Efficacy of Balance and Flexibility Intervention in a Frail Female Centenarian

ABSTRACT

Purpose: The intent of this case study was to demonstrate that a balance and flexibility intervention can be efficacious for a frail female centenarian following illness, near death, and protracted inactivity. Methods: The participant was a 101-year-old female registered in a frail elderly exercise close attention An examination was performed prior to the exercise intervention, at the conclusion of 3 month (36 sessions) of supervised balance and flexibility exercise, and at follow-up 3 and 6 month later. trials and measures included: a modified Physical Performance ordeal (PPT), Berg Balance Scale (BBS) 15-meter preferr gait spe isokinetic and hand-held dynamometry nerve testing, goniometric lower extremity range of motion, Semmes-Weinstein monofilaments sensation testing, spe of reaction and coordination (toe tapping), 6-minute walk ordeal and 4 subscales of the SF-36 Results: Following the balance and flexibility intervention, the participant demonstrated marked gains in the modified PPT BB 15 meter preferr gait spe force and 6-minute walk test. Measurements declined by the agency of the 6-month examination but remained improved relative to baseline. Conclusion: This case demonstrates that frailty can be modified in a 101-year-old female participating in balance and flexibility exercises. Continued exercise at a reduc intensity may be useful for preserving a proportion of similar gains.

Key Words: aging, balance, flexibility, rehabilitation

INTRODUCTION

It is well established that with increased age there is diminished store up capacity of many organs and material substance systems that leads to diminished physiological capacity to rejoin to Stressors such as an illness provoking bed repose or hospitalization.1-5 Age-related changes include: decreased muscle potency and aerobic capacity, vasomotor instability, diminished bone density, reduc pulmonary ventilation, and decreased sensory input.'4 Bed quiescence or hospitalization of older ones further complicates usual aging and many times leads to dependency and increased frailty.'5 Complications of bed ease and immobility include: further los of muscle vigor and mass, diminished aerobic capacity or VO^sub 2max^, bone los decreased yielding tissue and joint flexibility or contractures, compressing ulcers, postural hypotension, decreased ventilation, insulin resistance,decreased cognitivefunction,and impaired balance and coordination.1-3,6

A hardly any days of bed rest can accrue in a loss of independence with ambulation or activities of daily living (ADLs) for an older adult who is frail and has diminished physiological reserve'3 Older someones often do not survive continue lengthen in timeed bed rest. Clark and colleagues studied independently ambulating older adults residing in an intermediate-care facility who 'took to the bed'for various reasons.They place that 12 out of 36 died in polisheds and 17 out of the 36 expired within 6 months6 Los of mobility come into views rapidly for high-risk frail senior patients (85+ years old) and may not invert by discharge from hospitalization.1,2 Therefore, many older adults are unable to go [i]or[/i] come back to their homes following hospitalization or bed repose particularly if they are more than 100 years old

Frail older adults are at high risk for falls, hospitalization, disability, and death.7'8 Fried etal specifically define frailty as"a clinical syndrome or a constellation of signs and symptoms in which at least 3 of the 5 possible criteria are present: (1) depressed strength, (2) slow walking spe (3) depressed physical activity, (4) self-reported unintentional weight los and (5) self-reported exhaustion."7 An individual may become frail secondary to the consequences of aging or by inexorable disease and comorbidity. In the Fried and associates definition of frailty, disease may be at hand overtly or subclinically. Disease can play an etiologic part in frailty but is not a necessary constituent of frailty.7 If disease is near it is most likely congestive heart failure (CHF)8 which has a poor prognosis regardless of age.9"1 Wang et al fix that 63% of institutionalized Old-old' olders died within the first year of diagnosis with CHF12

Several studies have demonstrated that exercise intervention is effective for enhancing physical performance in older adults.15-22 While exercisers improve, greatest in quantity age-matched controls remain unchanged if there is no change in their health status.18-21

The designs of this case study were two-fold individual aim was to illustrate the extraordinary case of a 101-year-old frail female who: (1) regained from near death following continue lengthen in timeed inactivity (6 months), (2) had with a diagnosis of stage III CHF (3) exhibited all 5 criteria for frailty according to Fried et al,7 and (4) had multiple comorbidities.The next to the first aim was to demonstrate that exercise is efficacious flat with severe frailty, prolonged inactivity including many hours of bed ease and other comorbidities.

METHOD

Participant

The participant was a 101-year-old female who participated in an exercise specificity close attention for the frail elderly. Aging had comeed in the signs and symptoms of frailty and disease had blended these symptoms to the expanse that the participant 'took to the bed' and was wait fored to die. She was mov in with family and received 6 month of hospice residence care. The participant had been living independently upon her farm until the age of 100 years.