[Value and characteristics of physical medicine and health resort medicine in advanced age].

Physical medicine and spa medicine both have the impetus of rehabilitation in common. In addition, they share the therapeutical orientation toward the performance capacity of organs and functional systems, as well as to activities of daily living, the consideration of chronobiological rules of training and adaptation, and an acknowledging of the fact that diseases and, therefore, the basics of rehabilitation are constantly changing. With increasing age the relation of therapy to function resp. rehabilitation becomes increasingly important. Gerontorehabilitation is distinguished from general rehabilitation by the following three characteristics: a) the focus on particular diseases of the elderly, for instance osteoporosis; b) the therapeutical awareness of multimorbidity with the obvious involution of the skeletal muscle mass, the labilization and generalization of vegetative reactions and the special psychosocial situation; c) the consideration of specific reactions of the organism in advanced age to additional and unexpected events (immobilization syndrome, regulative rigidity, long-term adaptation). Gerontorehabilitation has to deal with specific problems of the elderly, problems that may seem medically banal, but which may be partly either serious or at least very inconvenient, e.g., the multifactorial-caused kyphosis, motor deficiency and slowed reactions, the tendency to fall, itching or stinging extremities due to many causes, latent heart insufficiency of undetermined origin, disturbance of sleep and therefore of recreation, and impairment of higher brain functions.