Sarcopenia: Causes and Clinical Implications And Postoperative Complications in the Elderly Stefany Shaibi, PT, DPT, OCS, GCS

Transcription

1 2018 Borden-Taber Lecture Series April 28-29, 2018 Physical Therapy Alumni Chapter Presents: A Practice Update: Physical Therapy Management of the Geriatric Patient, information for use across practice areas NAU Phoenix Biomedical Campus, Health Sciences Education Building Saturday April 28 Part I: Sarcopenia: Causes and Clinical Implications And Postoperative Complications in the Elderly Stefany Shaibi, PT, DPT, OCS, GCS Abstract: Sarcopenia is defined as the age-related loss of muscle mass and muscle function that occurs with age. It is generally considered a normal aspect of aging; however, the consequences of this condition can be extremely limiting for older individuals. There are many factors that contribute to sarcopenia, several of which are modifiable. Current literature supports a multi-faceted approach to address the impairments and functional deficits seen with sarcopenia. We will broadly cover causes, clinical assessment, and evidence-based treatment of sarcopenia in the geriatric patient. This information can be used across the continuum of practice areas. With increasing rates of orthopedic surgeries in the elderly, it is important to understand the variability of healing and the increased risk of complications in this population. There are physiologic changes that occur with normal aging that can have an effect on tissue healing. Additionally, several comorbidities may increase the risk of complication. We will discuss the evidence associated with specific complications, including clinical assessment. Furthermore, we will examine the current literature related to prevention of complications.

2 Objectives: As a result of having participated in this course participants will: 1. Understand normal aging with respect to muscle 2. Review current research highlighting the various causes of sarcopenia 3. Identify and understand the potential causes of sarcopenia 4. Appreciate the clinical implications for these physiologic changes 5. Understand the current literature regarding clinical assessment of muscle performance and sarcopenia 6. Discuss the practical application of the clinical assessments 7. Appreciate evidence-based interventions for sarcopenia 8. Discuss the practical application of the interventions in a variety of clinical settings 9. Understand the effect of aging on the ability to heal 10. Know the effect of specific comorbidities on post-operative management of older adults 11. Discuss the clinical assessment of a post-operative patient 12. Recognize the signs and symptoms of complications that warrant further medical assessment 13. Identify the risks associated with immobilization 14. Review the literature regarding prevention of postoperative complications Saturday April 28 Part II: Exercise Testing and Prescription for the Older Adult Pamela Bosch, PT, DPT, PhD Abstract: This session will review exercise testing and prescription for older adults. We will discuss safe physiological response to exercise and will practice measuring vitals and conducting submaximal tests of aerobic capacity. Participants should bring a stethoscope if they have one and dress for exercise testing Objectives: As a result of having participated in this course participants will: 1. State the relevance of measuring patient vitals and implications of abnormal values. 2. Accurately obtain blood pressure using techniques that minimize measurement error. 3. State the benefits of using a submaximal test of aerobic capacity. 4. Perform a submaximal test of aerobic capacity and use the information to formulate aerobic exercise prescription.

3 Sunday April 29 It s All About Balance: An anatomical based approach to recovering balance and gait speeds in the geriatric patient Valerie Carter, PT, DPT, NCS Abstract: The geriatric patient has an aging vestibular, vision, orthopedic, integumentary and cardiopulmonary systems that are all connected to an aging brain. All of these systems interact to create appropriate levels of balance and gait speeds. Depending on the amount of aging or disease that has occurred in any given system, each elderly individual s balance and gait training needs will vary. The elderly individual s balance and gait speed should be appropriately assessed through precise clinical outcome tools and addressed via the creation of a dynamic disease specific approach to exercise. In this session we will discuss the functional anatomy of the central and peripheral nervous system and learn to appropriately assess and apply a dynamic exercise driven treatment approach to improved balance and gait speeds. Participants should and come prepared to move and exercise. Objectives: To be able to. 1. Describe the function of the neurological anatomy associated with gait and balance 2. Describe the common neurological and increased age driven deficits that can cause dysfunction in gait and balance 3. Describe and apply the neuroplasticity principles that can drive change in the damaged central nervous system 4. Describe and demonstrate exercise based treatment strategies that can positively change balance and gait in the patient with neurological deficits, increased age and inactivity

4 Schedule: Saturday, April 28th 7:15-8:00 Registration and Introduction 8:00-9:15 Overview of Sarcopenia 9:15-9:30 Break 9:30-10:30 Clinical Assessment and Interventions for Impaired Muscle Performance 10:30-10:45 Break 10:45-12:00 Post Operative Complications in the Elderly 12:00-1:00 Lunch on your own 1:00-1:50 Evidence-based discussion of hypertension, its implications, and the influence of exercise in modulating it. 1:50-2:20 Practice blood pressure measurements using best practice 2:20-2:35 Break 2:35-3:05 Evidence-based review of aerobic exercise and all-cause mortality, and physical activity guidelines for Americans 3:05-3:55 Evidence-based aerobic exercise prescription for adults; review of normal and abnormal physiological response to aerobic exercise 3:55-4:10 Break 4:10-5:00 Administration of submaximal tests of aerobic capacity; formulation of exercise prescription 5:30-?? NAU Alumni Social at nearby brewpub (please RSVP in note when registering) Sunday, April 29 8:00-8:30 Registration and Introduction 8:30-10:00 What is the anatomy of gait and balance deficits associated with increased age, inactivity & damage to the CNS 10:00-10:15 Break 10:15-11:30 Great treatment strategies begin with great assessments: What do the tests and measures tell me about treatment 11:30-12:15 Introduction of treatment strategies that promote neuroplastic changes in gait and balance 12:15-12:30 Break 12:30-1:15 Treatment strategies that promote neuroplastic changes in gait and balance 1:15-2:00 Q and A End of Session Approved CEUs: (AzPTA approval pending) Cost: PT: $150, One Day Registration: $75 PTA $100/$50, Student $25 Registration: Please click on the following link for online registration: Handouts:

5 We will the dropbox link to registered participants once slides are available. Handouts will not be printed. This is a NAUPTAC event that directly benefits NAUPT students in the form of scholarships. Please attend and support this program! Any and all questions can be directed to racheledorsey@gmail.com