LEC15: Sensory System (Age-Related Changes in Physiology and the Effects of Exercise) Flashcards

1
Q

Fall Statistics: between (blank) of Canadians aged 65 and over fall each year

A

20-30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Fall Statistics: falls remain the leading cause of (blank) among Canadians aged 65 and over

A

injury-related hospitalizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fall Statistics: falls are the direct cause of (blank) of all hip fractures, leading to death in (blank) of cases

A

95%, 20%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fall Statistics: falls appear to be a catalyst for what?

A

The transition to long-term care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Activity associated with fall-related injury, age 65+

A

Walking in any other surface: 45%
Walking on snow or ice: 16%
Up or down stairs/steps: 13%
Due to health problems: 8%
From furniture/rising from furniture: 5%
From elevated position: 5%
Engaged in other sport or physical activity: 4%
Other (includes skating, skiing, and snowboarding): 4%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Body part affected by fall-related injury, age 65+

A

Knee, lower leg: 15%
Ankle, foot: 10%
Lower back or lower spine: 8%
Wrist: 8%
Hip: 7%
Head (including facial bones): 7%
Chest: 7%
Hand: 4%
Elbow, lower arm: 4%
Multiple sites: 4%
Abdomen or pelvis: 3%
Neck, upper back or upper spine: 3%
Thigh: 2%
Eyes (excluding facial bones): 1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Fall-related hospitalizations, by place of occurrence of fall, age 65+

A

Home: 50%
Residential Institution: 17%
Sports and athletic area: 0%
Industrial and construction: 0%
School, other institution, public area: 7%
Street and highway: 3%
Trade and service area: 2%
Other specified place: 2%
Farm: 0%
Unspecified place: 19%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Biological/intrinsic factors associated with an increased risk of falling among older adults

A
  1. Impaired mobility
  2. Balance deficit
  3. Gait deficit
  4. Muscle weakness
  5. Advanced age
  6. Chronic illness/disability:
    a. Cognitive impairment
    b. Stroke
    c. Parkinson’s disease
    d. Diabetes
    e. Arthritis
    f. Heart disease
    g. Incontinence
    h. Foot disorders
    i. Visual impairment
  7. Acute illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Behavioural factors associated with an increased risk of falling among older adults

A
  1. History of falls
  2. Fear of falling
  3. Multiple medications
  4. Use of:
    a. Antipsychotics
    b. Sedative/hypnotics
    c. Antidepressants
  5. Excessive alcohol
  6. Risk-taking behaviours
  7. Lack of exercise
  8. Inappropriate footwear/clothing
  9. Inappropriate assistive devices use
  10. Poor nutrition or hydration
  11. Lack of sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Social and Economic factors associated with an increased risk of falling among older adults

A
  1. Low income
  2. Lower level of education
  3. Illiteracy/language barriers
  4. Poor living conditions
  5. Living alone
  6. Lack of support networks and social interaction
  7. Lack of transportation
  8. Cultural/ethnicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Environmental factors associated with an increased risk of falling among older adults

A
  1. Poor building design and/or maintenance
  2. Inadequate building codes
  3. Stairs
  4. Home hazards
  5. Lack of:
    a. Handrails
    b. Curb ramps
    c. Rest areas
    d. Grab bars
    e. Good lighting or sharp contracts
  6. Slippery or uneven surfaces
  7. Obstacles and tripping hazards
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the systems contributing to balance?

A
  1. Sensory (visual, somatosensory, vestibular)
  2. Cognitive
  3. Motor
  4. Older adults and balance dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the sensory system?

A

Brings in information about the state of the body in relation to the environment and task

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the cognitive system?

A

Makes the decision about what action is needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the motor system?

A

Produces the actions required to maintain or restore balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the changes to the visual system with age?

A
  1. Reduced acuity
  2. Reduced contrast sensitivity
  3. Reduced depth perception
  4. A narrowing of the visual field (particularly in the peripheral region)
17
Q

What are the changes to the somatosensory system with age?

A
  1. Sensitivity to the cutaneous receptors to touch and pressure decreases
  2. Number of sensory pathways innervating the cutaneous receptors also decreases
  3. Older adults experience a 2-10 fold increase in vibration threshold needed to detect sensations of touch (this results in a reduced ability to feel the quality of the contact between the feet and the surface below)
18
Q

What are the changes to the vestibular system with age?

A
  1. By the age of 70, the number of vestibular hair and nerve cells have declined up to 40%
  2. A moderate reduction in the gain of the vestibulo-ocular reflex
19
Q

What is the vestibulo-ocular reflex responsible for?

A

This reflex is responsible for stabilizing vision when the head moves quickly through a space or when there are many moving parts in a space

20
Q

What are the changes to the cognitive system changes with age

A
  1. Deficits in attention, memory, and intelligence become more common with age
  2. Dual task situations have been found to be particularly challenging for older adults
21
Q

What are the changes in motor system changes with age?

A
  1. Decreased strength, power, and endurance
  2. Increased time spent in the action planning phase (Increased reaction time, movement time, and response time)
22
Q

What is the action planning phase?

A

The time to process incoming sensory information and formulate an appropriate motor response

23
Q

Does exercise reduce the rate of falls in community-dwelling older adults?

A

Yes. Meta-analysis showed 21% reduction in fall risk based on 88 studies involving ~19 000 participants

24
Q

Exercise as a single (stand alone) intervention in community-dwelling older adults has a fall prevention effect similar to (blank)

A

Multi-faceted interventions. Exercise may be more easily implementable and cost-effective compared to multi-faceted interventions

25
Q

What are the two things which show the best reduction in fall rates?

A
  1. The exercises prescribed provided a high challenge to balance
  2. Participants were exercising for 3 or more hours each week
26
Q

What are some exercise programs which aim to provide a high challenge to balance?

A
  1. Reducing the base of support (eg, standing with two legs close together, standing with one foot directly in front of the other, standing on one leg)
  2. Moving the centre of gravity and controlling body position while standing (eg, reaching, transferring body weight from one leg to another, stepping up onto a higher surface)
  3. Standing without using the arms for support, or if this is not possible then aim to reduce reliance on the upper limbs (eg, hold onto a surface with one hand rather than two, or one finger instead of the whole hand)
27
Q

(blank) training may be included in addition to balance training

A

Strength, walking

28
Q

(blank) in balance training is necessary or the benefits will be lost

A

On-going participation

29
Q

ACSM position statement on older adults and physical activity states that balance exercises should include the following:

A
  1. Progressively difficult postures that gradually reduce the base of support (eg, two-legged stand, tandem stand, one-legged stand)
  2. Dynamic movements that perturb the center of gravity (eg, tandem walk)
  3. Stressing postural muscle groups (eg, heel stands, toe stands)
  4. Reducing sensory input (eg, standing with eyes closed)