The Pulse

Pain is common in the geriatric population leading to a rapid decline in cognition and function with the eventual need for assistance and potential institutionalization. While opioids are often used to treat pain, their side effects are now well established. In therapy, multimodal non-pharmacologic pain management interventions are effective at improving clinical outcomes.

Acute and chronic pain are prevalent in the United States and can affect an individual’s mobility, function, and independence. According to the CDC, approximately 20% of the adult population suffers from chronic pain. Opioids including oxycodone, tramadol, and fentanyl are among medications often taken for acute and chronic pain. However, opioids have numerous side-effects, are highly addictive, and can lead to overdose and death. Non-pharmacologic alternatives are recommended to address pain and can play a role during the weaning process from opioids.

This 78-year-old woman (a left below knee amputee for 30-years) suffered a stroke and received four weeks of inpatient rehabilitation. Due to severe hip pain and inability to perform self-care, she was then referred to a skilled nursing facility for rehabilitation services. Prior to her stroke, this woman lived alone and was independent with self-care and mobility while wearing her prosthesis.

Patient Information: Female, Age 78

Patient Information: Female, Age 80

Diagnosis: Subluxed Humerus / Pain

History:
This woman, a long-term care resident of a skilled nursing facility, was referred for rehabilitation services to address pain, decreased strength, and impaired motion of the left shoulder after experiencing a fall which caused her left shoulder to become partially dislocated (subluxed). Prior to her fall, she was able to dress independently.

Patient Information: Female, Age 77

Diagnosis: Left Knee Pain

History: This woman, a long-term care resident of a skilled nursing facility, was referred to therapy due to knee pain and a decline in functional activity and ambulation. Prior to this recent decline, she was independent with ambulation throughout the facility.

Two recent studies show that ACP’s proprietary PENS waveform technology is effective in treating patellofemoral pain (PFP) and improving muscle function during movement.

Over the past several years, the body of evidence on the effectiveness of virtual reality (VR) in rehabilitation has significantly expanded. VR has been studied for a variety of diagnoses including stroke, Parkinson’s disease, multiple sclerosis, dementia, burns, pain, and total knee arthroplasty. VR helps enhance patient involvement and motivation while increasing the repetitions and duration of exercise. Benefits addressing ADL performance, balance, gait, pain, and cognition have been reported.

Patient Information: Male, Age 49

Diagnosis: Pneumonia / Neuropathy

History: This gentleman was found by EMS unable to get out of bed and covered in soiled bedding with insect infestation, and reported he hasn’t been out of bed for “quite some time.” He
was admitted to the hospital with pneumonia, then transferred to a skilled nursing facility
for rehabilitation services.