You've heard it before - as you age; you lose muscle mass largely due to inactivity. Along with the actual aging process, as people get older they no longer utilize as much muscle power, which in turn may lead to decreased range of motion (ROM) and other problems that affect daily living for the elderly. By recognizing early signs of diminished ROM and developing and/or encouraging participation in programs designed to improve strength and flexibility, health professionals, whether working with seniors in long term care, assisted living or independent living environments, can enhance the health and wellness of older adults.

Common causes
As defined, range of motion is the amount of movement allowed at a joint. Injuries, brain-related disorders and debilitating musculoskeletal diseases such as arthritis are all common contributors to declining ROM. Anything that inhibits the ability to move will be a factor in the decrease of muscle mass, strength and flexibility.

Complications
Whatever the cause, if left untreated, lack of motion tends to create a snowball effect, making the individual less and less willing to continue movement of the joint. For example, as a fracture heals, it is necessary to keep the bones stabilized and immobile. This lack of mobility may then affect the person's range of motion after the fracture heals, causing further inactivity that leads to increased stiffness and pain and a loss of ROM.

With this inactivity, various side effects may develop, including problems with joint integrity, stiffness, pain and immobility. Under normal conditions, when a joint is in motion, there is increased blood flow to the joint capsule, providing nourishment that enables the bones to move smoothly and without pain or discomfort. Limiting that movement reduces blood flow, typically resulting in stiff, painful joints, and this pain contributes to the spiral of inactivity and ROM loss.

The lack of mobility may also cause a loss in strength. Muscles are typically utilized as the joints move through their entire range of motion. A person may have full ROM in a joint, but have diminished muscle strength in one part of the range. For instance, a woman may be strong enough to move her arm easily through most of its ROM, but experience weakness in the last 10 degrees that prevents the arm from being fully straightened.

What you should know about ROM programs
Helping older adults achieve full ROM will not only assist them in maintaining their independence, but also improve safety and quality of life (e.g., the ability to engage in the familiar activities and socializing of every day life). This will, in turn, affect other areas of the person's life, such as their attitude, self-confidence and self-esteem.

Within a long-term-care environment, a team approach works best for identifying and treating those who show symptoms of decreased ROM. Residents with serious conditions would require individualized therapy programs to prevent serious complications from their diminished capabilities. Structured programs that incorporate stretching and exercises that focus on muscle strength, balance, flexibility and endurance are also recommended. Examples of enjoyable programs include water aerobics, tai chi, golf, walking, yoga, bowling, line dancing and general fitness. Changing routine and keeping activities fun and interesting will help keep participants involved as they improve ROM. Many of these programs could also be helpful for the wider population of the facility to help maintain their range and mobility.

In a more independent senior setting, referring those who exhibit symptoms of ROM loss to seek medical help would be advisable. For other individuals, the availability of fitness and wellness programs - or encouraging people to participate in a community program of that type - may help the elderly who live there to maintain or increase their ROM. Of course, as a general rule, older adults should never perform these exercises or activities without seeking medical advice first.

While many of us may take range of motion for granted, the lack of it is rapidly becoming more and more common due to injuries, neural disorders and the aging population. Providing a strength/flexibility program that focuses on ROM or a general fitness/wellness program for older adults will help to enhance their sense of independence, restore or maintain normalcy in their daily routine, and dramatically improve the quality of life.

For more information, contact Mike Herr at RehabWorks, (mike.herr@symphonyhealth.com)
(877) 957-7100.

Article provided by RehabWorks' Mike Herr.