| Physical Therapy Helps
Elderly Stave Off Disability
NEW YORK (Reuters
Health) - Physical therapy
may help prevent physical declines in older, frail people, study
Lead author Dr. Thomas M. Gill of Yale University in New Haven,
Connecticut, said that these results suggest that it is possible
for some older people to stave off the disabilities that their weakened
state puts them at risk of developing.
"We want to identify
older persons who are at risk of being disabled...and try to prevent
those outcomes," he told Reuters Health.
Reporting in the October
3rd issue of The New England Journal of Medicine, Gill and his
colleagues followed 188 frail patients at least 75 years old,
half of whom received a physical therapy program designed to improve
their balance, muscle strength and movement.
The remaining patients
underwent an educational program, during which healthcare workers
visited them and informed them about general health recommendations
for the elderly, such as obtaining vaccinations and remaining
Both programs consisted
of home visits by a healthcare worker during the first 6 months,
then regular phone calls for an additional 6 months.
The investigators found
that patients who completed the physical therapy program reported
less disability than their peers at both 7 months and 12 months
after the program began.
In an interview with
Reuters Health, Gill explained that the physical therapy program
may help frail patients prevent disabilities by working on the
underlying impairments that both characterize their weakened state
and put them at risk of future problems.
For example, he noted,
frailty often includes muscle weakness, a symptom that can progress
into a serious disability.
However, he added that
patients who were very frail at the outset of the program appeared
to receive no benefit from physical therapy, and even declined
during the program, suggesting that these patients may require
a more vigorous type of intervention.
"Our results suggest
that our program wasn't sufficient to prevent disability in this
group," Gill noted.
Currently, the government
health insurance plan Medicare does not cover the cost of home
care designed to prevent disabilities in older adults, Gill explained.
In the current study, he and his colleagues estimate that the
physical therapy program will cost $2,000 per patient. Gill
noted that further studies are needed to determine if the benefits
of the program--such as reducing the number of days spent in a
nursing home or hospital--outweigh its costs.
"It's an uphill battle,"
Gill noted, describing the difficulties in convincing insurers
to cover additional programs. But showing that a relatively inexpensive
program may prevent further physical declines "is, I think, a
wonderful first step," he added.
The research was funded
by the National Institute on Aging, a component of the National
Institutes of Health.
SOURCE: The New England
Journal of Medicine 2002;347:1068-1074.
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