Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated ...Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.展开更多
Total knee arthroplasty(TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known ab...Total knee arthroplasty(TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known about the influence of TKA on overall physical activity levels. Physical activity, defined as "any bodily movement produced by skeletal muscles that results in energy expenditure", confers many health benefits but typically decreases with endstage osteoarthritis. The purpose of this review is to describe the potential benefits(metabolic, functional, and orthopedic) of physical activity to patients undergoing TKA, present results from recent studies aimed to determine the effect of TKA on physical activity, and discuss potential sources of variability and conflicting results for physical activity outcomes. Several studies utilizing self-reported outcomes indicate that patients perceive themselves to be more physically active after TKA than they were before surgery. Accelerometry-based outcomes indicate that physical activity for patients after TKA remains at or below pre-surgical levels. Several different factors likely contributed to these variable results, including the use of different instruments, duration of follow-up, and characteristics of the subjects studied. Comparison to norms, however, suggests that daily physical activity for patients following TKA may fall short of healthy agematched controls. We propose that further study of the relationship between TKA and physical activity needs to be performed using accelerometry-based outcome measures at multiple post-surgical time points.展开更多
Background: Patellar tendinopathy(PT) or "jumper's knee" is generally found in active populations that perform jumping activities. Graded exposure of patellar tendon, stress through functional exercise h...Background: Patellar tendinopathy(PT) or "jumper's knee" is generally found in active populations that perform jumping activities. Graded exposure of patellar tendon, stress through functional exercise has been demonstrated to be effective for the treatment of PT. However, no studies have compared how anterior knee displacement variations during the commonly performed forward step lunge(FSL) affect patellar tendon stress.Methods:Twenty-five subjects(age: 22.69 ± 0.74 years; height: 169.39 ± 6.44 cm; mass: 61.55 ± 9.74 kg) performed 2 variations of an FSL with the anterior knee motion going in front of the toes(FSL-FT) and the knee remaining behind the toes(FSL-BT). Kinematic and kinetic data were used with an inverse-dynamics based static optimization technique to estimate individual muscle forces to determine patellar tendon stress during both lunge techniques. A repeated measures multivariate analysis was used to analyze these data.Results: The peak patellar tendon stress, stress impulse, quadriceps force, knee moment, knee flexion, and ankle dorsiflexion angle were significantly greater(p< 0.001) during the FSL-FT as compared to the FSL-BT. The peak patellar tendon stress rate did not differ between the FSL-FT and FSL-BT.Conclusion: The use of an FSL-FT as compared to an FSL-BT increased the load and stress on the patellar tendon. Because a graded exposure of patellar tendon loading with other closed kinetic chain exercises has proven to be effective in treating PT, consideration for the prescription of variations of the FSL and further clinical evaluation of this exercise is warranted in individuals with PT.展开更多
Background: Cardiac surgery, even when planned, has the potential for adverse outcomes, such that several factors are taken into consideration to help surgeons and their patients discuss the potential risks weighed ag...Background: Cardiac surgery, even when planned, has the potential for adverse outcomes, such that several factors are taken into consideration to help surgeons and their patients discuss the potential risks weighed against the expected recovery. Preoperative functional status and its influence on cardiac surgery, if any, have not been adequately evaluated to date. This study aimed to examine the relationship between preoperative functional status and postoperative mortality and morbidity in elective open heart patients. Methods: Preoperative baseline data (n = 43 subjects) were obtained to calculate Society of Thoracic Surgeons (STS) mortality and morbidity risk scores and preoperative functional status was measured using the Late-Life Function and Disability Instrument (LLFDI). Follow-up data were abstracted at one year postoperative to calculate actual mortality and morbidity events. Ordinary least squares and negative binomial regression analyses were conducted to assess the