthritis.[2]

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