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American Physical Therapy Association
United States

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Our mission at APTA is to improve the health and quality of life of individuals in society by advancing the physical therapy profession. Our blog posts will provide an opportunity for APTA member experts and staff to share their unique experiences in pursuing this goal relative to physical activity, including communicating to various audiences the message of the value of physical activity and assisting individuals who need an improved understanding or increased capacity to be physically active. APTA looks forward to partnering with other organizations via this blog to share its breadth of expertise and communicate with other experts or individuals interested in this important subject.

Guest Bloggers:

Lisa A. Chase, PhD, PT

Megann Schooley, PT, DPT, MTC, CSCS

Cindy Miles, PT, MEd, PCS

Recent Posts by APTA

Conducting a Conference to Promote using Research on Exercise for Older Adults in Clinical Practice

by APTA August 1, 2011

The American Physical Therapy Association Section on Geriatrics held a 3-day conference in July 2010 on the campus of the University of Indianapolis to promote the application of research on benefits of exercise for older adults into clinical practice. Both the content format and the unique meeting planning create a model that may be useful to other organizations planning an education offering on the value of physical activity.

The conference, Exercise and Physical Activity in Aging Conference (ExPAAC): Blending Research and Practice, was hosted by the University of Indianapolis Center for Aging & Community and Krannert School of Physical Therapy, and drew 350 participants. Presentation topics included the effects of PA and exercise on health and aging, how to affect behavioral change, and evidence-based prescription for older adults. Our goals for the conference were to: 1) make available current research about PA and exercise from middle through older adulthood; 2) translate research into evidence based practice; 3) identify barriers to translation of research into evidence based practice; 4) promote best practices in physical therapist practice; and 5) evaluate public policies that influence the capacity of physical therapists to provide services. Speakers included national and international researchers Jack Guralnik, MD, PhD, MPH; Pamela Duncan, PT, PhD, FAPTA, FAHA; Alexandre Kalache, MSc, MD, PhD, FRCPH; James Rimmer, PhD; Thomas Prochaska, PhD; Barbara Resnik, PhD, RN, CRNP, FAAN, FAANP; and Luigi Ferrucci, MD, PhD.

Session topics included national and international physical activity initiatives, effects of physical activity and exercise on components of health and aging, determinants of behavior change, and evidence based practice exercise for optimizing function. We also held an evening poster presentation session to highlight case reports, research studies, special interest reports, and theory reports. Some participants wished to attend ExPAAC but felt they needed a review in geriatrics, so we offered a one-day pre-conference course that enabled these participants to maximize their experience. The closing keynote speech was delivered by Dr. James Canton, PhD, renowned author and advisor from the Institute for Global Futures.

Holding the conference at the university allowed us to have many great opportunities for networking and discussion - both formal and informal - at mealtimes in the campus cafeteria, during breaks on the outdoor commons, and at several special social events planned for conference attendees. Attendees stayed in the nearby Holiday Inn or in the dormitories on campus, which had the advantages of lower hotel and meeting site costs. An additional benefit was that conference participants were invited to attend exercise classes and to use campus recreational facilities during their free time.

For those who were unable to attend ExPAAC, we made sure that all of the sessions could be purchased through the APTA Learning Center at (click on "Courses" and search for ExPAAC). The PowerPoint presentations and the commentary of the experts during their ExPAAC presentations were included. Each session features multiple choice question examinations for the purposes of CEU credit.

Because of ExPAAC's overwhelming success, the Section on Geriatrics is considering an "ExPAAC II" in the next 5-10 years. We hope that a model such as ours will be as successful for you as it was for us...

Written by guest bloggers: Ellen Milner, PT, PhD; David M. Morris, PT, PhD

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Creative programming | Events

Physical Activity and the Prevention of Falls in Older Adults

by APTA April 13, 2011

With the recent activities of the American Public Health Association's "Safety is No Accident: Live Injury-free" campaign during the week of April 4-10, we would like to continue to raise awareness about falls prevention. Falls are a major health concern among older adults. More than one-third of older adults fall each year, and fall rates increase with advancing age.1 Falls are the leading cause of injury deaths, the most common cause of non-fatal injuries, and the most common reason for hospital admission due to trauma in older adults.2 Every hour, there is one death and 183 emergency department visits for falls-related injuries among older adults and more than 95% of hip fractures are caused by falls.3

These facts are a scary reality; however, we know the most common risk factors4 of falling. They include the following:

  • Conditions associated with aging
  • Muscle weakness
  • Difficulty with balance or walking
  • Vision problems
  • Pre-existing medical conditions that limit mobility, such as Parkinson's disease, stroke or diabetes
  • Conditions that cause confusion
  • Being on more than four medications at the same time
  • Use of assistive walking device
  • Environmental hazards (e.g. throw rugs or pets)
  • Difficulty completing daily living activities
  • Low blood pressure
  • Fear of falling
  • History of fears

We also know that maintaining physical activity is critical in helping to prevent falls and can have a significant impact on many of the risk factors listed above. Performing physical activities of any fitness level - including programs, Tai Chi, aerobics and yoga - can help improve balance, strength and flexibility, and get patients moving again. In fact, effective interventions to prevent falls in community-dwelling older adults included exercise-based interventions provided in the home or group setting.5 Exercise interventions that appear to have the greatest impact are balance activities performed in standing (limit upper-extremity support), and exercise programs that are progressed based on the individual person. General exercise programs on the other hand, which do not focus specifically on balance and strength, are not as effective as individually tailored exercise.6 Finally, there has been strong evidence that supports a multifactorial approach to preventing falls with programs that include not just exercise but also appropriate screening, gait training and environmental assessments.7

According to the American Geriatrics Society's (AGS) Clinical Practice Guidelines, all should be screened for risk of falling. The AGS recommends a brief screening tool that includes three questions:

1) Have you ever fallen in the past year?

2) Has the patient had an acute fall?

3) Does the patient have difficulty with walking or balance?

If inviduals aged 65 years and older state that they have experienced two or more falls or has sustained an injury from a fall, they are considered to be at risk for falling. Likewise, if the person has difficulty with balance or walking, they may be at higher risk.

All professionals working with older adults should be aware of the risk for falls and the factors associated with a higher risk. With greater vigilance, we can prevent the injuries related to falls in older adults, as well as the related loss of function and participation in daily activities.

Are you screening older adults for falls? What community fall prevention programs are available for older adults in your community?

You can find more consumer resources about risk factors, testing balance, and where to find a physical therapist by visiting Move Forward.

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Older adults

Addressing a Communities Fitness Needs: One Person at a Time

by APTA February 4, 2011

Woman exercising with a physical therapist

Physical inactivity is a leading cause of death in the U.S. due to heart disease, stroke, diabetes, and cancer.  Physical activity is critical in the prevention of the detrimental effects of aging, obesity (33 to 35% of the US adult population), and chronic illnesses.  The Finnish Medical Society Duodecim, has also documented the importance of physical activity in the prevention, treatment and rehabilitation of diseases  .  Despite well‐documented evidence of the benefits of physical activity, we still have not approached the recommendations of the HHS Physical Activity Guidelines .  

What is the problem?  Approximately 70% of US adults are underactive,  40% of American adults do nothing to exercise, and  50% of individuals who start an exercise program drop out after 6 months.  (SportsEconomics:  Battling Attrition – A Study in Improving Member Retention at Health Club Facilities.  SportsEconomics Perspectives, Issue 3.  2001.)

Barriers to implementation  by physicians include limited time, lack of tools and skills, and lack of reimbursement.   Patient barriers to exercise include lack of time and confidence, presence of an injury, and incomplete/improper information regarding exercise relevance, content and dosing.    Research shows that  exercise advice given by a primary care physician may be effective in increasing physical activity in the short‐term [after two months], but not in the long‐term [after four and twelve months], due to insufficient support, accountability, and implementation strategies.

Who is currently in position?  The health and fitness industry is uniquely positioned to meet the growing need for easily accessible, supportive, and guided fitness venues.  They clearly have a role but  health clubs average a loss of 1 to 6 of every 10 members, and experience a mean attrition rate of 40% annually.,  Furthermore, program planning at most health clubs is targeted towards individuals who have already committed  to making physical activity a habit (which may explain why so many new members drop off).

Who else can help?   Successful exercise among those individuals who see more barriers than benefits to exercise depends on four key provider-driven characteristics:  clear, credible data; specific, attainable goals; directed programming; and appropriate reinforcement/support.

What’s Our Solution?  Conduct Annual Physical Therapist‐based Fitness Physicals to establish objective, norm‐referenced baseline measures of strength, flexibility, postural habits, cardio respiratory fitness, risks for injury, and readiness for change.  Develop individual fitness plans to specifically address findings; provide patient education, support, and ongoing feedback; establish multi‐modal fitness strategies including home exercise, private fitness training, and/or group fitness classes to best fit patient’s lifestyle, level of confidence and commitment, and experience; provide structured accountability and positive re‐enforcement systems.

What is your organization doing to engage communities to be more physically active?

Written by: Jennifer M. Gamboa, DPT, OCS, MTC

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Building Healthy Communities

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