relationship between the LLFDI preoperative score to the STS mortality and morbidity risk scores. Results: Mortality risk was significant, F (1, 39) = 4.75, p = 0.035, with an adjusted R2 = 0.086, and Function Total (measured by LLFDI) yielded a significant negative association with mortality risk, β = −0.329. Morbidity was found to be significant, F (1, 40) = 4.89, p = 0.033, with an adjusted R2 = 0.087 and Function Total yielded a significant negative association with morbidity risk, β = −0.328, as well. Estimation of the counts for postoperative complications as estimated by Function Total failed to reach significance (Wald χ2 = 0.34, p = 0.56), which provided a pseudo R2 = 0.009. Probabilities for frequencies of adverse events (major complications), therefore, could not be reliably calculated. Conclusion: Preoperative diminished functional status, as measured by the LLFDI, is associated with an increased risk of mortality and morbidity in patients undergoing elective cardiac surgery. The risks and benefits of cardiac surgery should be weighed carefully and include a patient's preoperative functional status, especially in the case of an elective procedure.展开更多
OBJECTIVE： More than one-third of college students reported the desire for stress reduction techniques and education. The purpose of this study was to determine the effects of a 20-week structured self-Reiki program ...OBJECTIVE： More than one-third of college students reported the desire for stress reduction techniques and education. The purpose of this study was to determine the effects of a 20-week structured self-Reiki program on stress reduction and relaxation in college students. METHODS： Students were recruited from Stockton University and sessions were conducted in the privacy of their residence. Twenty students completed the entire study consisting of 20 weeks of self- Reiki done twice weekly. Each participant completed a Reiki Baseline Credibility Scale, a Reiki Expectancy Scale, and a Perceived Stress Scale （PSS） after acceptance into the study. The PSS was completed every four weeks once the interventions were initiated. A global assessment questionnaire was completed at the end of the study. Logs summarizing the outcome of each session were submitted at the end of the study. RESULTS： With the exception of three participants, participants believed that Reiki is a credible technique for reducing stress levels. Except for two participants, participants agreed that Reiki would be effective in reducing stress levels. All participants experienced stress within the month prior to completing the initial PSS. There was a significant reduction in stress levels from pre-study to post-study. There was a correlation between self-rating of improvement and final PSS scores. With one exception, stress levels at 20 weeks did not return to pre-study stress levels. CONCLUSION： This study supports the hypothesis that the calming effect of Reiki may be achieved through the use of self-Reiki.展开更多
Despite the implementation of accelerated ACL reha-bilitation and improved surgical technique, persistent quadriceps weakness continues to be reported in the liter-ature following ACL reconstruction.[1-4] The literatu...Despite the implementation of accelerated ACL reha-bilitation and improved surgical technique, persistent quadriceps weakness continues to be reported in the liter-ature following ACL reconstruction.[1-4] The literature sug-gests, that the exclusive use of multijoint CKC展开更多
Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among com...Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among community dwelling females aged 65 years or older. Materials and Methods: A non-experimental correlational, descriptive, and cohort study included 38 community dwelling females (average age of 82.5 years). The kinesthetic ruler (K-Ruler) and kinesthetic test protocol were created and used to assess lower extremity kinesthetic awareness. The GaitRite System was used to assess gait speed. Each subject was categorized into four groups: “LL” (Low K-Score and low gait speed), “LH” (Low K-Score and high gait speed), “HL” (High K-Score and low gait speed), and “HH” (High K-Score and high gait speed) according to kinesthetic awareness and gait speed measured. Voluntary fall incidence reporting over the 6-month period was followed by the initial data collection. Results: Pearson product-moment correlation (2-tailed) showed that there is a statistically significant, positive moderate-to-strong correlation between K-score and gait speed (ICC = 0.692, p Discussion: Gait speed declines as kinesthetic awareness of lower extremity decreases in community dwelling 65 or older female subjects. Additionally, the combination of kinesthetic awareness and gait speed can be served as a predictor of fall risk. The K-ruler can be used to assess lower extremity kinesthetic awareness in older people as a feasible and standard test.展开更多
