Geriatric rehabilitation: state of the art.
Journal Article (Journal Article;Review)
OBJECTIVES: To provide a clinically useful conceptual framework for the evaluation and treatment of disability in older persons, to review the rehabilitation of common conditions affecting function in older persons, and to discuss the effects of the ongoing changes in the healthcare system on geriatric rehabilitation. METHODS: MedLine search and review of relevant texts for information on (1) geriatric disability and its treatment, (2) recent high quality research, guidelines, and review articles relevant to the rehabilitation of conditions commonly causing geriatric disability, (3) effects of recent changes in the healthcare system on geriatric rehabilitation. RESULTS: Several pertinent models for geriatric disability were identified. These are explicated, along with information on the epidemiology of geriatric disability and its causes and relevant clinical applications. Rehabilitation is reviewed for musculoskeletal disorders, stroke and peripheral vascular disease, amputation, cardiopulmonary disorders, hip fracture, and deconditioning. Changes in the healthcare system appear to be affecting geriatric rehabilitation, especially the advent of managed care; relevant articles and opinions are reviewed, along with strategies to accommodate these changes. CONCLUSIONS: Our understanding of the causes of disability in the older population has improved significantly over the last decade. There has also been noteworthy progress in our knowledge about the effects of selected rehabilitation interventions, especially exercise-related interventions. However, the cost-effectiveness of many rehabilitative interventions remains unclear, particularly for differing patient groups across the continuum of care. More research will be needed to evaluate the effects of managed care on rehabilitation outcomes in older persons.
Full Text
Duke Authors
Cited Authors
- Hoenig, H; Nusbaum, N; Brummel-Smith, K
Published Date
- November 1997
Published In
Volume / Issue
- 45 / 11
Start / End Page
- 1371 - 1381
PubMed ID
- 9361665
International Standard Serial Number (ISSN)
- 0002-8614
Digital Object Identifier (DOI)
- 10.1111/j.1532-5415.1997.tb02939.x
Language
- eng
Conference Location
- United States