Multiple Body System Analysis Across the Lifespan: Difference between revisions
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== Musculoskeletal System == | == Musculoskeletal System == | ||
The | 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.<ref name=":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. </ref> The following questionnaires are recommended:<ref name=":1" /> | ||
* | * The Oswestry Disability Index | ||
* | * The Pain Disability Index | ||
* | * The Roland-Morris Disability Questionnaire | ||
* | * The Upper Extremity Functional Scale | ||
{| class="wikitable" | {| class="wikitable" | ||
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|Muscle strength | |Muscle strength | ||
(Functional assessment to include sit to stand and stairs) | (Functional assessment to include sit-to-stand and stairs) | ||
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* Maximal volitional muscular force, contractile velocity and muscular power are lower than adults. | * Maximal volitional muscular force, contractile velocity and muscular power are lower than adults. | ||
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* Older adults often report difficulty with stair climbing, and it is reported as one of the top five most difficult tasks to perform. <ref>Gagliano-Jucá T, Li Z, Pencina KM, Traustadóttir T, Travison TG, Woodhouse L, Basaria S, Tsitouras PD, Harman SM, Bhasin S, Storer TW. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984416/pdf/gerona_75_6_1167.pdf 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. </ref> | * Older adults often report difficulty with stair climbing, and it is reported as one of the top five most difficult tasks to perform. <ref>Gagliano-Jucá T, Li Z, Pencina KM, Traustadóttir T, Travison TG, Woodhouse L, Basaria S, Tsitouras PD, Harman SM, Bhasin S, Storer TW. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7984416/pdf/gerona_75_6_1167.pdf 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. </ref> | ||
* Ability to climb stairs can help to assess hip and knee strength and stability <ref name=":4">Kapoor E. Multiple Body System Analysis Across the Lifespan. Plus course 2024</ref> | * Ability to climb stairs can help to assess hip and knee strength and stability <ref name=":4">Kapoor E. Multiple Body System Analysis Across the Lifespan. Plus course 2024</ref> | ||
* "The use of stair-climbing speed as an assessment tool should include both stair ascent and descent | * "The use of stair-climbing speed as an assessment tool should include both stair ascent and descent because differences in these speeds seem to be indicators of stair-climbing ability".<ref>Brodowski H, Andres N, Gumny M, Eicher C, Steinhagen-Thiessen E, Tannen A, Kiselev J.[[/www.magonlinelibrary.com/doi/abs/10.12968/ijtr.2020.0137|Reliability of stair-climbing speed in two cohorts of older adults.]]International Journal of Therapy and Rehabilitation 2021; 28(11):1-15. </ref> | ||
|- | |- | ||
|Flexibility/Range of motion | |Flexibility/Range of motion | ||
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|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:<ref>Adeboye A, Hart R, Senapathi SH, Ali N, Holman L, Thomas HW. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425136/pdf/cureus-0013-00000016847.pdf Assessment of Functional Pain Score by Comparing to Traditional Pain Scores.] Cureus. 2021 Aug 3;13(8):e16847.</ref> | |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:<ref>Adeboye A, Hart R, Senapathi SH, Ali N, Holman L, Thomas HW. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425136/pdf/cureus-0013-00000016847.pdf Assessment of Functional Pain Score by Comparing to Traditional Pain Scores.] Cureus. 2021 Aug 3;13(8):e16847.</ref> | ||
* First, the patient is asked if they have pain. If no answer due to pain, their pain is rated a “10” | * First, the patient is asked if they have pain. If there is no answer due to pain, their pain is rated a “10” | ||
* Next, the patient is asked if the pain is tolerable or intolerable (intolerable pain is rated “5” or greater). | * Next, the patient is asked if the pain is tolerable or intolerable (intolerable pain is rated “5” or greater). | ||
* Finally, | * Finally, how the pain interferes with passive vs. active activities is determined. | ||
| | | | ||
* The Functional Pain Scale is "an effective way to assess pain in the elderly and has proven helpful in identifying changes in pain". <ref>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]</ref> | * The Functional Pain Scale is "an effective way to assess pain in the elderly and has proven helpful in identifying changes in pain". <ref>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]</ref> | ||
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* Physical activity and calcium and vitamin D intake are interventions that improve BMD in older children.<ref name=":5" /> | * Physical activity and calcium and vitamin D intake are interventions that improve BMD in older children.<ref name=":5" /> | ||
| | | | ||
* | * calcium, vitamin D, and BMD deficiencies are common in adults with coeliac disease.<ref name=":4" /> | ||
* Patients with chronic obstructive pulmonary diseases and on long-term corticosteroids are more prone to having decreased BMD.<ref name=":4" /> | * Patients with chronic obstructive pulmonary diseases and on long-term corticosteroids are more prone to having decreased BMD.<ref name=":4" /> | ||
* Patients with haemophilia or other bleeding disorders and patients who are on long-term anticoagulation present with a higher incidence of decreased BMD.<ref name=":4" /> | * Patients with haemophilia or other bleeding disorders and patients who are on long-term anticoagulation present with a higher incidence of decreased BMD.<ref name=":4" /> | ||
| | | | ||
