Physio for Seniors offers seminars, classes and workshops on the following topics.  Customized educational sessions can be conducted at your request.  We strive to educate healthcare professionals, care givers and seniors so as to promote healthy lifestyles with fewer injuries.

  • Safe Handling and body Mechanics

This workshop is specially designed for nurses and care aids in long term care.  The goal is to educate about correct posture, body mechanics and ways to assist residents while minimizing the load on the body.   Participants can have their posture and movement assessed while working together to practice resident handling on each other, (such as shifting up the bed, or transferring from wheelchair to bed) as safely as possible.  A few safety tips and movement training can go a long way in prevention of injuries for a lifetime.

  • Movement and Mobility for Seniors

This seminar can be adapted to be more theory-based, more practical or somewhere in between, depending on the preference of the audience.  A common request is to focus on balance and falls prevention.  Participants are educated on facts and statistics about aging, falls, exercise as well as practical tips on health, wellness, exercise and falls prevention.  Interspersed between the topics are opportunities for movement, balance training, posture correction and deep breathing.

  • Posture and breathing for Seniors

This is a largely practical session during which participants are made aware of the common postural faults and how to correct them. It is done in exercise format in a large space.  People suffering from chronic obstructive pulmonary diseases will also benefit as it includes breathing exercises combined with good posture training. Good posture is best learned through regular, focused, dedicated practice and can be corrected at any age with enough motivation and determination.

  • Balance and stability class

The focus of this workshop is alignment, movement, stability and balance training.  Participants learn to sit or stand with correct alignment, then weight shift and progress from simple to more complicated balance exercises with decreasing base of support.  Safety is paramount in this class and the exercises are catered to the abilities of those attending.  Walkers and chairs are used for support and instructors provide hand-held assistance as needed.

  • Strength training class

This group classes uses weights, elastic bands and body weight to provide the resistance for building stronger muscles.   All the major muscle groups are targeted in functional and balanced ways, exercising opposing muscle groups as well.  Good posture, core muscle control and balance are incorporated as foundations for the building up of strength and endurance.   The goal is to become stronger for ease of carrying out the activities of daily living and being resilient enough to weather times of illness.

  • Stretching and mobility class

As we age, we spend more and more time seated and hunched over. As a result, the same, predictable patterns of muscle shortening and tightening occurs. This class focuses on moving the joints through normal joint ranges of motion and stretching soft tissues that characteristically tighten up. If participants have particularly stiff areas as a result of previous injuries, these can be worked on as well.

  • Getting up from the floor

In some cultures, sitting on the floor and squatting is the norm.  Elderly in these cultures tend to be more mobile and have no trouble getting up and down from the floor. In the west with prolonged sitting on chairs and seated toilets, mobility is gradually lost in the hips, knees and ankles as well as strength to lift the body through a greater range of motion.   In this workshop, we practice getting up and down from the floor in a safe way.  This task may need to be broken into simpler, component parts in preparation for the actual task.

  • Healthy aging and how to care for an aged loved one

This is a class for care givers, family members and anyone who would like to engage in an interactive session on healthy aging and practical tips on caring for the elderly with emphasis on the physical aspects of caring.   Safe handling and body mechanics is discussed and practised.  Participants can share with the group difficulties they are having or methods that worked well for them.  This can be turned into a support group or sharing session.

 

Stroke Rehabilitation

Stroke rehabilitation should begin once the person is medically stable and as soon as possible.  The goals of physiotherapy and rehabilitation post stroke is to minimize loss of function, promote normal posture, movement and balance reactions, and prevent or reduce contractures due to spasticity.

Stroke rehab consists of taking the client through movements that they should be performing in everyday life and performing them as normally as possible. The person is encouraged to engage in activities such as dressing, brushing hair, feeding, writing, sitting up in bed, standing up, walking, stair climbing, getting in and out of a car if able.  Wheelchairs, walking aids, splints and orthoses may be required and ordered.

Areas worked on:

  • Posture and alignment is improved with positioning in bed and wheelchair using aids that facilitate normal posture. Clients practice sitting and standing correctly with equal weight distribution and may practice weight transfers.
  • Movement and mobility is fostered by stretching, joint mobility, splinting, and practising normal postures and movement. Referrals can be made to a physician who will administer Botox injections to reduce spasticity and contractures.
  • Balance and stability are often affected. Sitting and standing balance can be fostered by balance activities such as throwing and catching balls, reaching, sitting or standing with eyes opened, then closed, reducing base of support and making the activities more challenging.
  • Gait training – clients are taught to use a walking aid if needed and walk with as normal a gait pattern as possible. Orthoses and splints may be used to support weak or contracted areas such as foot drop.
  • Fine motor skills can be facilitated through peg boards, board games, writing, knitting and other such activities.

We provide lots of encouragement focusing on achievements and what the person can do rather than on what has been lost.

 

Falls Prevention

Falls are caused by environmental factors such as slippery surfaces, obstacles, inadequate lighting and poor footwear or by inherent factors such as poor safety awareness, weakness, poor vision, posture and balance. Medication that lowers blood pressure, leads to drowsiness and dizziness can cause falls, as can medical conditions, poor diet and nutrition that cause weakening.

The first step is to identify the cause of the fall, such as risk factors in the environment, for example, rugs, chair legs, lighting and minimize the risk.  Clients should be protected against harm by ensuring proper footwear, wearing hip protectors, installing falls mattresses, bedside rails, alarms and such precautions.  The client’s physical ability and balance reactions should be enhanced using stretching, strengthening, posture correction, balance and gait training, aerobic conditioning and compensations for poor vision and balance.  Walking aids and companions may be required for extra security.

