Teaching Ergonomic Training Skills to Reduce the Fall Risk in an Elderly Patient - A Case Study

Abstract

Background: Ergonomics is a study in the efficiency of movement. This can be an important tool when examining a patient to determine what a root cause of a patient’s dysfunction is. And then, what can be done to resolve that dysfunction. Accepting a patient’s medical diagnosis, age, or self-report as to what their problem is, may not be the best measure of a patient’s loss of function. This is especially true when the clinician may be biased against a patient due to their advanced age. Case Description: The following is a case report of a 68-year-old man named ‘Casey’ (not his real name), who was diagnosed with vertigo and with shoulder pain due to arthritis. Casey had fallen several times in the recent past and his physician had advised him to stop playing sports to protect him from injury. The shoulder evaluation was revealing for loss of motion and weakness. However, Casey’s balance and coordination skills were primarily intact. There did not seem an obvious cause for a history of falling. On taking Casey out to the parking lot, he could easily field, catch, and throw a ball without difficulty. It was noted that Casey was left handed and further noted that he had recently started playing third base. As a left handed player, Casey needed to pivot almost 180 degrees every time he threw the ball to first base. This was a difficult movement pattern for Casey, and he lost his balance every time he had to field a ball, pivot 180 degrees and throw the ball to ‘first base’. It was likely that Casey did not have as much of a problem with vertigo as he did with learning an efficient movement pattern that would allow him to play third base as a left handed player. Casey was seen 5 times in physical therapy and was taught lower extremity movement patterns so he could safely throw a ball to first base without losing his balance. Casey accomplished this very quickly, which then let us focus on his limitations in shoulder pain and weakness, which also recovered quickly. Discussion: A Medical Diagnosis will usually offer an incomplete description of the patient. The Physical Therapist needs to be mindful in studying the patient’s movement, which will be helpful in revealing a root cause of a patient’s loss of function. This is especially true in the elderly, who we expect to have limited abilities.