Care of Elderly: a Solution for Disability
Practical Guide of PPCR Model for Rehabilitation Professionals )

Learning objective 1: To understand the relationship between aging and disability and application of PPCR model to reduce disability in aging.
Learning objective 2: To be able to offer evidence-based advice on appropriate exercises based on PPCR model.


People worldwide are living longer. By 2050, the world’s population aged 60 years and older is expected to total 2 billion, up from 900 million in 2015. At a biological level, ageing is associated with the gradual accumulation of a wide variety of molecular and cellular damage over time. This damage leads to a gradual decrease in physical and mental capacity, an increased risk of many diseases, and a general decline in the capacity of the individual. Common conditions in older age include hearing loss, cataracts and refractive errors, back and neck pain and osteoarthritis, chronic obstructive pulmonary disease, diabetes, depression, and dementia. Furthermore, as people age, they are more likely to experience several conditions at the same time. Older age is also characterized by the emergence of several complex health states that tend to occur only later in life and that do not fall into discrete disease categories. These are commonly called geriatric syndromes. They are often the consequence of multiple underlying factors and include frailty, urinary incontinence, falls, delirium and pressure ulcers. Inactivity in old age is another factor that may causes or furthers these health related problems.

The changes of the body and health in older age, with or without the influence of environmental factors lead to lower the functional ability and participation, and confined them into the state of disability. This process can be limited by influencing the changes of the body and health in older age. Most of the body changes and health conditions, which may leads the older people into disability can be influenced through measures including physical exercises and physical activities.

The World Health Organization (WHO) has provided the recommendations for the sufficient amounts of physical activity for adults and older adults since this has significant health benefits and helps prevent some non-communicable diseases. However the expected amount of physical activities has not been reached due to various reasons. The PPCR model provides a practical way to provide sufficient amounts of exercises for this target group. This model suggested to achieve this influence through either “Prehabilitation”, “Prevention”, “Cure” or “Rehabilitation” or with a combination of these approaches. This system is mainly consisted with a home and community based and also a user friendly approach.


Implications / Conclusions:
Rehabilitation professionals meet elderly population in many occasions and settings during their practice as the geriatric care and rehabilitation is a rapidly growing specialty. Therefore the rehabilitation professionals can be identifies as the ideal professionals to promote, guide, prescribe and manage exercise activities focusing to prevent disabilities in elderly populations.

In addition to the existing skills, rehabilitation professionals require an understanding of the impact of their exercise advice on older adults. This workshop will offer a practical guide in provision of such exercises. Also this workshop will discuss the evidence available and address the issues of offering practical advice for this target group.

Target Audience

  • Rehabilitation Professionals working with Older Adults.
  • Any Rehabilitation Professionals with an interest in exercise advice.
  • Disability and Rehabilitation Researches and Professionals

Resource Persons

Mr. Sanjeewa Thunpaththu
Senior Physiotherapist, National Hospital of Sri Lanka
Visiting Lecturer, University of Colombo
Sri Lanka

Dr. Sujeewa Weerasinghe
Executive Director and Consultant in Physiotherapy,
PhysioLife Care (Physical Medicine,
Rehabilitation and Research),
Sri Lanka
Visiting Lecturer,
University of Colombo
Sri Lanka