Multiple Body System Analysis Across the Lifespan: Difference between revisions
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* Strength training in healthy males focusing on improving strength of the trunk rotators, improves the ability to generate higher levels of voluntarily induced intra-abdominal pressure and increases the rate of intra-abdominal pressure development during functional situations.<ref>Cresswell AG, Blake PL, Thorstensson A. The effect of an abdominal muscle training program on intra-abdominal pressure. Scand J Rehabil Med. 1994 Jun;26(2):79-86.</ref> | * Strength training in healthy males focusing on improving strength of the trunk rotators, improves the ability to generate higher levels of voluntarily induced intra-abdominal pressure and increases the rate of intra-abdominal pressure development during functional situations.<ref>Cresswell AG, Blake PL, Thorstensson A. The effect of an abdominal muscle training program on intra-abdominal pressure. Scand J Rehabil Med. 1994 Jun;26(2):79-86.</ref> | ||
'''Older Adults:'''<ref>Bajaj JS, Long M. [https://journals.lww.com/ajg/fulltext/2023/03000/exploring_gi_diseases_across_the_lifespan.1.aspx Exploring GI Diseases Across the Lifespan.] The American Journal of Gastroenterology 118(3):p 381-382, March 2023.</ref> | |||
* The strength of the esophageal contractions and the tension in the upper esophageal sphincter decrease | |||
* Stomach lining's capacity to resist damage decreases which may lead to peptic ulcer disease | |||
* Stomach elasticity decreases | |||
* Reduction in physical activity and exercises and pelvic floor weakness may become factors in constipation or feral incontinence. | |||
== Cardiopulmonary System == | == Cardiopulmonary System == |
Revision as of 23:52, 24 March 2024
Original Editor - User Name
Top Contributors - Ewa Jaraczewska, Jess Bell and Kim Jackson
Introduction[edit | edit source]
Musculoskeletal System[edit | edit source]
The functional capacity of the musculoskeletal system should be assessed within the context of school, play, work, daily activities, and sports. Due to differences in the levels of reliability and validity for the functional tests, a combination of a questionnaire and a functional test appears to be the best instrument to assess the functional capacity of the musculoskeletal system.[1] The following questionnaires are recommended:[1]
- The Oswestry Disability Index
- The Pain Disability Index
- The Roland-Morris Disability Questionnaire
- The Upper Extremity Functional Scale
Children/Adolescents | Adults | Older Adults | |
---|---|---|---|
Muscle strength
(Functional assessment to include sit-to-stand and stairs) |
|
1MMSTST: ranges from 8.1(patient with stroke), 24 (advanced lung disease)[5] to 50 (healthy male adult)[6] |
|
Flexibility/Range of motion
(spinal and chest wall mobility) |
Chest wall mobility:
Age 3 through adulthood: Chest wall mobility measurement for tidal volume excursion: [11]
Pediatric:
Spinal mobility:
|
Chest wall mobility:
Spinal mobility: Measurement in the standing position using the inclinometer technique:[13]
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Chest wall mobility:
Spinal mobility: Measurement as for adults.
|
Pain |
|
Functional Pain Scale (FPS) is a tool for the objective assessment of pain and its impact on sleep, ability to complete activities of daily living (ADLs), and concentration:[16]
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Bone Mineral Density |
|
| |
Core Stability |
|
Same as in children/adolescents | Same as in children/adolescents |
Neurological System[edit | edit source]
"Neurons that fire together, wire together."[9]--Eena Kapoor
"Each time we practise that certain type of movement or certain type of action, we're laying down those pathways in our brain."[9]--Eena Kapoor
Components of the neurological system examination include :
- Proprioception
- Ability to determine body segment positions and movements in space[22]
- Vestibular system, including the ability to coordinate movement with balance
- Static and dynamic balance
- Interoception
Children/Adolescents | Adults | Older Adults | |
---|---|---|---|
Proprioception |
|
There are three main testing techniques for assessing proprioception in adults: |
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Vestibular system |
|
|
|
Interception[edit | edit source]
Interception is the ability to perceive internal bodily states. Our perception of internal body signals influences our emotions, decision-making, and sense of self. This video explores the concept of interception:
For a detailed assessment of the neurological system, please refer to the Neurological Screening course.
Integumentary System[edit | edit source]
Adequate skin and other connective tissue mobility is needed for free movement of the underlying structures to provide postural support and assure proper ventilation.[11] If fascial restrictions are present, they may cause multiple impairments.
