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Managing mobility problems in older Australians (ES-8064-11)
Ageing is seen to be closely associated to a decline in physical well-being. Are there ways we can minimise the impact of changes seen with ageing? Are there ways to prevent falls? This presentation by Linda MacDonald and Jenny Nitz will discuss mobility, causes of decreased mobility, assessment of falls risk and preventative measures.

Learning Objectives:

  • Have a strategy for systematically assessing and screening all patients at risk of falling, and how to minimise these
  • To demonstrate a clinical framework for the assessment for instability and falls risk in older Australians
  • To be aware of the impact of immobility on the health of older Australians, likely causes and management approaches
  • To understand the mechanisms of immobility in older Australians and key prevention and management issues for the GP
  • Understand the key determinants of health related quality of life in older people and be aware of tools to measure them
  • To be aware of current practice regarding falls risk assessment and screening
This education program is developed and delivered for The University of Queensland, by The University of Queensland (UQ) Health Insitu. UQ Health Insitu is the lifelong learning arm of The University of Queensland Faculty of Health Sciences.

Expert presenters:
Dr Jenny Nitz
Dr Jenny Nitz is a currently a Senior Lecturer at the University of Queensland, for the School of Health and Rehabilitation Sciences. Dr Nitz is also the adviser on geriatric physiotherapy practise for the Australian Physiotherapy Association Queensland Branch. She is the National chairperson for the committee to grant titled membership to the APA in recognition of specialisation by physiotherapists in the field of gerontology, and is an expert panel member of the Australian Council of Physiotherapy Regulating Authority. In 2003 Dr Nitz received an award for ‘Contribution to Physiotherapy Research’ from the Australian Physiotherapy Association in recognition of her commitment to research into ageing. She lectures widely and has been an invited speaker at professional conferences where she has presented workshops at both national and international levels. She has presented research papers at many international and national multi-professional physiotherapy conferences.

Linda MacDonald
Linda MacDonald is a physiotherapist and is working as a Clinical Educator with Med-E-Serv. Linda has been actively involved in medical education of medical undergraduates, and she has worked as a clinical physiotherapist in both community and aged care facilities. Her special interests include aged care and rehabilitation.

References:

[1] Royal Australian College of General Practioners. Guidelines for preventive activities in general practice 6th edition (The Red Book).  2005. Viewed on 01/02/2008 at http://www.racgp.org.au/redbook

Linda MacDonald presentation

[1] Haines T. Falls Prevention – A Practical Approach. Notes to the Royal College of Nursing.
[2] Hill K, Vrantsidis F, Haralambous B, Fearn M, Smith R, Murray K, Sims J. An analysis of research on preventing falls and falls injury in older people: Community, residential care and hospital settings. Report to the Australian Government. February 2005. Viewed on 07/09/06 at www.health.gov.au.
[3] Moller. Projected costs of fall related injury to the older persons due to demographic change in Australia. Report to the Commonwealth Department of Health and Ageing. 2004 Viewed 10/09/2006, at www.health.gov.au.
[4] Tinetti ME. Preventing falls in elderly persons. NEJM 2003;348:42-49.
[5] Lawlor DA, Patel R, Ebrahim S. Association between falls in elderly women and chronic diseases and drug use: cross sectional study. BMJ 2003;327:712-718.
[6] American Geriatrics Society, British Geriatrics Society, and American Academy of Orthopaedic Surgeons Panel on Falls Prevention. Guideline for the Prevention of Falls in Older Persons. JAGS 2001;49:664-672.
[7] Podsiadlo D, Richardson S. The timed 'Up and Go': A Test of Basic Functional Mobility for Frail Elderly Persons. JAGS 1991;39:142-148.
[8] Gillespie LD, Gillespie WJ, Robertson MC, Lamb SE, Cumming RG, Rowe BP. Interventions for preventing falls in elderly people. Cochrane Database of Systematic Reviews 2003, Issue 4. Art.No.:CD000340. DOI: 10.1002/14651858.CD000340.
[9] Arnadottir SA, Mercer VS. Effects of footwear on measurements of balance and gait in women between the ages of 65 and 93 years. Physical Therapy 2000;80:17-27.
[10] Lord SR, Bashford GM, Howland A, Munroe BJ. Effects of shoe collar height and sole hardness on balance in older women. J Am Geriatr Soc.1999;47(6):681-684.
[11] Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ et al. Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised clinical trials. BMJ 2004;328:680-687.
[12] Muldoon MF, Bargar SD, Flory JD, Manuck SB. What are quality of life measurements measuring? BMJ 1998;316:542-545.
[13] O’Connor R. Issues in the measurement of health-related quality of life. NHMRC paper.Melbourne 1993.
[14] WHO. WHOQOL-BREF: Introduction, administration, scoring and generic version of the assessment. Geneva: WHO;1996. Viewed on 19/0720/07 at www.who.int/entity/mental_health/media/en/76.pdf
[15] van Stel HF, Buskens E. Comparison of the SD-6D and the EQ-5D in patients with coronary heart disease. Health and Quality of Life Outcomes 2006;4:20. Viewed on 19/07/2007 at: http://www.hqlo.com/content/4/1/20.

Jenny Nitz presentation

[1] Hirvensalo M, Lintunen T, Rantanen T. The continuity of physical activity--a retrospective and prospective study among older people. Scand J Med Sci Sports 2000; 10(1):37-41.
[2] Nitz JC, Low Choy NL, Isles RC. Medial-lateral postural stability and balance in community dwelling women over 40 years of age. Clinical Rehabilitation 2003;17(7):765-767.
[3] Nitz JC, Low Choy NL. The relationship between ankle dorsiflexion range and falls in women aged 40 to 80 years. New Zealand Journal of Physiotherapy 2004;32(3);121-125.
[4] Nitz JC, Low Choy NL. The efficacy of a specific balance strategy training program for preventing falls among the frail elderly. A pilot RCT. Age & Ageing 2004;33:52-58.
[5] Nitz JC, Low Choy NL. Changes in activity level in women age 40 to 80 years. Climacteric (accepted in press 1 March 2007)
[6] Lord SR, Clark RD. Simple physiological and clinical tests for the accurate prediction of falling in older people. Gerontology 1996;42(4):199-203.
[7] Low Choy NL, Brauer SG, Nitz JC. Timed stance performances reflect differences in age, prevalence of co-morbidities, medication use, fall’s history and activity level: early screening for balance loss is indicated. Australasian Journal on Ageing 2007;26(1):29-34.

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Time: 2 hours 15 minutes
Catalogued by:
  • Clinical knowledge and skills
    • Injuries and their prevention
  • Clinical continuum
    • Chronic disease management
  • Patient types
    • Elderly patients' health
  • Units by type
    • Case studies
  • RACGP Domains of General Practice
    • Applied professional knowledge and skills
  • ACRRM Educational Domains and Curriculum Areas of Rural & Remote Medicine
    • Aged Care (Area)

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