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April 2009 --  Vol 1, Issue 2
CEO's Corner
EDUCATA's commitment is to offer you quality, clinical content. 
With that in mind, this issue is dedicated to 'The Aging Patient'.  Drs. Avers & VanBeveren have convinced me how to optimize my treatment of this population. 
Also, with this issue we are proud to announce free clinical research articles available to our members!  See the message below for how to access this valuable content.

Let us know what you think!

Marilyn M. Pink, PT, Ph.D.
EDUCATA'sCourses meet the Continuing Professional Development (CPD) and Continuing Education Units (CEU) requirements in most countries, states, provinces and territories.
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Do you treat any patients over the age of 35?  If so, you are dealing with physiological changes known of as 'Aging'. 
Thanks to the great research that is now available at EDUCATA, physical therapists are able to better optimize treatment and conditioning!  Join us for these courses - or get your feet wet with just one of the lectures!  

Pat VanBeveren and Dale Avers
Test your familiarity with this subject.  Take this quiz about treating the aging adult (answers below):

1. Which exercise would have the greatest effect on improving functional ability in the aging population?
a.    Running
b.    Swimming
c.    Strengthening
d.    Exercise bike

2. Community dwelling older adults, who are functioning well in the community, are able to:
a.    Walk over mile
b.    Climb 20 stairs
c.    Carry a 15 lb package
d.    Have a gait speed of at least 1.5 meters/second
3. The most powerful predictor of functional decline is:
a.    Speed of movement
b.    Strength of a muscle
c.    Weight of the person
d.    Age of the person
4. The optimal stretching time  and number of repetitions for an adult over the age of 65 years is:
a.    10 seconds, 10 repetitions
b.    5 seconds, 20 repetitions
c.    30 seconds, 4 repetitions
d.    60 seconds, 4 repetitions
5. Of the following, what is the best standard for community mobility?
a.    Ability to transfer
b.    MMT
c.    Ability to ambulate 1000 feet at a rate of 0.8m/s
d.    Self report of ability to move about in the community
6. A score of the Timed Up and Go (TUG) of 15 seconds most likely means the individual has:
a.    No risk for falls
b.    Risk for falls
c.    No mobility impairments
d.    Dependency
And the correct answers are...
1. c    --    2. a    --    3. a    --    4. d    --    5. c    --   6. b
How did you do?  Is this a subject about which you would like to learn more?  If so, please check out Dr. Avers and Dr. VanBeveren's excellent interactive class: Functional Assessment and Exercise for the Aging Adult -- Part I.
Pictured here: aging progression.  Please notice that in the 67-year-old there is a smaller muscle mass, increased intra-muscular fat, larger subcutaneous fat, and decreasted cortical bone mass.
Roubenof, Journal of Gerontology, 2003.  Click here to access full article.
Age-related decline in lean body mass affects functional capacity of older adults:
-- Men experience a decline in body mass almost 2X that of women 
-- If sarcopenia were completely eliminated,
   o)  85.5% of the disability cases in older men would be eliminated
   o)  26% in older women would be eliminated
Jensen, 2004.  Click here for abstract.
Natural aging produces a strength decline of 10% a decade -- with an accelerated loss when reaching the age of 50 years.
-- Exercise can slow this decline
-- Lack of activity increases this rate
Lindle et al, 1997.  Click here to access full article. 
THE SLIPPERY SLOPE OF AGING  Slippery slope of againg -- right
Without exercise, aging is accompanied by a slippery slope of decreased vigor, as seen in the first curve in image to the right.  With exercise --and the correct exercise-- physical therapists can help their patients stay in the "fun" category with all the requisite vigor and energy as they age, as illustrated by the lines with arrow in the image.
Aging_coursesFunctional Assessment and Exercise for the Aging Adult Course & Lectures
a. Introduction to Functional Assessment          
b. Mobility Disability
c. Introduction to Exercise                      
d. Strengthening Principles          
Part II - Coming Soon!
a.  Assessment of, and Intervention for, Frailty  
b.  Assessment of Impairments Related to Mobility Disability
c.  Functional Assessment of Balance & Balance Confidence
d.  Intervention for Balance and Falls   
Physical Therapy Interventions for the Aging Patient - Coming Soon!
a.  The Knee  
b.  The Hip 
c.  The Spine
d.  The Shoulder 
Exercise for the Aging Patient - Coming Soon! 
a.  Incorporating Motor Learning and Strengthening into interventions for 
     the CNS   
b.  Interventions for Posture and Osteoporosis
c.  Aerobic Exercise  
d.  Cardiovascular Exercise Interventions  
We are very pleased to offer our members a new service: articles containing original research on topics of relevance for physical therapists around the world.  No matter where you live of whether or not you have access to medical libraries, you now have clinical research available .  We trust that you will find them to be important tool in your continued professional development. 
They are available FREE OF CHARGE and we encourage you to share this treasure trove of knowledge with your friends and colleagues: pass along this e-mail and tell them to register with EDUCATA to get access to our professional articles feature.
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