The skin is one of the largest organs of the body. It has many functions, including the following:[29]
- Structural barrier
- Thermoregulation
- An impact on the cardiovascular system because it regulates body's temperature.
- Contributes to sensation for neuromuscular control
- Provides fascial mobility for range of motion of the joint
Learn more about the integumentary system from this Physiopedia article.
Skin diseases including atopic dermatitis, psoriasis, and allergic or irritant contact dermatitis affect skin transepidermal water loss (TEWL, the amount of water loss through the epidermis through evaporation), hydration, and acidity.[30]
Children/Adolescents:
- Skin barrier function is weaker than in adult
- "Changing infant skin barrier is not a deficit but beneficial as adaptive flexibility allowing constant optimisation, balancing growth, thermoregulation, water barrier and protective functions. "[30]
- Newborns have the lowest skin hydration and water content. [31]
- Premature infants have high TEWL at birth leading to skin's immature barrier function and thinner epidermal layers. It causes increased insensible water loss.[30]
- Neonatal skin has higher pH compared to older paediatric and adult patients. Mature skin pH is maintained between 4.5 to 6.0.[30]
- Paediatric skin have tendency to develop xerosis and excessively dry skin, particularly on the exposed facial skin. It can lead to development irritant or allergic contact dermatitis.[32]
- Scarring from G-tube or a chest tube placement can cause severe restriction in child's trunk mobility and abdominal mobility.[9]
Adults:
- Extrinsic ageing includes chronic exposure to various environmental elements such as the sun, air/water pollution, smoking, diet, exercise, stress, lifestyle, repetitive muscle contractions, gravity, or general diseases.[33]
- Intrinsic ageing is a natural process resulting from oxidative cellular metabolism and is influenced by genetics, metabolism, hormonal, immunological, cardiovascular, gastrointestinal, psychogenic, degenerative, or neoplastic disease.[33]
- In women, the skin thickens to 25 to 30 years of age, followed by a progressive declination of all skin layers as age progresses.[33]
- Androgens, cortisol, progesterone and thyroid hormone influence skin health. For example, thyroid hormone "regulates the metabolic rate of the body and helps regulate epidermal cell proliferation, differentiation, hair and nail growth, wound healing, and skin hydration by affecting the function of dermal fibroblasts."[33]
Older Adults:[34]
- Skin is thinner and less elastic
- Age spots/Liver spots tends to develop
- Blood vessels under the skin become more fragile causing bruising or bleeding under the skin
- Decrease in oil production leading to dry and itchy skin
- Decrease in subcutaneous tissue with increasing risk for pressure injuries and hypothermia
- Decrease in sweat function increasing risk for overheating
- Increase risk for skin cancer
Gastrointestinal System[edit | edit source]
- Gastrointestinal system occupies majority of space in the abdominal compartment.
- The abdominal compartment is surrounded by the following structures:
- The diaphragm and abdominal wall anteriorly
- Spine posteriorly
- Costal arch on both sides
- Pelvis on the bottom
- The abdominal compartment contains multiple solid and hollow organs, adipose tissue and major blood vessels. They are located intra- and/ or retroperitoneally.
- The healthy functioning of the GI system depends on body's ability to generate intra-abdominal pressure.
Children/Adolescents:
- Prune belly syndrome (PBS) is associated with laxity of the abdominal wall musculature. Children with PBS often experience gastrointestinal complications due to inability to generate adequate intra-abdominal pressure.[9][35]
- Hypotonic trunk in children with cerebral palsy affects their ability to maintain appropriate level of intra-abdominal pressure. It is a main factor in development of digestive issues, including upset stomach, vomiting, bloating, and constipation.[36]
Adults
- Strength training in healthy males focusing on improving strength of the trunk rotators, improves the ability to generate higher levels of voluntarily induced intra-abdominal pressure and increases the rate of intra-abdominal pressure development during functional situations.[37]
Older Adults:[38]
- The strength of the esophageal contractions and the tension in the upper esophageal sphincter decrease
- Stomach lining's capacity to resist damage decreases which may lead to peptic ulcer disease
- Stomach elasticity decreases
- Reduction in physical activity and exercises and pelvic floor weakness may become factors in constipation or feral incontinence.
