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Ann Geriatr Med Res > Volume 19(2); 2015 > Article
Journal of the Korean Geriatrics Society 2015;19(2):61-70.
DOI: https://doi.org/10.4235/jkgs.2015.19.2.61    Published online June 30, 2015.
Rehabilitation Strategy to Improve Physical Function of Oldest-Old Adults
Hyun Kyung Do, Jae Young Lim
Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. drlim1@snu.ac.kr
초고령 노인의 신체기능장애와 재활 전략
도현경?임재영
서울대학교 의과대학 재활의학교실, 분당서울대학교병원 재활의학과
Abstract
In recent, oldest-old adults over 85 years are increasing rapidly. Major geriatric problems such as frailty, fall, osteoporosis, sarcopenia, gait disturbance in this population are higher prevalent and more severe than those in older adults under 85 years. Therefore, strategy to evaluate and manage them with combined medical problems and related impairments should be considered to prepare for super aged society in the near future. We introduced comprehensive geriatric physical performance battery to examine a variety of physical function in multidomains, which can be applied to prescribe exercise, nutrition and medications as single or combined therapy specific to the level of physical function. It would be desirable that modality-specific exercise intervention to prevent from functional decline of oldest-old adults will be integrated with clinical setting. Eccentric biased strengthening exercise is highlighted as an appropriate exercise intervention for sarcopenic oldest-old because of low energy expenditure and utilization of the aged muscle stiffness. Furthermore, specially designed exercise machines enabling them to do exercise are developed for severe deconditioned patients that can't participate in the conventional strengthening exercise. Oldest-old adults are expected to become a major patient group in geriatric medicine sooner or later. Basic principles of management for oldest-old adults are not different from geriatric management of frailty and sarcopenia in general old population. Along with the assessment of the multidomain of physical parameters, multidimensional modality-specific interventions should be developed based on each individual physical profiles.
Key Words: Oldest old, Frailty, Physical function, Exercise


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