older people’s health issues
Gait Disorders in Older Adults
Treatment of Gait Disorders
A gait disorder does not always need to be treated or modified. A slow, abnormal gait may help an older person walk safely and without assistance. However, doctors may offer to treat a person's gait to help improve quality of life. Treatments include Exercise in Older Adults , balance training, and assistive devices. Frail older people with mobility problems may improve with an exercise program. Walking or A combination of leg press machines (or alternatively chair rises with weight vests or weights attached to the waist), step ups, stair climbing, and knee extension machines may be recommended to strengthen all the large muscle groups involved in walking. Nordic walking is a walking exercise that exercises the whole body. It includes adjustable length walking poles. Compared with traditional walking, the Nordic walking motion uses shoulder and arm muscles and requires greater pelvic rotation, increasing step length and walking speed. When starting a Nordic walking program, frail walkers need supervision and training to use the walking sticks safely. Many people with balance problems improve with balance training. First, health care professionals help teach people a good standing posture and balance while standing still. People are then taught to be aware of the location of pressure on their feet and how the location of pressure moves with slow leaning or turning to look to the left or right. People practice leaning forward (using a wall or counter for support), backward (with a wall directly behind), and to each side. The goal is to be able stand on one leg for 10 seconds. Balance training can also be more dynamic. Dynamic balance training can involve slow movements in a single stance, simple Tai chi movements, tandem (heel to toe) walking, turns while walking, walking backward, walking over a virtual object (for example, a stripe on the floor), slow forward lunges, and slow dance movements. Assistive devices, such as canes and walkers, can help people maintain mobility and Quality of Life in Older People . are particularly helpful for people with pain caused by knee or hip Osteoarthritis (OA) or with Walkerscan reduce the force and pain at an arthritic joint more than a cane, in people with enough arm and shoulder strength to use them. Walkers provide good stability and moderate protection from forward falls but do little or nothing to help prevent backward falls for people with balance problems. When prescribing a walker, a physical therapist considers the sometimes competing needs of providing stability and maximizing walking efficiency. Four-wheeled walkers with larger wheels and brakes maximize efficiency but provide less stability. Using a cane that is the correct height is important. A cane that is too long or too short can cause low back pain, poor posture, and instability. The cane should be held on the side opposite the weak leg. 