Cardiopulmonary System[edit | edit source]
Mental Health System[edit | edit source]
Resources[edit | edit source]
- https://www.researchgate.net/profile/Margaret-Schenkman/publication/20341766_A_Model_for_Multisystem_Evaluation_Treatment_of_Individuals_with_Parkinson%27s_Disease/links/0c96051786d5fb1da5000000/A-Model-for-Multisystem-Evaluation-Treatment-of-Individuals-with-Parkinsons-Disease.pdf
- https://www.masserypt.com/wp-content/uploads/2016/02/MasseryCh28AsthmaCampbellPedPTTextbook2006.pdf
References[edit | edit source]
- ↑ 1.0 1.1 Wind H, Gouttebarge V, Kuijer PP, Frings-Dresen MH. Assessment of functional capacity of the musculoskeletal system in the context of work, daily living, and sport: a systematic review. J Occup Rehabil. 2005 Jun;15(2):253-72.
- ↑ Falk B, Dotan R. Child-adult differences in the recovery from high-intensity exercise. Exerc Sport Sci Rev. 2006 Jul;34(3):107-12.
- ↑ Haile SR, Fühner T, Granacher U, Stocker J, Radtke T, Kriemler S. Reference values and validation of the 1-minute sit-to-stand test in healthy 5-16-year-old youth: a cross-sectional study. BMJ Open. 2021 May 7;11(5):e049143.
- ↑ 4.0 4.1 Schorling DC, Rawer R, Kuhlmann I, Müller C, Pechmann A, Kirschner J. Mechanographic analysis of the timed 4 stair climb test - methodology and reference data of healthy children and adolescents. J Musculoskelet Neuronal Interact. 2023 Mar 1;23(1):4-25.
- ↑ Watson K, Winship P, Cavalheri V, Vicary C, Stray S, Bear N, Hill K. In adults with advanced lung disease, the 1-minute sit-to-stand test underestimates exertional desaturation compared with the 6-minute walk test: an observational study. J Physiother. 2023 Apr;69(2):108-113.
- ↑ Bohannon RW, Crouch R. 1-Minute Sit-to-Stand Test: SYSTEMATIC REVIEW OF PROCEDURES, PERFORMANCE, AND CLINIMETRIC PROPERTIES. J Cardiopulm Rehabil Prev. 2019 Jan;39(1):2-8.
- ↑ Strassmann A, Steurer-Stey C, Lana KD, Zoller M, Turk AJ, Suter P, Puhan MA. Population-based reference values for the 1-min sit-to-stand test. Int J Public Health. 2013 Dec;58(6):949-53.
- ↑ Gagliano-Jucá T, Li Z, Pencina KM, Traustadóttir T, Travison TG, Woodhouse L, Basaria S, Tsitouras PD, Harman SM, Bhasin S, Storer TW. The Stair Climb Power Test as an Efficacy Outcome in Randomized Trials of Function Promoting Therapies in Older Men. J Gerontol A Biol Sci Med Sci. 2020 May 22;75(6):1167-1175.
- ↑ 9.0 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 Kapoor E. Multiple Body System Analysis Across the Lifespan. Plus course 2024
- ↑ Brodowski H, Andres N, Gumny M, Eicher C, Steinhagen-Thiessen E, Tannen A, Kiselev J.Reliability of stair-climbing speed in two cohorts of older adults.International Journal of Therapy and Rehabilitation 2021; 28(11):1-15.
- ↑ 11.0 11.1 11.2 Massery, M. "If You Can't Breathe, You Can't Function" continuing education class 20 hrs. 2008, Chicago, IL. USA www.MasseryPT.com
- ↑ 12.0 12.1 Kondratek M, Krauss J, Stiller C, Olson R. Normative values for active lumbar range of motion in children. Pediatr Phys Ther. 2007 Fall;19(3):236-44.
- ↑ Waddell G, Somerville D, Henderson I, Newton M. Objective clinical evaluation of physical impairment in chronic low back pain. Spine 1992;17:617–28.
- ↑ Saidu IA, Maduagwu SM, Abbas AD, Adetunji OO, Jajere AM. Lumbar spinal mobility changes among adults with advancing age. J Midlife Health. 2011 Jul;2(2):65-71.
- ↑ Sansone L, Gentile C, Grasso EA, Di Ludovico A, La Bella S, Chiarelli F, Breda L. Pain Evaluation and Treatment in Children: A Practical Approach. Children (Basel). 2023 Jul 13;10(7):1212.
- ↑ Adeboye A, Hart R, Senapathi SH, Ali N, Holman L, Thomas HW. Assessment of Functional Pain Score by Comparing to Traditional Pain Scores. Cureus. 2021 Aug 3;13(8):e16847.
