A Movement Framework for Older Adults: Application of the Geriatric 5Ms

Physical therapy for older adults must evolve to address the increasingly complex needs of older adults, who are living longer and managing multiple chronic conditions within challenging psychosocial and environmental contexts. Foundational models, such as the International Classification of Functioning, Disability and Health and the Patient/Client Management model provide structural guidance but fail to fully integrate critical components necessary for comprehensive geriatric care. These models often emphasize immediate medical concerns rather than considering the broader, multifaceted influences on function and overall well-being. The prevailing focus remains on restorative approaches rather than proactive prevention and individualized management strategies, limiting their effectiveness in optimizing movement, function, and quality of life. The Movement Framework for Older Adults (MFOA) offers a paradigm shift in geriatric physical therapy by bridging these gaps and prioritizing a holistic, movement-centered approach. Rooted in the Geriatric 5Ms-Mind, Mobility, Medication, Multicomplexity, and what Matters Most-the MFOA provides a structured yet adaptable model by integrating movement with the physiological, cognitive, psychosocial, and pharmacological factors influencing mobility and function. This approach compels clinicians to assess and address the unique needs of each older adult, moving beyond impairment-based care toward a more comprehensive, person-centered strategy. Developed by the APTA Academy of Geriatrics' Geriatric Movement System Task Force, the MFOA builds upon existing frameworks by explicitly incorporating movement and the Geriatric 5Ms into the assessment and intervention process. It aligns with hypothesis-driven clinical reasoning, equipping physical therapists with a systematic method to analyze movement impairments and functional limitations. This paper introduces the MFOA as a critical advancement in geriatric physical therapy, strengthening the foundation of current practice and enhancing its relevance to the evolving landscape of aging and health care. By emphasizing movement as a fundamental determinant of function and well-being, the MFOA empowers physical therapists to deliver targeted, effective, and person-centered care that aligns with what Matters Most to older adults.