Musculoskeletal Changes, Falls, and Rehabilitation in Aging

Changes in the Musculoskeletal System During Aging

During aging, there is a loss of bone mass, decreased muscle strength, osteoarticular changes, an increase in reaction time, and decreased speed of movement.

Gait Alterations

One of the consequences of changes that occur in the musculoskeletal system is an alteration in the structure of harmonious gait and balance.

Characteristics of Movement

• Slow movements.
• Slowing of trunk rotation.
• Reduced arm swing.
• Absence of heel lift.
• Minimal toe lift.
• Reduced single-leg stance.

Care for Nurses

• Re-educate balance.
• Encourage the use of assistive devices.
• Reduce environmental barriers.
• Recommend exercises to delay deterioration.

Osteoarticular Problems

Older adults may experience various joint diseases. The risk of disability is greater. In addition to factors such as heredity, injuries are the result of aging cartilage structures due to overuse or overstimulation.

Foot Disorders

Etiology includes: inappropriate footwear, repeated friction and pressure, changes in the skin (decreased sebaceous activity, less hydration, nutritional and metabolic disorders), and reduced mobility.

Care for Nurses

• Ensure the elder wears appropriate shoes for each activity.
• Moisturize the elder's feet.
• Use insoles to ease shoe pressure.
• Provide nail care, possibly by a chiropodist.

Falls and Fracture Risk

Fractures can be spontaneous or result from minimal trauma. Recovery requires immobilization, which causes a decrease in muscle mass and local and general deterioration of mobility.

Classification of Falls

Falls are categorized as intrinsic (due to individual factors) or extrinsic (due to environmental factors). This distinction is artificial because most falls result from a combination of causes. Fall prevention can be the first indication of an undetected disease. Repeated falls often indicate a decline in the patient's general condition. Preventing falls is an integral part of treating the elderly.

Targeted Physical Exercise

Regular exercise slows age-related changes.

Rehabilitation

Rehabilitation is a program aimed at compensating for disabling syndromes frequently suffered by the elderly. It should follow these evaluations:

• Physical assessment to establish guidelines for functional rehabilitation.
• Psychological assessment to understand the elderly's motivation.
• Assessment to identify the degree of collaboration of family members.
• Social assessment to identify resources available to the elderly and their families for rehabilitation and integration.

To establish a relationship of trust and cooperation with the patient, encourage participation in care, create realistic and optimistic expectations, maintain mobility for maximum functionality, regain independence, and integrate the elderly into the multidisciplinary team.

Recovery Stages

The recovery of disabling syndromes has two stages:

Acute Phase

This is the first phase of mobility recovery, and the final result depends on this phase. Care includes controlling the position, especially in the elderly.

Chronic Phase

This phase consists of adapting to everyday life with the changes presented. It aims to achieve functional recovery, balance in walking, training in daily activities, and training for the elderly to achieve independence.