 

Pain Management

Seniors suffer from pain generally as a result of a previous injury such as car accident or fall, faulty habitual postures or movement patterns and some kind of medical condition or disease such as arthritis.  Pain is often treated using ice, heat, manual therapy, exercise, electrotherapy, acupuncture, TENS, drugs and surgery.  Musculoskeletal pain is best resolved by finding the root cause of the pain and reducing loading on the symptomatic area by A aligning, B balancing and C centering the body.

A thorough physiotherapy assessment aims to identify the root cause and contributing factors of the symptoms.  For example, knock knees, bow legs, rolled in ankles, a twisted pelvis or hunched posture may need correction.

A previous trauma together with daily incorrect habitual postures is a common recipe for pain. Commonly, car accidents that happened years ago introduce restrictions and mal-alignment into the body. It may take years for the symptoms to surface because of the cumulative wear and tear and compensatory mechanisms.

The solution can be found in accurately diagnosing the cause and contributing factors. The client should be made aware and modifications made to reduce the stress and strain.  Correct posture and movement is taught and practised.  Strategic use of release techniques such as manual therapy, heat and massage as well as exercise to strengthen weak areas will help with A aligning, B balancing and C centering to relieve pain.

 

Post hospital recovery

Hospitalization often takes a toll on patients even if they are admitted for a short time.  For every day spent in bed it takes 3 days to rebuild base-line strength and endurance. They may not be mobilizing and walking often enough and the illness may leave them considerably weaker on discharge. Add to this, the use and side effects of drugs and any secondary infections they may have caught at the hospital.  Often times, the mobility loss can be reversed.   A dedicated period of strength and balance training, deep breathing and walking can bring about recovery to the pre-hospital state and restore independence.  Even if this does not happen, it is possible to improve the level of function and mobility to a certain extent, especially if the client is willing and cooperative.

Physio for Seniors offers rehabilitation post surgical repair of fractures, total hip and knee reconstruction and any other orthopaedic surgical procedures.  We follow the protocols recommended by the surgeon and health authority when mobilizing and progressing the patient through the stages of recovery.  Precautions and mobility restrictions are enforced to ensure good healing and minimal complications.  We also teach the patient and care givers home exercises they can do in between physiotherapy or rehabilitation sessions.

We offer support through motivation and encouragement, and reminders of the benefits of adhering to the rehabilitation program.  Seniors are often faced with a new level of ability, pain or weakness, or have obtained a new assistive device or walking aide.  They need support to use these safely and to adapt to changes in physical ability.

 

Post fall recovery

A patient may suffer a gamut of injuries ranging from minor bruising, soft tissue strains, spinal compression fractures to a fractured shoulder, hip or pelvis after a fall.   A fracture may need surgical repair, weight bearing limitations, pain management and gradual return to movement.  Outcomes vary client by client. Our goal is to reduce pain, regain function and strength to return to the pre-fall level of mobility and independence as best as possible.

After a fall there is often anxiety, change of posture, alignment and gait.  We can help reinstate a sense of confidence by providing close physical support and gradually withdrawing this as the patient becomes more capable, restoring greater freedom of movement with less fear or worry.

Change in alignment is corrected using gentle release and stretching of soft tissues and strengthening where weakness develops. Protective postures develop and are difficult to correct if left for long periods of time.  Working with people soon after a fall promptly helps to restore optimal posture and prevent muscle shortening or lengthening that leads to poor posture or misalignment.

Seated Sail and dynamic balance exercises will be prescribed.  The individual weaknesses and factors causing the fall will be identified and corrected.  We help clients become more self-aware of their bodies in space (proprioception training).  After a fall, the chance of recurring falls increases.  Hip protectors, walking aids, companions, personal medical alert system, bed or chair alarms, and wheelchairs may be recommended.


Rehab for dementia clients

Dementia clients can be both rewarding and challenging to work with. Extra grace and patience is sometimes required but when good rapport and trust is established, the experience can be very rewarding.

The challenge is to keep them focused on a task.  If short term memory is poor, the patient may forget who you are, what they are doing and why they are doing it.  They might repeat themselves over and over again and the conversation can go around in circles.  They may also have issues of hypersensitivity to touch and a low pain threshold.

Physio for Seniors staff is experienced at refocusing patients back to the task at hand with gentle touch cueing, guidance, simple instructions, finding what works for each patient, what they enjoy and going with the flow rather than adhering to a strict regime to get the therapy done.

The key is sometimes to follow the patient’s lead and go with more automatic movements that they might initiate, like reaching for objects, sit to stand, and walking.  Some patients do not like to exercise, so allowing for spontaneous movement that is similar to what is being achieved, enjoyable and meaningful to the patient can work better.

Part of therapy can include sharing a moment looking at photos, flowers, art work, throwing and catching a ball or playing a game such as soccer with a soft ball.  Establishing trust, rapport and familiarity is essential to overcoming resistance to therapy.  We can gently reframe tasks such as “can I join you for a walk?” rather than insisting that they must walk because it is time for therapy.

One of the most rewarding experiences is when a dependent patient progresses to becoming a safe and independent walker actively participating in the world around them, being mentally and physically stimulated, instead of spending day after day lying down or sitting alone in a room.

Physio for Seniors staff is skilled at establishing a human connection with dementia patients and making therapy enjoyable.  Once the trust and repetition is established, the therapy session can be a source of comfort and familiarity to the patient and they really start to look forward to it.