Physical impairment is highly prevalent among the elderly, which is closely associated with sarcopenia, falls, and frailty. It severely impairs the elderlys quality of life and health, imposing a heavy burden on families and society. Although exercise recommendations and prevention - control guidelines/ expert consensuses have been issued domestically and internationally for healthy elderly individuals and diseases related to functional impairment, there is a lack of targeted guidance on the prevention and control interventions for elderly people with physical functional impairment. In China, the significance of preventing and controlling functional impairment in the elderly has not been fully recognized, and there are many drawbacks such as non - standardized diagnosis and treatment as well as relatively single intervention methods. Therefore, by referring to relevant domestic and foreign guidelines and consensuses on elderly functional impairment, the expert group formulated this consensus to provide guidance for medical professionals engaged in geriatrics in China.
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Preventing physical impairment, identifying it early and implementing scientific interventions are conducive to improving the prognosis and quality of life of the elderly.
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The risk factors for physical impairment are complex, including age, gender, comorbidity of chronic diseases, daily behaviors, psychology, socioeconomic status, marital status, educational level and family conditions.
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At present, there is no special assessment scale for elderly physical impairment worldwide. It is recommended to select appropriate assessment scales according to patients different clinical symptoms, and refer to the FIST scale which is first constructed by the research team and suitable for Chinese elderly people.
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A multidisciplinary team - based comprehensive management model for the elderly should be adopted. Health education related to physical impairment should be regularly carried out for patients and intervention practitioners to enhance their understanding and improve intervention skills.
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Exercise rehabilitation training is an ideal way to delay or reverse physical impairment. It mainly includes resistance training, balance training, aerobic training and structured training. A complete exercise session should consist of warm - up exercise, intensive exercise, cool - down exercise and stretching exercise. Individualized training programs should be formulated based on the severity of the elderlys physical impairment.
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An ideal exercise rehabilitation program should meet the health and physical fitness needs of patients. The main contents of an exercise prescription include exercise mode, intensity, duration, frequency, precautions, total amount and progress. The specific plan should be adjusted according to the actual situation and tolerance of elderly patients with physical impairment.
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Warm - up exercise is particularly important for elderly patients. It can not only reduce the risk of sports injuries to muscles, ligaments and joints, but also improve exercise effectiveness. The elderly should adhere to the principle of gradual progress in exercise and conduct adequate warm - up for about 5 - 10 minutes before exercise, such as jogging and brisk walking, until the body sweats slightly and the heart rate accelerates moderately.
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Resistance training is the most effective way to improve muscle mass and strength. It can also increase bone mineral density, reduce the risk of fractures and falls in the elderly, improve sarcopenia and muscle function, and prevent disability. It is recommended to carry out resistance training 2 - 3 times a week, starting with 1 - 2 sets per day and gradually increasing to 2 - 3 sets per day, with 8 - 12 repetitions of exercises targeting major muscle groups each set.
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Balance training and gait training are important for preventing falls. In addition to single - leg standing, heel standing and toe standing, traditional Chinese fitness methods such as Tai Chi, Five - Animal Frolics and Eight - Section Brocade are also good choices. Balance training can be carried out 1 - 7 times a week, with 1 - 2 sets of dynamic or static balance exercises each time. Protective measures should be taken during training to avoid accidental injuries.
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Aerobic training can effectively improve muscle mass and exercise endurance of patients with physical impairment. Moderate - intensity continuous training (MICT) and high - intensity interval training (HIIT) both have good effects. Suitable aerobic exercises include dancing, cycling, hiking, jogging and swimming. In the first few weeks, the daily training duration can start from 5 - 10 minutes and gradually increase to 15 - 30 minutes, and finally reach 20 - 60 minutes, with a frequency of 3 - 7 times a week.