Geriatric Concerns and Arthritis

Osteoarthritis (OA) primarily affects

•the articular cartilage and subchondral bone.  Most commonly occurs in weightbearing bones

•Risk factors: Obesity, trauma, infection, repeated overuse

Intervention Goals for Patients with OA

•Relieving pain

•Minimizing disability

•Reducing risk of disease progression

•Education (disease, nutrition, weight control, use of assistive device)

•Modification of activities

•Maintenance of ROM

Conservative Interventions

•Gait and Balance training

•Manually therapy techniques

•Progression of strengthening exercises

•Stretching exercise to maintain  or improve flexibility

General Precautions

•Use caution with closed-chain activities and high impact activities as they can cause shear and compression forces

Hip OA possible interventions

•Stretching of the iliopsoas

•Strengthening of the gluteus medius

•Alter G

•Aquatic exercise

Knee OA possible interventions

•Strengthening of quads, hamstrings, hip musculature

•Stretching of hamstrings, quadriceps, hip flexors, gastrocsoleus

•Gait and balance training

•Reduced weight bearing exercises

•Unloader braces

Glenohumeral OA

•Postural corrections

•Joint mobilizations

•Flexibility exercises

•Strengthening exercises

•Activity modification

OA of the thumb CMC

•Often occurs with people who perform manual labor.  Also PT/PTAs (especially with lots of manual therapy)

•Often begin with hypermobility then ends in hypomobility 

•Protective splinting may be used (thumb spica)