Susan J Leach, Marni Larkin, Laura Z Gras, Myla U Quiben, Kenneth L Miller, Michelle M Lusardi, Gregory W Hartley
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The prevailing focus remains on restorative approaches rather than proactive prevention and individualized management strategies, limiting their effectiveness in optimizing movement, function, and quality of life. The Movement Framework for Older Adults (MFOA) offers a paradigm shift in geriatric physical therapy by bridging these gaps and prioritizing a holistic, movement-centered approach. Rooted in the Geriatric 5Ms-Mind, Mobility, Medication, Multicomplexity, and what Matters Most-the MFOA provides a structured yet adaptable model by integrating movement with the physiological, cognitive, psychosocial, and pharmacological factors influencing mobility and function. This approach compels clinicians to assess and address the unique needs of each older adult, moving beyond impairment-based care toward a more comprehensive, person-centered strategy. 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引用次数: 0
摘要
老年人的物理治疗必须不断发展,以满足老年人日益复杂的需求,老年人的寿命更长,并在具有挑战性的社会心理和环境背景下管理多种慢性疾病。诸如国际功能、残疾和健康分类以及病人/客户管理模式等基础模式提供了结构性指导,但未能充分整合全面老年护理所需的关键组成部分。这些模型往往强调直接的医疗问题,而不是考虑对功能和整体健康的更广泛、多方面的影响。目前的重点仍然是恢复性方法,而不是主动预防和个性化管理策略,这限制了它们在优化运动、功能和生活质量方面的有效性。老年人运动框架(MFOA)通过弥合这些差距并优先考虑整体的、以运动为中心的方法,为老年物理治疗提供了范式转变。MFOA根植于老年医学的5Ms-Mind, Mobility, Medication, Multicomplexity, and what Matters most - MFOA通过将运动与影响Mobility和功能的生理、认知、社会心理和药理学因素相结合,提供了一个结构化的适应性模型。这种方法迫使临床医生评估和解决每个老年人的独特需求,从以损伤为基础的护理转向更全面、以人为本的策略。MFOA是由美国老年医学会老年运动系统工作组制定的,它建立在现有框架的基础上,明确地将运动和老年5m纳入评估和干预过程。它与假设驱动的临床推理相一致,为物理治疗师提供了一种系统的方法来分析运动障碍和功能限制。本文介绍了MFOA作为老年物理治疗的关键进步,加强了当前实践的基础,并增强了其与不断变化的老龄化和卫生保健景观的相关性。通过强调运动是功能和健康的基本决定因素,MFOA使物理治疗师能够提供有针对性的、有效的、以人为本的护理,这与老年人最关心的事情是一致的。
A Movement Framework for Older Adults: Application of the Geriatric 5Ms.
Physical therapy for older adults must evolve to address the increasingly complex needs of older adults, who are living longer and managing multiple chronic conditions within challenging psychosocial and environmental contexts. Foundational models, such as the International Classification of Functioning, Disability and Health and the Patient/Client Management model provide structural guidance but fail to fully integrate critical components necessary for comprehensive geriatric care. These models often emphasize immediate medical concerns rather than considering the broader, multifaceted influences on function and overall well-being. The prevailing focus remains on restorative approaches rather than proactive prevention and individualized management strategies, limiting their effectiveness in optimizing movement, function, and quality of life. The Movement Framework for Older Adults (MFOA) offers a paradigm shift in geriatric physical therapy by bridging these gaps and prioritizing a holistic, movement-centered approach. Rooted in the Geriatric 5Ms-Mind, Mobility, Medication, Multicomplexity, and what Matters Most-the MFOA provides a structured yet adaptable model by integrating movement with the physiological, cognitive, psychosocial, and pharmacological factors influencing mobility and function. This approach compels clinicians to assess and address the unique needs of each older adult, moving beyond impairment-based care toward a more comprehensive, person-centered strategy. Developed by the APTA Academy of Geriatrics' Geriatric Movement System Task Force, the MFOA builds upon existing frameworks by explicitly incorporating movement and the Geriatric 5Ms into the assessment and intervention process. It aligns with hypothesis-driven clinical reasoning, equipping physical therapists with a systematic method to analyze movement impairments and functional limitations. This paper introduces the MFOA as a critical advancement in geriatric physical therapy, strengthening the foundation of current practice and enhancing its relevance to the evolving landscape of aging and health care. By emphasizing movement as a fundamental determinant of function and well-being, the MFOA empowers physical therapists to deliver targeted, effective, and person-centered care that aligns with what Matters Most to older adults.
期刊介绍:
Journal of Geriatric Physical Therapy is the leading source of clinically applicable evidence for achieving optimal health, wellness, mobility, and physical function across the continuum of health status for the aging adult.
The mission of the Academy of Geriatric Physical Therapy is building a community that advances the profession of physical therapy to optimize the experience of aging.