Study Design: A Quasi Experimental Single Group Pre-Test Post-Test. Objectives: The aim of this study was to determine the effects of sensory stimulation and motor control cueing of the foot on balance in females over...Study Design: A Quasi Experimental Single Group Pre-Test Post-Test. Objectives: The aim of this study was to determine the effects of sensory stimulation and motor control cueing of the foot on balance in females over the age of 65. Background: Balance deficits in the elderly population have shown to have detrimental consequences. Evidence suggests that sensory stimulation and motor control of the foot improve postural sway, however, studies have yet to compare the effects of both interventions on balance. Method and Measures: A total of 40 participants were contacted to complete the study with 32 participants meeting inclusion criteria for data collection and completing the research study. Two data collection days were utilized to perform pre and post-test outcome measures using the Functional Reach Test and Overall Sway Index (collected using the Biodex Medical System Inc., Biodex Biosway Portable Balance System). The interventions were 2-minute sensory stimulation to the sole of each foot on day one, and the “short foot” motor control cue on day two. Four related sample T-tests were conducted with the interventions as the dependent variable and the time of observation (pre and post) as the independent variable. Results: The results revealed sensory stimulation significantly improved balance as indicated by a decline in postural sway from pretest (5.92 ± 3.05) to posttest (5.00 ± 2.92) (p = 0.045) and a significant increase in Functional Reach from pretest (8.01 ± 2.55) to posttest (8.70 ± 2.66) (p Conclusion: Based on the results, researchers concluded that sensory stimulation is a viable intervention to utilize in order to improve balance in the elderly population. Further research to identify the appropriate prescription of sensory stimulation to maximize effects should be completed.展开更多
Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated out...Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.展开更多
Introduction:Chronic low back pain(cLBP)among older adults is a complex,biopsychosocial condition that despite research efforts and innovative interventions remains a prevalent,disabling and costly condition.This case...Introduction:Chronic low back pain(cLBP)among older adults is a complex,biopsychosocial condition that despite research efforts and innovative interventions remains a prevalent,disabling and costly condition.This case highlights the use of tai chi(TC)for persistent geriatric LBP.Case Presentation:A 68-year-old Caucasian female with cLBP,neuromuscular imbalances,leg weakness and fall risk was treated with a walking program(aerobic),manual therapy(mobility),lumbar stabilization(strength)and group TC class(neuromuscular function).Discussion:Research validates TC for a variety of older adult health conditions,but few studies demonstrated effectiveness for cLBP.This case outlines the use of a simplified Yang-style TC for management of persistent geriatric LBP.Conclusion:The addition of group TC to standard treatment for cLBP resulted in improved functional outcomes,decreased pain ratings and improved leg strength,flexibility and balance as compared to standard treatment for cLBP.Following the group TC class the client reported significant self-perception of recovery,and these functional and confidence gains eliminated the need for physiotherapy services for cLBP for three subsequent years.Level of Evidence:Therapy,level 4.展开更多
文摘Coronary heart disease （CHD） is the leading cause of death worldwide and becomes increasingly prevalent among patients aged 65 years and older.Elderly patients are at a higher risk for complications and accelerated physical deconditioning after a cardiovascular event,especially compared to their younger counterparts.The last few decades were privy to multiple studies that demonstrated the beneficial effects of cardiac rehabilitation （CR） and exercise therapy on mortality,exercise capacity,psychological risk factors,inflammation,and obesity among patients with CHD.Unfortunately,a significant portion of the available data in this field pertains to younger patients.A viable explanation is that older patients are grossly underrepresented in these programs for multiple reasons starting with the patient and extending to the physician.In this article,we will review the benefits of CR programs among the elderly,as well as some of the barriers that hinder their participation.