* Bone mineral density decreases with age.<ref>Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261527/pdf/nihms947379.pdf Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment.] J Biomed (Syd). 2018;3:40-49.</ref> | * Bone mineral density decreases with age.<ref>Padilla Colón CJ, Molina-Vicenty IL, Frontera-Rodríguez M, García-Ferré A, Rivera BP, Cintrón-Vélez G, Frontera-Rodríguez S. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6261527/pdf/nihms947379.pdf Muscle and Bone Mass Loss in the Elderly Population: Advances in diagnosis and treatment.] J Biomed (Syd). 2018;3:40-49.</ref> | ||
* "By | * "By age 80, it is estimated that 40% of the muscle mass present at age 20 is lost."<ref name=":6">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.</ref> | ||
* Osteopenia is a condition associated with bone mass loss.<ref name=":6" /> | * Osteopenia is a condition associated with bone mass loss.<ref name=":6" /> | ||
* Osteopenia often progresses to osteoporosis. | * Osteopenia often progresses to osteoporosis. | ||
* Strength training can stimulate hypertrophy and increase muscle strength to counteract the loss of muscle mass.<ref>Johnston AP, De Lisio M, Parise G. Resistance training, sarcopenia, and the mitochondrial theory of | * Strength training can stimulate hypertrophy and increase muscle strength to counteract the loss of muscle mass.<ref>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. </ref> | ||
|- | |- | ||
|Core Stability | |Core Stability | ||
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* Proprioception | * Proprioception | ||
** Ability to determine body segment positions and movements in space<ref>Han J, Waddington G, Adams R, Anson J, Liu Y. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191985/pdf/main.pdf Assessing proprioception: A critical review of methods]. J Sport Health Sci. 2016 Mar;5(1):80-90. </ref> | ** Ability to determine body segment positions and movements in space<ref>Han J, Waddington G, Adams R, Anson J, Liu Y. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6191985/pdf/main.pdf Assessing proprioception: A critical review of methods]. J Sport Health Sci. 2016 Mar;5(1):80-90. </ref> | ||
* Vestibular system, including ability to coordinate movement with balance | * Vestibular system, including the ability to coordinate movement with balance | ||
** Static and dynamic balance | ** Static and dynamic balance | ||
* Interoception | * Interoception | ||
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* Ageing is associated with a decline in proprioceptive function.<ref name=":9">Ferlinc A, Fabiani E, Velnar T, Gradisnik L. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853739/pdf/MSM-31-219.pdf The Importance and Role of Proprioception in the Elderly: a Short Review.] Mater Sociomed. 2019 Sep;31(3):219-221.</ref> | * Ageing is associated with a decline in proprioceptive function.<ref name=":9">Ferlinc A, Fabiani E, Velnar T, Gradisnik L. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853739/pdf/MSM-31-219.pdf The Importance and Role of Proprioception in the Elderly: a Short Review.] Mater Sociomed. 2019 Sep;31(3):219-221.</ref> | ||
* Proprioception is required for normal | * Proprioception is required for the normal body to function during movements and maintain balance. <ref name=":9" /> | ||
* Decline in proprioception due to ageing affects mobility and | * Decline in proprioception due to ageing affects mobility and increases the risk of falls.<ref name=":9" /> | ||
* Balance deficits are | * Balance deficits are linked to proprioceptive functions decline during the ageing process.<ref name=":9" /> | ||
|- | |- | ||
|Vestibular system | |Vestibular system | ||
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* Dynamic balance tests include ''low-beam walking test.'' | * Dynamic balance tests include ''low-beam walking test.'' | ||
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* Vestibular | * Vestibular signal impairment is associated with balance disorders and spatial disorientation in neurodegenerative diseases, including Alzheimer's and Parkinson's disease. <ref>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. [https://www.sciencedirect.com/science/article/pii/S1672293021000271 Peripheral vestibular system: Age-related vestibular loss and associated deficits.] J Otol. 2021 Oct;16(4):258-265. </ref> | ||
* Balance testing may include Romberg Test of Standing Balance on Firm and Compliant Support Surfaces. | * Balance testing may include the Romberg Test of Standing Balance on Firm and Compliant Support Surfaces. | ||
** Balance test on a foam-padded surface with eyes closed | ** Balance test on a foam-padded surface with eyes closed | ||
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=== Interception === | === Interception === | ||
Interception is | 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: | This video explores the concept of interception: | ||
For detailed assessment of the neurological system, please refer to the [https://members.physio-pedia.com/neurological-screening-course/ Neurological Screening] course. | {{#ev:youtube|v=rms5I02Rzg0&t=39s|300}}<ref>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]</ref> | ||
For a detailed assessment of the neurological system, please refer to the [https://members.physio-pedia.com/neurological-screening-course/ Neurological Screening] course. | |||
== Integumentary System == | == Integumentary System == |
Revision as of 23:45, 23 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 people | |
---|---|---|---|
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]
|
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]
|
|
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 People | |
---|---|---|---|
Proprioception |
|
There are three main testing techniques for assessing proprioception in adults: |
|
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.
Gastrointestinal System[edit | edit source]
Cardiopulmonary System[edit | edit source]
Mental Health System[edit | edit source]
Resources[edit | edit source]
- bulleted list
- x
or
- numbered list
- x
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 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]