The nervous system may also show signs of advanced deterioration with excessive alcohol use. These irreversible problems may make the physical rehabilitation experience more challenging for the patient as well as the physical therapist. For example, impaired learning and impaired short term memory secondary to alcoholism could cause an elder with a total hip replacement to forget his total hip precautions. A physical therapist must modify the rehabilitation approach for this patient such as placing written hip precautions next to the patient's bed as a reminder. From the same article, it was stated that alcoholic peripheral neuropathy can cause impaired proprioception, numbness, muscle wasting, and even paralysis.
Any peripheral neuropathy requires special considerations by the physical therapist.
Lack of sensory input may cause gait deviations such as a high-steppage gait or foot drag. An alcoholic elder with muscle wasting and numbness may have difficulty with independent ADLs. Another problems with asensate tissue is pressure sores and abrasion wounds. The physical therapist may need to prescribe an assistive device to normalize gait and regularly perform skin inspections if alcoholic peripheral neuropathy develops. On the other hand, most damage to the cardiovascular system resulting from excessive drinking is not reversible and can dramatically increase one's risk of mortality due to cardiovascular disease.