基金Supported by Grants from the National Institutes of Health,Nos.NIH K23-AG029978 and NIH T32-000279
文摘Total knee arthroplasty(TKA) is the most commonly performed elective surgery in the United States. TKA typically improves functional performance and reduces pain associated with knee osteoarthritis. Little is known about the influence of TKA on overall physical activity levels. Physical activity, defined as "any bodily movement produced by skeletal muscles that results in energy expenditure", confers many health benefits but typically decreases with endstage osteoarthritis. The purpose of this review is to describe the potential benefits(metabolic, functional, and orthopedic) of physical activity to patients undergoing TKA, present results from recent studies aimed to determine the effect of TKA on physical activity, and discuss potential sources of variability and conflicting results for physical activity outcomes. Several studies utilizing self-reported outcomes indicate that patients perceive themselves to be more physically active after TKA than they were before surgery. Accelerometry-based outcomes indicate that physical activity for patients after TKA remains at or below pre-surgical levels. Several different factors likely contributed to these variable results, including the use of different instruments, duration of follow-up, and characteristics of the subjects studied. Comparison to norms, however, suggests that daily physical activity for patients following TKA may fall short of healthy agematched controls. We propose that further study of the relationship between TKA and physical activity needs to be performed using accelerometry-based outcome measures at multiple post-surgical time points.
基金funding from a Graduate Student Research, Service, and Educational Leadership Grant at the University of Wisconsin-La Crosse
文摘Background: Patellar tendinopathy(PT) or "jumper's knee" is generally found in active populations that perform jumping activities. Graded exposure of patellar tendon, stress through functional exercise has been demonstrated to be effective for the treatment of PT. However, no studies have compared how anterior knee displacement variations during the commonly performed forward step lunge(FSL) affect patellar tendon stress.Methods:Twenty-five subjects(age: 22.69 ± 0.74 years; height: 169.39 ± 6.44 cm; mass: 61.55 ± 9.74 kg) performed 2 variations of an FSL with the anterior knee motion going in front of the toes(FSL-FT) and the knee remaining behind the toes(FSL-BT). Kinematic and kinetic data were used with an inverse-dynamics based static optimization technique to estimate individual muscle forces to determine patellar tendon stress during both lunge techniques. A repeated measures multivariate analysis was used to analyze these data.Results: The peak patellar tendon stress, stress impulse, quadriceps force, knee moment, knee flexion, and ankle dorsiflexion angle were significantly greater(p< 0.001) during the FSL-FT as compared to the FSL-BT. The peak patellar tendon stress rate did not differ between the FSL-FT and FSL-BT.Conclusion: The use of an FSL-FT as compared to an FSL-BT increased the load and stress on the patellar tendon. Because a graded exposure of patellar tendon loading with other closed kinetic chain exercises has proven to be effective in treating PT, consideration for the prescription of variations of the FSL and further clinical evaluation of this exercise is warranted in individuals with PT.
文摘Background: Cardiac surgery, even when planned, has the potential for adverse outcomes, such that several factors are taken into consideration to help surgeons and their patients discuss the potential risks weighed against the expected recovery. Preoperative functional status and its influence on cardiac surgery, if any, have not been adequately evaluated to date. This study aimed to examine the relationship between preoperative functional status and postoperative mortality and morbidity in elective open heart patients. Methods: Preoperative baseline data (n = 43 subjects) were obtained to calculate Society of Thoracic Surgeons (STS) mortality and morbidity risk scores and preoperative functional status was measured using the Late-Life Function and Disability Instrument (LLFDI). Follow-up data were abstracted at one year postoperative to calculate actual mortality and morbidity events. Ordinary least squares and negative binomial regression analyses were conducted to assess the relationship between the LLFDI preoperative score to the STS mortality and morbidity risk scores. Results: Mortality risk was significant, F (1, 39) = 4.75, p = 0.035, with an adjusted R2 = 0.086, and Function Total (measured by LLFDI) yielded a significant negative association with mortality risk, β = −0.329. Morbidity was found to be significant, F (1, 40) = 4.89, p = 0.033, with an adjusted R2 = 0.087 and Function Total yielded a significant negative association with morbidity risk, β = −0.328, as well. Estimation of the counts for postoperative complications as estimated by Function Total failed to reach significance (Wald χ2 = 0.34, p = 0.56), which provided a pseudo R2 = 0.009. Probabilities for frequencies of adverse events (major complications), therefore, could not be reliably calculated. Conclusion: Preoperative diminished functional status, as measured by the LLFDI, is associated with an increased risk of mortality and morbidity in patients undergoing elective cardiac surgery. The risks and benefits of cardiac surgery should be weighed carefully and include a patient's preoperative functional status, especially in the case of an elective procedure.
