I’m going to be working with an older client who has a history of a lumbar spinal fusion. I am new to the PT world and CES, so I am looking through my references for contraindications/nuances with doing movement assessments/fitness assessments. He has been cleared by his MD to use elliptical, swim, bike, walk and is currently exercising 4-5 days per week. From those of you seasoned CPT/CES’s… any advice?
has he been cleared only for those modalities you stated? In that case you need to have him cleared for other exercise before you proceed.
In cases like that I always ask to have records from what he did in physical therapy to use as a starting point. As far as assessment are concerned, you should be able to do at least a standing assessment. I find that I can do a squat assessment with all clients as well, After all, everybody has to have the ability to sit down. Balance assessments should also be possible.
I often decide on what I do when I see the client. Just because somebody is older and has a spinal fusion does not mean that he is incapacitated or non-functioning.
Good luck with your client.
I would check to make sure that he or she has a note from the surgeon clearing him or her from spinal precautions (BLT – bending, lifting, twisting). Assuming precautions are lifted I very much agree with Ms. Singleton in suggesting that you get a sense for what your client was working on in physical therapy prior to discharge. That would be a great starting point for an assessment and progression of training.
Personal training is knowledge and part art. You have to design programs specific to the client’s needs, desires, their strengths, and their limitation. Keep sharpening the saw, learn as much as you can from reputable sources, train without causing harm, and we do not want to limit a person’s vision because of some label we see the world through – like “senior” or “older” or “whatever”. Observe, define, clarify, and design.