- ↑ BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet. Available from https://instruct.uwo.ca/kinesiology/9641/Assessments/Biological/FPS.html [last access 22.03.2024]
- ↑ 18.0 18.1 McVey MK, Geraghty AA, O'Brien EC, McKenna MJ, Kilbane MT, Crowley RK, Twomey PJ, McAuliffe FM. The impact of diet, body composition, and physical activity on child bone mineral density at five years of age-findings from the ROLO Kids Study. Eur J Pediatr. 2020 Jan;179(1):121-131.
- ↑ Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment. J Biomed (Syd). 2018;3:40-49.
- ↑ 20.0 20.1 Liu CK, Leng X, Hsu FC, et al. The impact of sarcopenia on a physical activity intervention: the Lifestyle Interventions and Independence for Elders Pilot Study (LIFE-P) J Nutr Health Aging. 2014;18(1):59–64.
- ↑ Johnston AP, De Lisio M, Parise G. Resistance training, sarcopenia, and the mitochondrial theory of ageing. Appl Physiol Nutr Metab. 2008 Feb;33(1):191-9.
- ↑ Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: A critical review of methods. J Sport Health Sci. 2016 Mar;5(1):80-90.
- ↑ 23.0 23.1 23.2 23.3 23.4 Chu VWT. Assessing Proprioception in Children: A Review. J Mot Behav. 2017 Jul-Aug;49(4):458-466.
- ↑ 24.0 24.1 Yang N, Waddington G, Adams R, Han J. Joint position reproduction and joint position discrimination at the ankle are not related. Somatosens Mot Res. 2020 Jun;37(2):97-105.
- ↑ 25.0 25.1 25.2 25.3 Ferlinc A, Fabiani E, Velnar T, Gradisnik L. The Importance and Role of Proprioception in the Elderly: a Short Review. Mater Sociomed. 2019 Sep;31(3):219-221.
- ↑ Coto J, Alvarez CL, Cejas I, Colbert BM, Levin BE, Huppert J, Rundek T, Balaban C, Blanton SH, Lee DJ, Loewenstein D, Hoffer M, Liu XZ. Peripheral vestibular system: Age-related vestibular loss and associated deficits. J Otol. 2021 Oct;16(4):258-265.
- ↑ 27.0 27.1 27.2 Nnodim JO, Yung RL. Balance and its Clinical Assessment in Older Adults - A Review. J Geriatr Med Gerontol. 2015;1(1):003.
- ↑ Neuroscience News. Exploring Interoception: The Neuroscience of Internal Body Signals - Neuroscience News. Available from: https://www.youtube.com/watch?v=rms5I02Rzg0&t=39s [last accessed 23/3/2024]
- ↑ Lucas K, Todd P, Ness BM. A Multi-Systems Approach to Human Movement after ACL Reconstruction: The Integumentary System. Int J Sports Phys Ther. 2021 Dec 1;17(1):74-80.
- ↑ 30.0 30.1 30.2 30.3 King A, Balaji S, Keswani SG. Biology and function of fetal and pediatric skin. Facial Plast Surg Clin North Am. 2013 Feb;21(1):1-6.
- ↑ Fluhr JW, Darlenski R, Lachmann N, Baudouin C, Msika P, De Belilovsky C, Hachem JP. Infant epidermal skin physiology: adaptation after birth. Br J Dermatol. 2012 Mar;166(3):483-90.
- ↑ Giusti F, Martella A, Bertoni L, Seidenari S. Skin barrier, hydration, and pH of the skin of infants under 2 years of age. Pediatr Dermatol. 2001 Mar-Apr;18(2):93-6.
- ↑ 33.0 33.1 33.2 33.3 Knaggs H, Lephart ED. Enhancing Skin Anti-Aging through Healthy Lifestyle Factors. Cosmetics. 2023; 10(5):142.
- ↑ Russell-Goldman E, Murphy GF. The Pathobiology of Skin Aging: New Insights into an Old Dilemma. Am J Pathol. 2020 Jul;190(7):1356-1369.
- ↑ Arlen AM, Nawaf C, Kirsch AJ. Prune belly syndrome: current perspectives. Pediatric Health Med Ther. 2019 Aug 6;10:75-81.
- ↑ Cerebral Palsy Digestive Issues and Health. Available from https://www.cerebralpalsyguidance.com/cerebral-palsy/associated-disorders/digestive-issues-and-health/ [last access 24.03.2024]
- ↑ Cresswell AG, Blake PL, Thorstensson A. The effect of an abdominal muscle training program on intra-abdominal pressure. Scand J Rehabil Med. 1994 Jun;26(2):79-86.
- ↑ Bajaj JS, Long M. Exploring GI Diseases Across the Lifespan. The American Journal of Gastroenterology 118(3):p 381-382, March 2023.