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Category Archives: Physiotherapy

Preventing Falls: The Otago Exercise Program

Our Services Guy in gym

The Otago Exercise Program is a simple to complete program with strong evidence for decreasing falls in elderly people living in the community. Shown to decrease falls by 35%, the program has strong evidence to support its effect.

According to the study, the following groups of people are at higher risk of falls:

  • Aged 80+
  • Previous falls
  • Female
  • Recent illness or surgery
  • Reduced strength or balance

 

So what’s involved in the program?

This evidence based program targets leg muscle weakness, difficulty walking and balance systems which are some of the most common risk factors for falling.

  1. Strength exercises: 3 x per week
  2. Balance exercises: 3 x per week
  3. Walking: 2 x per week

Strength exercises focus on major leg muscles required for important movements like walking and standing. Physiotherapists are experts identifying deficiencies and selecting the right exercises to address identified problems. Importantly, they will also teach you how to do the exercises properly for maximum benefits.

Balance exercises are designed to retrain people in maintaining balance. Selected exercises will improve your ability to balance and your ability to recover your balance when something goes wrong. Selection of appropriate exercises and advice on performing challenging exercises safely by a physiotherapist is important.

As the saying goes, practice makes perfect. You’re never too old for this adage! Regular walking helps you to regain endurance and challenge your body to improve. Walking is the simplest part of the program to do safely and effectively, so some tips are provided below for getting started.

 

Getting Started With Walking

Now you know about the program, it’s time to get started with some walking.

The aim is to walk for 30 minutes two days each week. This needs to become a habit! Here are some things to keep in mind:

  • Walk at a comfortable pace.
  • Use your usual walker or stick if you have one.
  • If someone normally walks with you for safety, walk with them.
  • If you can’t walk 30 minutes continuously, break it down into multiple shorter walks. Try 3 lots of 10 minutes or 2 lots of 15 minutes.
  • Push yourself! It should be a challenge but not exhausting.

 

Next steps

Talk to our team about seeing one of our exceptional physiotherapists for tailored strength and balance exercises. We can see you in the comfort of your home, at our Cheltenham clinic or in a Residential Care facility. Call us on 9583 1364 or submit an enquiry to find out more.…

Wheelchair Prescription – Part 1: Wheelchair Types

customlong

For people with limited mobility Wheelchairs can often be a game changer. But with so many options on the market how do you know what to look for?

We’ve put together this 3 part blog to help you learn more about the different types of chairs on the market, what customisations are available and the important considerations around seating and positioning in a wheelchair.

  • Part 1: Different Types of Wheelchairs and what to consider.
  • Part 2: Standardisation vs Customisation.
  • Part 3: Seating and Positioning guideline.

Part 1 – Different Types of Wheelchairs and what to consider.

When looking at purchasing a Wheelchair it’s important to think about the following things as this will steer you in the right direction to choosing the right chair for you.

  • What is the primary use of the chair?
  • How often will the chair be used?
  • Will the chair be used indoors, outdoors or both?
  • Will you be propelling the chair or will you need someone to propel it for you?

Once you have a good understanding of the above you can then look at the different types of chairs to determine what will suit your needs. Ideally having a Physiotherapist, Occupational Therapist or Equipment Provider involved in this process is highly recommended to help guide you down the right path and make sure you end up with a chair that is right for you!

Manual vs Electric

Generally, the first differentiating factor when prescribing a wheelchair is whether the requirement is for a Manual or Electric Wheelchair. Manual Wheelchairs are the most common types of wheelchairs and require someone to “manually” push the chair. This can be either self propelled or require someone to push the chair. Electric chairs on the other hand are (as the name suggests) chairs that are propelled  by an electric motor.

Standard

Standard wheelchairs are the common “off the shelf” type of chair and generally quite basic and economical. They come with a durable steel frame and standard sizes of 16 x 16, 18 x 18 and 20 x 20inch chairs (the size refers to the seat’s width and depth). These chairs can often be folded but are generally quite heavy and cumbersome due to the steel frame.

Lightweight

In comparison to a Standard Wheelchair a Lightweight Chair is well…much lighter. The main reason for this is that these are made with lighter metals, generally aluminium, titanium or carbon fibre. They are generally used as a transit chair (transport someone from one place to another) and come with castors as opposed to large wheels with spokes and tyres which means you can’t propel yourself and will need someone to propel the chair for you.

The Castors along with the change in metal have a significant impact on the chairs weight and can often be half the weight of a standard wheelchair (Standard chairs are generally~15kgs vs a lightweight chair which weighs ~8kgs if not lighter!) These chair are commonly used in people that are ambulant but may not be able to walk long distances so are ideal for a family member to fold it up and easily lift it into the car.

Tilt in Space

Tilt in space chairs are often prescribed for clients that may spend most of their day in a chair. Tilt in Space chairs have the ability of tilting the entire chairs frame as one solid unit. This means that you can maintain the angles of key joints (hips, knees and feet – Part 3 of this blog will provide more info on seating posture and positioning) and help redistribute pressure to offload the ischial tuberosities (the bony parts of your bottom) to support comfort and reduce the risk of pressure sores from developing as a result of constant pressure due to lack of movement.

Some Tilt in space chairs come with a recline function which enables the chair’s backrest to change position on its own. This is especially helpful in clients with limited hip flexion and can be adjusted to ensure comfort as well as reduce the risk of sliding off the chair.

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Wheelchair Prescription – Part 2: Standardisation vs Customisation

Pimped Up Custom Wheelchairs Meet The Designers

Part 2 – Standardisation vs Customisation

Now that you’ve worked out what type of wheelchair to purchase it’s time think about the next question. Will a “standard off the shelf” wheelchair suffice or do i need to “pimp my ride?”

Well…it really depends on the individual using the chair, the frequency the chair will be used and how the chair will be used.

Some simple indicators may exclude the suitability of a standard chair for example:

Size:

Most standard wheelchairs come in 16/18/20inch x 16/18/20inch. When referring to chair sizes the first number always refers to the chairs width (measurement across someones hips) and the second number refers to the chairs depth (in a seated position measure from the back of the knees to the end of the bottom).  Modifications to chair width and depth may be required as most standard chairs come in common sizes.. It is recommended you speak with an Equipment Supplier such as FIsherlane Mobility or Rehabhire around available customisations on particular chairs prior to purchasing.

 

Frame:

Standard chair frames are commonly made from steel or aluminium. For people looking at lightweight or sports chairs it might be better to look at chairs made from titanium or carbon fiber. Many accessories like wheel rims and foot plates can also be customised to match.

 

Upholstery:

The two most common types of upholstery on wheelchairs are Vinyl and Nylon. They both have their pros and cons. Nylon is more breathable and lighter in weight but can be difficult to clean and is more expensive than Vinyl. Vinyl on the other hand is the cheaper alternative, easier to clean and can be disinfected but not recommended for everyday use as the non-porous material makes you more likely to sweat!

 

Physical ability:

The physical ability of the  user is paramount as this will determine the level of customisation required. For example someone who has sustained a stroke and has limited function in one side of their body can still independently propel themselves with a one arm drive system. One Arm Drive (OAD) Systems like the lever drive or double hand rim enable the user to propel and steer with one arm.

In circumstances with significant physical disability many customisations can be made to a chair. Most people are familiar with Professor Stephen Hawking who suffered from Motor Neuron Disease yet still excelled as a visionary scientist. Check out some of the customisations to his chair below!

 

 

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