Title: Octogenarian with Chronic Low Back Ache, Decreased Balance Unilateral Leg Muscle Atrophy Treated with Physiotherapy – Evidence Based Case Study Report

Author: Dr S.S.Subramanian

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i2.125

Abstract

Octogenarian subject with chronic lowback ache, disturbed balance, requiring hand support for walking and moderate dependence for his daily activities was treated with evidence based physiotherapy on clinical evaluation. With a frequency of twice a week in 4 months duration he is able to walk unaided, improved balance and Oswestry functional subjective score from 70% to 40%. Chronic pain, decrease in balance and increased dependence for daily activities can be enhanced with physical therapy with due clinical evidence, an 84 year old patient exhibiting adequate prognosis is the major outcome of this case report.

Keywords: Oswestry Disability Index, Visual Analogue Scale, British Geriatric Society (BGS), American Geriatric Society (AGS) Sarcopenia.

References

1.      ACMS (American College of Sports Medicine). Exercise and physical activity for older adults. Med Sci Sports Exercise 2009: 1510–1530

2.      Ciolac EG, Exercise Training and Aging. Exercise training as a preventive tool for age-related disorders: a brief review. Clinics 2013; 68(5):710-717.

3.      Chodzko-Zajko WJ, Proctor DN, Fiatarone-Singh MA, Minson CT, Nigg CR, Salem GJ, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009; 41(7):1510-30.

4.      Ciolac EG, Guimara˜es GV. Importaˆncia do exercı´cio resistido para o idoso. Rev Soc Cardiol Estado de Sa˜o Paulo. 2002; 12(Supp A):5-26.

5.      James E. Leone and Steve Middleton  (2016) Nontraumatic Testicular Pain due to Sacroiliac-Joint Dysfunction: A Case Report. Journal of Athletic Training: August 2016, Vol. 51, No. 8, pp. 651-657.

6.      Fiatarone-Singh MA. Exercise comes of age: Rationale and recommendations for a geriatric exercise prescription. J  Gerontol  A Biol Sci Med Sci. 2002; 57(5):M262–82.

7.      Klitgaard H, Zhou M, Schiaffino S, Betto R, Salviati G, Saltin B. Ageing alters the myosin heavy chain composition of single fibres from human skeletal muscle. Acta Physiol Scand. 1990 Sep; 140(1):55-62.

8.      Rantanen T, Jack M. Guralnik, LuigiFerrucci,Suzanne Leveille, and Linda P Fried. Coimpairments: Strength and Balance as Predictors of Severe Walking Disability. Journal of Gerontology: MEDICAL SCIENCES 1999, Vol. 54A, No.4, M172-M 176

9.      Ciolac EG, Garcez-Leme LE, Greve JMD. Resistance exercise intensity progression in older men. Int J Sports Med. 2010; 31(6):433–8.

10.  Guralnik JM, Ferrucci L, Pieper CF, et al. Lower extremity function and subsequent disability: consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery. J Gerontol A Biol Sci Med Sci. 2000; 55(4):M221–M231.

11.  Fiatarone M A, Marks E C, Ryan N D, Meredith C N, Lipsitz L A, Evans W J. High-intensity strength training in nonagenarians. Effects on skeletal muscle. Journal of the American Medical Association. 1990;263:3029–3034.

12.  Mangione KK, Craik RL, Palombaro KM, Tomlinson SS, Hofmann MT. Home-based leg-strengthening exercise improves function 1 year after hip fracture: a randomized controlled study. J Am Geriatr Soc. 2010; 58:1911–1917. 

13.  Sattelmair, J. R., Pertman, J. H., and Forman, D. E. (2009). Effects of physical activity on cardiovascular and noncardio-vascular outcomes in older adults. Clin. Geriatr. Med. 25, 677–702. doi: 10.1016/j.cger.2009.07.004

14.  Ciolac EG, Brech GC, Greve JMD. Age does not affect exercise intensity progression among women. J Strength Cond Res. 2010; 24:3023–31. 

15.  Binder EF, Schechtman KB, Ehsani AA, Steger-May K, Brown M, Sinacore DR, et al. Effects of exercise training on frailty in community-dwelling older adults: results of a randomized, controlled trial. J Am Geriatr Soc. 2002; 50(12):1921–28.

16.  Lord SR, Ward JA, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 1994;42:1110-7.

17.  Chodzko-Zajko WJ, Proctor DN, Fiatarone-Singh MA, Minson CT, Nigg CR, Salem GJ, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc. 2009; 41(7):1510–30.

18.  American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the prevention of falls in older persons. J Am Geriatr Soc. 2001; 49(5):664–72.

19.  Singh N, Clements K, Fiatarone-Singh M. The efficacy of exercise as a long-term antidepressant in the elderly: A random-ized controlled trial. J Gerontol  A Med Sci. 2001; 56(8):M1–M8.

20.  Haykowsky, M., McGavock, J., Vonder Muhll, I., Koller, M., Mandic, S., Welsh, R., et al. (2005). Effect of exercise training on peak aerobic power, left ventricular morphology, and muscle strength in healthy older women. J. Gerontol. A Biol. Sci. Med. Sci. 60, 307–311.

Corresponding Author

Dr S.S.Subramanian

M.P.T (Orthopaedics), M.S (Education), M. Phil (Education), Ph.D (Physiotherapy)

The Principal, Sree Balaji College Of physiotherapy, Chennai – 100

Affiliated To (Bharath) University, BIHER Chennai – 73

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., This email address is being protected from spambots. You need JavaScript enabled to view it.

Phone: 99400 47137