A decline in physical function and significant increases in the risk for disability and dependence are typical of advanced adult age. In humans, a number of age- related changes in various biological systems contribute to this decline including, but not limited to, decreases in muscle and bone mass, increases in body fat, loss of brain volume and cognitive capacity, loss of cardiovascular and pulmonary reserves, impaired visual and hearing function, sleeping disorders, anxiety and depression, and changes in dietary habits leading to mal-/undernutrition. Some of these changes are directly associated with lower levels of habitual physical activity.
In the broad eld of musculoskeletal medicine, the last 50 years have seen significant progress in our understanding of clinical conditions manifesting in the complex musculoskeletal system. Mechanistic models – inherited from the origins of Western medicine – are now slowly being replaced by neurological models that better reflect the realities of human physiology, particularly with regard to the miscellaneous conditions we term ‘functional disorders’ that, arguably, constitute most of the challenging clinical problems that most ‘manual medicine practitioners’ face every day. Not only are techniques evolving, but also professions. Manual medicine is quickly becoming an international umbrella term to describe the daily practice of professionals with diverse denominations and licences, who use their hands and some, or all, of the tools and techniques presented in this book, to assess and treat musculoskeletal disorders.
The Physiotherapist‘s knowledge of the body in health and disease and of function, movement, specific exercise and health behavior as well as of health promotion approaches is important in the context of physical activity in disease prevention, management and health promotion in elderly population.