Examqo › Examqo library › Geriatric medicine › Long-term care, ethics and end of life · IMLE
Geriatric rehabilitation
Geriatric rehabilitation returns an older adult to the best possible function after an acute event (hip fracture, stroke, prolonged admission) through a multidisciplinary team working towards personal goals; old age or mild-to-moderate cognitive impairment is not a reason to deny rehabilitation.
Why it matters in the exam
The exam asks about measurement tools: the FIM (18 items, score 18–126, 13 motor and 5 cognitive) and the Barthel index (0–100), and about predictors of success: function before the event, cognition, motivation and support at home. A recurring question: will a patient with mild dementia after a hip fracture benefit from rehabilitation? Yes, although sometimes less.
Candidates are also asked about rehabilitation settings (geriatric rehabilitation ward, day hospital, home rehabilitation), the roles of the team (physiotherapy — mobility and strength; occupational therapy — daily activities and home adaptations; speech and language therapy — swallowing and language; social work — setting and support), and timing after stroke: early rehabilitation, but very intensive mobilisation within the first 24 hours did not help and even harmed in the AVERT trial.
The exam also asks about walking aids: the cane goes in the hand on the side away from the affected leg, and a walker suits someone needing more support; its height should reach the wrist crease when the arm hangs straight. Further topics are pain management during rehabilitation, treating depression that slows progress, and rehabilitation of patients after leg amputation or after a prolonged stay in intensive care.
Key points
- Rehabilitation — a multidisciplinary team around personal goals.
- FIM 18–126 (13 motor, 5 cognitive); Barthel 0–100.
- Predictors: prior function, cognition, motivation, support.
- Age and mild dementia do not exclude rehabilitation.
- Stroke — early rehabilitation, not very intensive mobilisation in the first 24 hours.
Summary table
| Issue | Key point | Exam point |
|---|---|---|
| Measurement | FIM 18–126; Barthel 0–100 | FIM includes a cognitive component |
| Predictors of success | Prior function, cognition, motivation, support at home | Mild dementia does not exclude rehabilitation |
| Settings | Rehabilitation ward, day hospital, home rehabilitation | According to tolerance and support |
| The team | Physiotherapy, occupational therapy, speech and language therapy, social work, nursing, physician | Shared, measurable goals |
| Stroke | Early, graded rehabilitation | Very intensive mobilisation within 24 hours — no |
| After hip fracture | Early full weight-bearing, strength and balance | Combine falls prevention and osteoporosis care |
Free exam questions
בן 85, מתגורר בביתו עם מטפל צמוד בעקבות דמנציה וצורך בהשגחה. מתהלך ללא אביזר עזר. מאושפז בעקבות אירוע מוחי נרחב בטריטוריה של MCA, פלגיה מימין ואפזיה מעורבת. במהלך האשפוז אירועי אספירציה, טופל באנטיביוטיקה, מוזן דרך זונדה. בפיזיותרפיה לא מבין הוראות. לא מבצע פקודות פשוטות. מעברים במנוף. משפחתו מבקשת להעבירו למסגרת שיקומית. מה הגורם השולל התאמת המטופל לשיקום על פי נוהל אמות מידה למתן טיפול שיקומי לקשישים? (the question as examined, in Hebrew)
- א. מגורים קודמים עם מטפל צמוד
- ב. הזנה דרך זונדה
- ג. צורך בהעברות במנוף
- ד. חוסר יכולת לשתף פעולה
.כחלק מהליך שיקום לאחר פציעה, הומלץ למטופל על חזרה לפעילות ריצה מה עשויות להיות השפעות המלצה זו על סחוס המפרק? (the question as examined, in Hebrew)
- א. ירידה בכמות ה- Glycosaminoglycans
- ב. עליה בעובי הסחוס
- ג. עליה בכמות המים בסחוס
- ד. ירידה בכמות החומצה ההיאלרונית בסחוס
In the full version for subscribers
- A simple algorithm
- Memory aid
- Exam traps
- 5 review cards
- Enough for IMLE
The full version is open to subscribers of: Geriatrics, Medical licensing exam (IMLE), Physical medicine and rehabilitation, Family medicine, Orthopedic surgery, Neurology.
Subscriber? Read the full topic Plans and prices 25 free questions
Sources
- Hazzard's Geriatric Medicine and Gerontology, 8th edition (2022) — Rehabilitation of the older adult
- AHA/ASA Guidelines for adult stroke rehabilitation and recovery, 2016 — Timing, intensity and settings of rehabilitation
- Geriatrics Review Syllabus (American Geriatrics Society), 11th edition (2022) — Rehabilitation
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.