Chapter 12: Neuromuscular and Neuromotor Conditions

LEARNING OUTCOMES

By the end of this chapter, readers will be able to:

• 12-1. Identify typical age-related neuromotor changes you may see in an older adult while they are conducting activities of daily living (ADLs).

• 12-2. Justify three precautions to be taken when working with a client with different neuromotor conditions in relation to physical motor performance.

• 12-3. Critique the use of traditional motor control theories in relation to modern task-oriented motor learning theories.

• 12-4. Develop an evidence-based assessment plan for physical performance of an older adult with a neuromotor condition that considers the stage of the health condition.

• 12-5. Develop an evidence-based intervention plan for task performance for an older adult with a neuromotor condition that considers the stage of the health condition.

• 12-6. Design a plan for referrals to your interprofessional team members for an older adult with a neuromotor condition including a rationale for each referral.

Mini Case Study

Mrs. Boupha Voeum is a 92-year-old widow who lives with her adult son (age 67) and his wife (age 73) and her 30-year-old grandson. All the bedrooms and the bathroom are on the second floor of the home. Mrs. Voeum is originally from Cambodia, and her favorite occupation is volunteering at her local church and immigrant community center. Mrs. Voeum has osteoporosis, macular degeneration, and diabetes. Until very recently, Mrs. Voeum either walked or took the bus to the locations where she volunteers. However, Mrs. Voeum has not attended her volunteering as regularly, as she has noticed that she is becoming increasingly unsteady on her feet and is afraid of falling if the bus driver does not wait for her to sit down. When walking, she is rarely able to make it through the crosswalk without the crossing sign changing from “Walk” to “Don’t Walk.” Mrs. Voeum has been using a cane that she bought at the local pharmacy in her right hand to feel steadier when she walks outside the home.

Mrs. Voeum is also getting discouraged with cooking—something she enjoys doing for the whole family. Her hands feel weak. She is struggling to do things like open jars and grasp a knife firmly when cutting large hard objects (like a squash), and she has almost dropped pots filled with water or food when carrying them between the stove, counter, sink, and table. She also notices that her coordination is not as good when she is doing things like chopping vegetables; it seems like it takes much longer than it used to.

Provocative Questions

1. What typical age-related changes are illustrated in this case study about Mrs. Voeum?

2. What adaptations could be made to support Mrs. Voeum with maintaining her volunteering and meal-preparation activities?