Medical Clearance of Older Adults Participating in Preventative Direct Access Physical Therapy

Cureus. 2023 Mar 5;15(3):e35784. doi: 10.7759/cureus.35784. eCollection 2023 Mar.

Abstract

Background The purpose of this study was to determine if the use of evidence-based cognitive and cardiovascular screening prior to initiating a prevention-focused exercise program that utilizes a physical therapist (PT) direct consumer access referral model is safe. Methods A retrospective descriptive analysis of data from a prior randomized controlled trial (RCT) was performed. Two data sets emerged: Group S was screened for study inclusion but not enrolled, and Group E was enrolled and participated in preventative exercise. Participant outcomes of cognitive screenings (Mini-Cog, Trail Making Test-Part B) and cardiovascular screening (American College of Sports Medicine Exercise Pre-participation Health Screening) were extracted. Descriptive statistics were generated for demographic and outcome variables and inferential statistics were analyzed (p < 0.05). Results Records from 70 individuals (Group S) and 144 individuals (Group E) were available for analysis. Overall, 18.6% (n = 13) in Group S were not enrolled due to medical instability or potential safety considerations. The need for medical clearance prior to initiating an exercise program was identified and then clearance was obtained for 40% (n = 58) of the participants in Group E. No adverse events related to program participation were reported. Conclusions A PT-led program utilizing direct access referrals from senior centers offers a safe option for older adults to participate in individualized preventative exercise programming.

Keywords: cardiovascular screening; cognition screening; exercise; physical therapy; prevention.

Grants and funding

Funding for this work was from a 2018 Michigan Health Endowment Fund-Healthy Aging Award ($201,558) that was awarded to Oakland University. Authors SA, CW, and LB are employees of Oakland University and conducted this research as a component of their employment requirements.