文摘OBJECTIVE： More than one-third of college students reported the desire for stress reduction techniques and education. The purpose of this study was to determine the effects of a 20-week structured self-Reiki program on stress reduction and relaxation in college students. METHODS： Students were recruited from Stockton University and sessions were conducted in the privacy of their residence. Twenty students completed the entire study consisting of 20 weeks of self- Reiki done twice weekly. Each participant completed a Reiki Baseline Credibility Scale, a Reiki Expectancy Scale, and a Perceived Stress Scale （PSS） after acceptance into the study. The PSS was completed every four weeks once the interventions were initiated. A global assessment questionnaire was completed at the end of the study. Logs summarizing the outcome of each session were submitted at the end of the study. RESULTS： With the exception of three participants, participants believed that Reiki is a credible technique for reducing stress levels. Except for two participants, participants agreed that Reiki would be effective in reducing stress levels. All participants experienced stress within the month prior to completing the initial PSS. There was a significant reduction in stress levels from pre-study to post-study. There was a correlation between self-rating of improvement and final PSS scores. With one exception, stress levels at 20 weeks did not return to pre-study stress levels. CONCLUSION： This study supports the hypothesis that the calming effect of Reiki may be achieved through the use of self-Reiki.
文摘Despite the implementation of accelerated ACL reha-bilitation and improved surgical technique, persistent quadriceps weakness continues to be reported in the liter-ature following ACL reconstruction.[1-4] The literature sug-gests, that the exclusive use of multijoint CKC
文摘Purpose: This study investigates the existence of a correlation between the gait speed and kinesthetic sense in lower legs and to conduct further analysis of kinesthetic sense in relation to the risk of fall among community dwelling females aged 65 years or older. Materials and Methods: A non-experimental correlational, descriptive, and cohort study included 38 community dwelling females (average age of 82.5 years). The kinesthetic ruler (K-Ruler) and kinesthetic test protocol were created and used to assess lower extremity kinesthetic awareness. The GaitRite System was used to assess gait speed. Each subject was categorized into four groups: “LL” (Low K-Score and low gait speed), “LH” (Low K-Score and high gait speed), “HL” (High K-Score and low gait speed), and “HH” (High K-Score and high gait speed) according to kinesthetic awareness and gait speed measured. Voluntary fall incidence reporting over the 6-month period was followed by the initial data collection. Results: Pearson product-moment correlation (2-tailed) showed that there is a statistically significant, positive moderate-to-strong correlation between K-score and gait speed (ICC = 0.692, p Discussion: Gait speed declines as kinesthetic awareness of lower extremity decreases in community dwelling 65 or older female subjects. Additionally, the combination of kinesthetic awareness and gait speed can be served as a predictor of fall risk. The K-ruler can be used to assess lower extremity kinesthetic awareness in older people as a feasible and standard test.
