Community Therapy recently received a referral from one of our Home Care partners who needed Physiotherapy care for an inspiring 80-year-old man.
The man lives with his wife at Gillieston Heights and is used to being very active and capable. His normal routine involves playing lawn bowls twice a week.
This referral was initiated because he had experienced a couple of near-miss falls that were concerning and the family wanted to mitigate further risk.
Initial Assessment
The client had noticed a decline in their strength and balance, and felt that this was contributing to the near-miss falls.
The initial assessment included objective measures of strength, balance, and mobility to determine exactly why the client was falling, and to identify any deficits that could be improved upon.
In addition, the client also suggested that:
- Endurance had become a problem recently; he was finding it taxing to play bowling for as long as he usually did
- He was starting to have difficulty stepping onto and off the bowling green
Goal Setting
This client was passionate about bowls. Having noticed the decline in his physical capability, he was determined to do his best to prevent further deterioration.
His goals related to:
- Increasing strength and balance
- Increasing endurance
- Reducing falls risk
- Continuing to play competitive bowls twice a week!
From a Physiotherapists’ perspective these goals were fantastic because they were very specific, and very meaningful for the client.
A Carefully-Tailored Exercise Program
After the initial assessment, weekly Physiotherapy sessions commenced. These 30-minute sessions were carried out at the client’s home.
A significant portion of the exercise program was tailored towards improving the client’s bowling delivery technique as well. This involved:
- Advanced balance exercises (including developing an improved lunge and working on a narrowed stance balance)
- Strength work (including single leg strength as relevant to bowling)
- Improving the ability to get down to the floor and back up again
- Developing recovery techniques to manage falls should they occur
- Comprehensive stepping exercises
At Community Therapy we have two different stepping exercise systems that we work with. One is BlazePods, which is a system of light sensors. The other is an app called ‘Clock Yourself’, which provides a cognitive stepping challenge using a clock face.
During each session, the client’s weekly self-directed exercise program was also reviewed and upgraded (if required) so that they had exercises to work on between each Physiotherapy session.
Considerations
One of our main considerations was ensuring that we focused on the client’s ability to safely and comfortably continue to play bowls. Bowling was an important part of his life, and of his family’s life (he had been club champion and has family members who are champions as well).
Another consideration to be addressed was the use of assistive equipment. The client was interested in using a quad stick which the family had purchased for him. However, a review of the stick and of his balance and mobility showed that the stick was actually not appropriate or required. It didn’t decrease the client’s falls risk, and so the outcome of this consideration was that a mobility aid was not required.
A Meaningful Outcome
At Community Therapy we like to say ‘you can’t go wrong with getting strong’, and that’s certainly been clear in this case.
The client is very happy that he can continue to participate in the community in the way that he wants to. He has reported that:
- His endurance has improved
- His control and accuracy when bowling have improved since working with Community Therapy
This client is continuing to have weekly Physiotherapy, and we regularly review and upgrade his program to ensure that we are challenging him in the right ways all the time.
This has been a great outcome for everyone, and that certainly means a lot to our clinicians. It is fantastic for us when clients have quite specific, meaningful goals that are tied to a passion. It makes it easy for the clinician to provide an exercise program or interventions and strategies that are fun and meaningful for the person to do. It also generally means that the client is going to be more engaged and more motivated to get the results that they’re after.
It’s very rewarding to see someone so happy about seeing their strength and balance improved because they’re able to engage with a sport, in this case of bowls, that they’ve loved for many decades.
Everybody feels positive with a case like this.
July 1, 2024
