Geriatrics ECHO Clinic AIM Statement : The Geriatrics ECHO clinic will coach interprofessional teams on the principles of person-centered care for older adults with chronic health conditions.
Disclaimer Video will be taken at this clinic and potentially used in Project ECHO promotional materials. By attending this clinic, you consent to have your photo taken and allow Project ECHO to use this photo and/or video. If you don’t want your photo taken, please let us know. Thank you!
Please DO NOT disclose any Protected Health Information (PHI) PHI includes, but is not limited to: - Patient name - Date of birth - Address - Occupation - Name of patient’s friends/family - Other identifiable features, i.e. scars, tattoos, hair/eye color
Thank you! • This project is/was supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1QHP33111, Geriatrics Workforce Enhancement Program for $726,584. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by, HRSA, HHS, or the U.S. Government. • Special thanks to the EJC Foundation for their support of the Project ECHO geriatrics clinics and the Sanford Center Geriatric Specialty Clinic.
Announcements • Clinics are the third Tuesday of each month • We encourage Case Presentations. See our website for the case review form • We are starting a 5-month Patient Engagement Series November- March • Next geriatrics clinic: Tuesday, January 21 st , 12 to 1 pm • January topic - Nutrition • February topic - Transitions in Care • March topic – Sleep • Please complete the demographic form at: https://bit.ly/33GX3uq
Keys to Maintaining Physical Function in Older Adults Jim Fitzsimmons, VP Student Services, UNR
Conflicts of Interest • No conflicts of interest related to today’s discussion
Objectives • Explain the benefits, set-up, execution and points of performance for the air-squat and deadlift for older adults • Describe “scaling” of movements and how to apply it to older adults • Apply the concepts of strength and power to increase work capacity in their clients
Strength – Basis of Function • Balance • Coordination • Agility • Proprioception • Power • Endurance are ALL grounded in strength
What are the Performance needs of a Geriatric Patient versus an Olympic Athlete? None They are simply on a different order of magnitude
The Five ADLs: • Bathing: personal hygiene and grooming • Dressing: dressing and undressing • Transferring: movement and mobility • Toileting: continence-related tasks including control and hygiene • Eating: preparing food and feeding
Common “Senior” Fitness Tests • Groningen Fitness Test • Senior Fitness Test (aka Fullerton Functional Test) • AAHPERD Functional Fitness Test
Squat (Basic Set-Up and Points of Performance) • Shoulder width stance • Weight in heels • Butt moves back and down • Maintain lumbar curve • Knees track parallel to toes • Seam of hip lower than top of knee (below parallel) • Return to full extension
Squat Modifications • Scale the Depth • Scale the Starting Point • Provide Balance Points
Squat Training Volume • Set a goal – example: 20 squats ( that meet the performance standard) for time • When goal is achieved reassess and choose loading or volume or speed increase.
(Top Down) Deadlift Set up and Execution • Hip width stance • Weight in heels • Bar at waist - grip one thumb outside of thigh • Push hip back slight bend in knee (shin remains vertical) • Bar down top of knee • Bar to mid shin • Knees behind arms • Lift chest (name tag) • Chin neutral • Load, hip and shoulder rise at same rate!
Deadlift Modifications • Weight of the load • Height of the Load
References Edemekong, P., Bomgaars, D., Shoshana, B. (2019) Stat Pearls, Activities of Daily Living. National Institute of Health Glassman, G. CFL 1 Training Guide (2019) Baechle, E. National Strength and Conditioning Association (2015) –Essentials of Strength Training and Conditioning 4 th Edition. Rippentoe, M., Kilgore, L (2007) Starting Strength 2 nd Edition. Aasgard Press ChoosingWisely.Org: http://www.choosingwisely.org/wp- content/uploads/2015/02/APTA-Choosing-Wisely-List.pdf
Additional Announcements Refer your patient for a Comprehensive Geriatrics Assessment at the Sanford Center for Aging or via telemedicine at: med.unr.edu/aging or call 775-784-4774 The funding agencies that provide support for the geriatrics ECHO ask us to provide information about the type of attendees who attend our sessions. Please complete the demographic form at: https://bit.ly/33GX3uq
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