Frailty
Frailty, which is a geriatric syndrome that affects 5% to 17% of older adults, is a state of increased vulnerability across multiple health domains that leads to adverse health outcomes. Frailty is separate from, but related to ageing. While older people tend to be frailer, you will not be frail just because you are old. Frailty depends on your physiological state and how well you can respond to stressors (injury/illness). Frail older adults are at increased risk of falls, disability, hospitalizations, and death.
One widely recognized framework is the Fried’s Frailty Phenotype model, which identifies five key components that helps to conceptualize the multifaceted nature of frailty, focusing on various domains that contribute to an individual’s vulnerability:
- Unintentional Weight Loss: A significant loss of body weight (usually more than 5% in the past year) without trying to lose it.
- Exhaustion: Self-reported fatigue or a feeling of exhaustion during daily activities.
- Low Physical Activity: Reduced levels of physical activity compared to peers, often assessed through questionnaires or activity monitors.
- Weakness: Measured by grip strength; individuals in the frail category show diminished strength compared to healthy counterparts.
- Slow Walking Speed: A slow pace when walking, which can be measured using standardized timed walking tests.
Each subcategory is scored as 0 (no) or 1 (yes). It assumes an individual is frail if s/he has a score of greater than three.
The scoring is as follows:
- 0-1 = not frail
- 1-2 = pre-frail
- 3+ = frail (mild, moderate and severe)
- Physiotherapy Managements:
- Strength Training
- Resistance Exercises: Focus on building muscle strength to combat weakness and improve functional capacity.
- Progressive Overload: Gradually increasing the intensity of exercises helps stimulate muscle growth.
- Balance and Coordination :
- Balance Exercises: Targeting stability can reduce the risk of falls, a common concern in frail individuals.
- Functional Training: Activities that mimic daily tasks can improve coordination and confidence.
- Mobility and Flexibility
- Stretching: Enhances flexibility, which can help maintain a range of motion and reduce stiffness.
- Gait Training: Techniques to improve walking patterns and increase mobility.
- Aerobic Conditioning: Activities like walking or cycling can improve cardiovascular health and overall stamina.
- Personalized Exercise Programs: Tailoring programs to individual needs and capabilities ensures safety and effectiveness.
- Education and Support: Providing education about the importance of physical activity and how to incorporate it into daily life can empower individuals to take control of their health.
- Multidisciplinary Approach: Working alongside other healthcare professionals (e.g., nutritionists, occupational therapists) ensures a comprehensive approach to managing frailty.
- Benefits of Physiotherapy for Frail Individuals:
- Improved strength and mobility.
- Reduced risk of falls and associated injuries.
- Enhanced quality of life and independence.
- Better management of chronic conditions.
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