MD Ramon C. Henson
Know How Hard to Push the Patient in Front of You Geriatric physical therapy is defined by narrowed physiologic reserve rather than by a body region or a diagnosis, and the decision that most often determines an older adult’s outcome is the dose. Twenty-eight chapters build examination, prescription, and condition-specific management around that decision, grounding each in the physiology of reserve loss and in the patient’s own measured capacity. Written for physical therapist students, for clinicians whose caseload is predominantly older adults, and for candidates preparing for geriatric specialist certification.Every chapter names the measurement that sets the ceiling, the intensity that is both safe and sufficient, the signals that close the window, and the criterion that licenses advancing the load. Inside, the clinical detail to:• Physiology of aging from motor unit loss to arterial stiffening - explain where a patient’s ceiling comes from and which part of it is trainable• Performance measurement with cut-points, measurement error, and ceiling effects - distinguish real change from noise instead of discharging at an apparent plateau• Resistance, power, aerobic, interval, and balance prescription with written progression rules - load older adults at an intensity that produces adaptation rather than reassurance• Sarcopenia, frailty, and polypharmacy treated as dosing inputs - convert a frailty result into a prescription rather than a reason for caution• Osteoarthritis, fragility fracture, stroke, Parkinson disease, dementia, cardiopulmonary disease, diabetic neuropathy, and cancer - adapt loading to each constraint without abandoning it• Acute care, critical illness recovery, and hospital-associated deconditioning - prescribe upright time and walking distance as numbers the whole team delivers• Palliative rehabilitation, health promotion, decision-making capacity, and informed risk - keep treating when restoration is not the goal• The Master Dosing Window Index - 112 dosing windows indexed by presentation, capacity marker, condition, and practice setting for lookup at the point of care Put it on the clinical shelf and prescribe from measured capacity.
