Front Matter

Chapter 18 Rehabilitation for Geriatric Patients 471

Improving mobility

After pain has been managed, the next step in
the physical rehabilitation plan is to improve
mobility, as it is critical for quality of life.
Increasing daily exercise in moderation will start
to improve cardiovascular fitness,  endurance,
neuromuscular function, muscular strength,
and flexibility, as well as joint ROM.
Biological therapies, including stem cell and
platelet‐rich plasma (PRP) therapies, are poten­
tially valuable modalities for improving mobil­
ity and function. See Chapter 16 for information
regarding biological therapies.
Some geriatric patients may need assistance
with mobility, for walking, rising, or maneuver­
ing in their home environment. Frequent nail
trims and keeping the hair between the foot
pads and on the bottom of the foot short can aid
traction on slippery floors. Yoga mats or run­
ners can be placed over slippery floors. Skid‐
resistant dog socks, foot waxes, or sprays
promoting traction are available to help pre­
vent slipping. Canine‐specific booties are help­
ful in winter to prevent snow from forming ice
between the foot pads and to prevent salt from
irritating them (Figure 18.8).
After traction has been addressed, strength
and ability to rise independently should be
evaluated. Patients with severe DJD may lack
pain‐free ROM in the affected joints, inhibiting
ability to transition into a standing position.
Muscle atrophy from sarcopenia or from pain‐
related inactivity may contribute to weakness,

incoordination, and inability or difficulty ris­

ing. Patients needing assistance rising benefit

from devices that aid elevation from the floor

such as slings under the belly, chest harnesses,

harnesses that lift under the pelvis, or harnesses

that combine lifting and support under the

chest and the pelvis. These devices also provide

balance support for ambulation. Patient needs,

including a consideration of the environment

as well as client abilities and needs, ease of use,

and patient comfort all should be considered

when recommending and selecting an appro­

priate harness or sling (Figure 18.9).

Figure 18.8 Boots can provide protection from cold

temperatures as well as increased traction in wintery

climates.

Figure 18.9 Patient demonstrating a harness that assists in lifting through both the chest and pelvis.