Older adults, for whom mobility is critical to maintain independence, make up a significant percentage of the patients cared for by rheumatologists. Those who lose independence are less likely to remain in the community and have higher rates of morbidity, mortality, and self-care disability while experiencing poorer quality of life.
The ARHP session, Keep’em Moving: Mobility Disability in Research & Patient Care, will address the importance of maintaining mobility, the consequences of mobility disability, methods for measurement in clinic, and research and interventions to improve functional outcomes among older patients. The session will take place on Sunday from 2:30 – 4:00 pm in Room 11 A.
Stephanie Studenski, MD, MPH, Chief of the Longitudinal Studies Section at the NIH National Institute on Aging, will talk about the importance of functional measurement in patients with reduced performance primarily due to rheumatologic problems.
“Rheumatology was among the very first disciplines to develop functional measures, such as the 50-foot walk and grip strength, and in my original training as a rheumatologist, I was struck by how potentially powerful and meaningful these functional measurements are,” Dr. Studenski said. “We’ve found that these measures are powerful predictors of overall effect in human adults, including risk of hospitalization, length of stay, hospital-related complications, surgery-related complications, discharge destination, and overall survival.”
Knowing this, Dr. Studenski said, researchers need to dissect out the independent contribution of rheumatologic problems from the many other factors that influence these measures, including cardiopulmonary problems or neurological problems.
“It’s important because reduced performance due primarily to pain or musculoskeletal problems may be much less damaging to overall survival and healthcare use than reduced performance due to other problems,” she said. “People who have poor performance are often categorized as high risk for surgery, for example, and there may be a population of people with reduced performance primarily due to rheumatologic problems that have a better prognosis and need to be separated from people who have reduced performance because of other problems.”
Also during this session, Daniel White, PT, ScD, MSc, Assistant Professor in the Department of Physical Therapy at the University of Delaware in Newark, will discuss how physical activity interventions can improve mobility.
“This is really important for patients with knee osteoarthritis, for example, because mobility is problematic in most people with this condition,” White said. “In fact, knee osteoarthritis (OA) is the most common cause of difficulty moving around for older adults compared with any other disease, so being able to preserve mobility is not only a big priority for these patients, but for the medical community as well.”
Numerous organizations recommend exercise as a first-line intervention for people with knee OA, he said.
“The old belief was, if you have painful knee OA, you should basically just sit and do nothing,” White said. “We now have a good amount of evidence showing that walking-based interventions, for example, do help people with painful knee OA and that it is actually better to get up and start moving around as much as possible.”
White said it is important that rheumatologists promote the importance of exercise to patients and if they are unclear or unsure about how to prescribe physical activity or a walking-based intervention, they should refer them to physical therapy.
“Physical therapists are highly trained health professionals who are experts in knee OA and exercise,” White said. “They know how to marry the two and are excellent at assessing and prescribing an exercise regimen for people with knee OA.”