文摘Study Design: A Quasi Experimental Single Group Pre-Test Post-Test. Objectives: The aim of this study was to determine the effects of sensory stimulation and motor control cueing of the foot on balance in females over the age of 65. Background: Balance deficits in the elderly population have shown to have detrimental consequences. Evidence suggests that sensory stimulation and motor control of the foot improve postural sway, however, studies have yet to compare the effects of both interventions on balance. Method and Measures: A total of 40 participants were contacted to complete the study with 32 participants meeting inclusion criteria for data collection and completing the research study. Two data collection days were utilized to perform pre and post-test outcome measures using the Functional Reach Test and Overall Sway Index (collected using the Biodex Medical System Inc., Biodex Biosway Portable Balance System). The interventions were 2-minute sensory stimulation to the sole of each foot on day one, and the “short foot” motor control cue on day two. Four related sample T-tests were conducted with the interventions as the dependent variable and the time of observation (pre and post) as the independent variable. Results: The results revealed sensory stimulation significantly improved balance as indicated by a decline in postural sway from pretest (5.92 ± 3.05) to posttest (5.00 ± 2.92) (p = 0.045) and a significant increase in Functional Reach from pretest (8.01 ± 2.55) to posttest (8.70 ± 2.66) (p Conclusion: Based on the results, researchers concluded that sensory stimulation is a viable intervention to utilize in order to improve balance in the elderly population. Further research to identify the appropriate prescription of sensory stimulation to maximize effects should be completed.
文摘Purpose: Although patient-related factors affect surgical outcomes, preoperative functional status is not measured by any cardiac risk score. Functional status can, however, be objectively measured using validated outcome tools such as the Late-Life Function and Disability Instrument (LLFDI). The purpose of this study was to determine 1) if there was a change over time in functional status, as measured by the LLFDI, in patients who underwent elective cardiac surgery, and if so, 2) what specific aspect(s) of functional status changed. Methods: A prospective longitudinal study of one year was conducted on elective cardiac surgery patients (n = 43) using the self-reported LLFDI, which measures Disability Frequency (frequency of participation in social tasks), Disability Limitation (ability to participate in social tasks) and Function Total (ease in performing routine activities). Higher scores indicate increased function and decreased disability. LLFDI scores were compared at three times (preoperative, six-week and one-year postoperative) using repeated measures ANOVA. Post hoc pairwise comparison was conducted for specific interactions. Results: Both Function Total and Disability Frequency significantly changed over time (p = 0.047 and p = 0.013, respectively). Specifically, patients’ function level was significantly higher one-year postoperative compared to preoperative (M difference = +3.48, SE = 1.48, p = 0.026). Likewise, Disability Frequency scores were significantly higher (i.e. more active) at one-year postoperative versus preoperative (M difference= +5.98, SE = 2.19, p = 0.033). Disability Limitation scores were not significantly different between any time points (p > 0.05). Conclusion: By one-year postoperative, patients demonstrated increased ease in their routine physical activities and were more participatory in social life tasks. Individuals who underwent elective cardiac surgery took more than six weeks to detect notable improvement in functional status, which was expected with a sternotomy approach. This study provides support for the use of the LLFDI as an effective tool to capture functional status in the cardiac population. These findings may assist cardiac patients in recovery timeline expectations.
文摘Introduction:Chronic low back pain(cLBP)among older adults is a complex,biopsychosocial condition that despite research efforts and innovative interventions remains a prevalent,disabling and costly condition.This case highlights the use of tai chi(TC)for persistent geriatric LBP.Case Presentation:A 68-year-old Caucasian female with cLBP,neuromuscular imbalances,leg weakness and fall risk was treated with a walking program(aerobic),manual therapy(mobility),lumbar stabilization(strength)and group TC class(neuromuscular function).Discussion:Research validates TC for a variety of older adult health conditions,but few studies demonstrated effectiveness for cLBP.This case outlines the use of a simplified Yang-style TC for management of persistent geriatric LBP.Conclusion:The addition of group TC to standard treatment for cLBP resulted in improved functional outcomes,decreased pain ratings and improved leg strength,flexibility and balance as compared to standard treatment for cLBP.Following the group TC class the client reported significant self-perception of recovery,and these functional and confidence gains eliminated the need for physiotherapy services for cLBP for three subsequent years.Level of Evidence:Therapy,level 4.
