Front Matter

Chapter 18 Rehabilitation for Geriatric Patients 457

Rehabilitation objectives for the geriatric
patient include managing pain, improving
mobility and strength, providing appropriate
assistive devices to promote independent
ambulation, and modifying the patient’s home
environment to provide adequate traction, bed­
ding, and obstacle‐free space for ambulation.

Conditions commonly affecting
the geriatric patient

Susceptibility to disease increases with age as
the body’s ability to respond to stress and main­
tain homeostasis declines. Graying of a dog’s
muzzle with age is a common occurrence
(Figure 18.2). A 2016 study indicates that anxi­
ety may contribute to premature graying of the
muzzles of young dogs (King et al., 2016).
Cellular metabolism releases reactive oxygen
species that cause free radical or oxidative dam­
age. Oxidative damage reduces mitochondrial
function, which affects the normal mechanisms
of cell differentiation and apoptosis (Johnson et
al., 1999). In the case of cancer, it is suspected
that normal apoptosis (programmed, orderly
cell death) is interrupted, and rapidly dividing
cells or cells with mutations propagate (Guyton
& Hall, 2011).
Physical rehabilitation in geriatric patients
often must be tailored to accommodate for

medical issues to avoid compromising the

patient’s condition when providing treatment.

Older patients can have issues with lethargy,

weakness, wound healing, change in quality

of hair coat, urinary habits, body weight,

and general immune resistance to infection

(Strasser et al., 2000). Proper diagnosis of con­

ditions that contribute to these issues is impor­

tant to allow patients to tolerate and receive

Figure 18.2 Oxidative stress is one hypothesis for the

graying of the coat that occurs in most older dogs.

Figure 18.1 A rehabilitation therapist can improve the quality of life of a geriatric dog by challenging the dog with
new, but safe, ways to strengthen supporting musculature, such as standing on a disc.