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Questions and Answers
What major symptom is associated with Autonomic Dysreflexia in patients with spinal cord injury?
What major symptom is associated with Autonomic Dysreflexia in patients with spinal cord injury?
What is a common absolute contraindication to exercise for a patient with spinal cord injury?
What is a common absolute contraindication to exercise for a patient with spinal cord injury?
Why is it important for a patient with spinal cord injury to empty their bladder before exercise?
Why is it important for a patient with spinal cord injury to empty their bladder before exercise?
What is a relative contraindication to exercise for a patient with spinal cord injury?
What is a relative contraindication to exercise for a patient with spinal cord injury?
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What should be monitored during exercise in a patient with spinal cord injury?
What should be monitored during exercise in a patient with spinal cord injury?
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Which of the following is NOT a potential application of functional electrical stimulation (FES) in patients with spinal cord injury?
Which of the following is NOT a potential application of functional electrical stimulation (FES) in patients with spinal cord injury?
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Which of the following is a potential benefit of FES for lower extremity muscles in individuals with spinal cord injury?
Which of the following is a potential benefit of FES for lower extremity muscles in individuals with spinal cord injury?
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How does the heart rate response (HRR) during peak exercise vary in individuals with spinal cord injury?
How does the heart rate response (HRR) during peak exercise vary in individuals with spinal cord injury?
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Which of the following is a potential contraindication for exercise in individuals with spinal cord injury?
Which of the following is a potential contraindication for exercise in individuals with spinal cord injury?
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What is the primary mechanism by which FES can improve bladder function in individuals with spinal cord injury?
What is the primary mechanism by which FES can improve bladder function in individuals with spinal cord injury?
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Which of the following is a potential benefit of FES for upper extremity muscles in individuals with spinal cord injury?
Which of the following is a potential benefit of FES for upper extremity muscles in individuals with spinal cord injury?
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Which of the following is a common contraindication for exercise in individuals with spinal cord injury?
Which of the following is a common contraindication for exercise in individuals with spinal cord injury?
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Which of the following statements about circulatory hypokinesis in spinal cord injury is true?
Which of the following statements about circulatory hypokinesis in spinal cord injury is true?
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Which of the following statements about spasticity in spinal cord injury is false?
Which of the following statements about spasticity in spinal cord injury is false?
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Which of the following is not a potential application of exercise for individuals with spinal cord injury?
Which of the following is not a potential application of exercise for individuals with spinal cord injury?
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Which of the following statements about pressure sores in individuals with spinal cord injury is true?
Which of the following statements about pressure sores in individuals with spinal cord injury is true?
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Which of the following is a potential benefit of exercise for individuals with spinal cord injury?
Which of the following is a potential benefit of exercise for individuals with spinal cord injury?
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Which of the following is NOT a characteristic of autonomic dysreflexia in individuals with spinal cord injury?
Which of the following is NOT a characteristic of autonomic dysreflexia in individuals with spinal cord injury?
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In individuals with tetraplegia, which of the following muscle groups is most likely to be impaired?
In individuals with tetraplegia, which of the following muscle groups is most likely to be impaired?
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What is a primary goal of rehabilitation for individuals with paraplegia?
What is a primary goal of rehabilitation for individuals with paraplegia?
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Which of the following interventions is likely to be most beneficial for improving bladder function in individuals with spinal cord injury?
Which of the following interventions is likely to be most beneficial for improving bladder function in individuals with spinal cord injury?
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In individuals with tetraplegia, which of the following muscle groups is most likely to be preserved?
In individuals with tetraplegia, which of the following muscle groups is most likely to be preserved?
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Which of the following interventions is likely to be most beneficial for improving respiratory function in individuals with high-level spinal cord injury?
Which of the following interventions is likely to be most beneficial for improving respiratory function in individuals with high-level spinal cord injury?
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In individuals with arthritis, which of the following is the primary reason for avoiding joint manipulation during stretching?
In individuals with arthritis, which of the following is the primary reason for avoiding joint manipulation during stretching?
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Wedged shoe insoles are often prescribed for which condition, and what is their primary purpose?
Wedged shoe insoles are often prescribed for which condition, and what is their primary purpose?
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Which of the following is NOT a potential benefit of aquatic exercise for individuals with various forms of arthritis?
Which of the following is NOT a potential benefit of aquatic exercise for individuals with various forms of arthritis?
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According to the information provided, which of the following is a potential drawback of aquatic exercise for individuals with rheumatoid arthritis?
According to the information provided, which of the following is a potential drawback of aquatic exercise for individuals with rheumatoid arthritis?
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Which of the following statements is TRUE regarding fibromyalgia?
Which of the following statements is TRUE regarding fibromyalgia?
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Which of the following considerations should be taken into account when designing an exercise program for an individual with fibromyalgia?
Which of the following considerations should be taken into account when designing an exercise program for an individual with fibromyalgia?
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Study Notes
Benefits of Supervised Exercise Program
- Increases physical activity tolerance, pain tolerance, range of motion, physical fitness, and strength
- Improves health-related quality of life (QOL) and functional capacity
- Enhances overall physical activity participation levels
Therapeutic Benefits of Unloaded Exercise
- Effective for improving pain and function in people with non-specific chronic LBP
- Strong evidence supports the use of unloaded movement facilitation exercise
Primary Care Management Objectives
- Obtain similar improvements in physical activity tolerance, physical function, and health-related QOL as persons without NSLBP
Spinal Cord Injury (SCI)
- Tetraplegia: injury to the spinal cord that results in impaired arm, trunk, and leg function
- Paraplegia: injury resulting in impaired function of the trunk and legs
- Autonomic dysreflexia (AD): affects individuals with SCI above the splanchnic sympathetic outflow (i.e., T6 or above), causing abnormal reactions to CNS stimulation and disrupting homeostasis
- Comorbidities: obesity, diabetes, cardiovascular disease, respiratory disease, depression, and pain management
- Symptoms: abnormal reactions to CNS stimulation, disrupted homeostasis, and impaired function
Medical Clearance and Exercise
- Thermoregulation, balance, and coordination, and hypertensive responses need to be considered
- Empty urine bag (bladder) prior to exercise to prevent incontinence
- Absolute contraindications: autonomic dysreflexia from recent fracture, may not be absolute anymore
- Relative contraindications: acute tendinitis in the shoulder, risk of pressure sores
Medication and Physical Exam
- Monitor shoulder pain and dizziness, occasional PVCs are normal but should be monitored
- Deconditioned patient may need O2 during exercise
Functional Electrical Stimulation (FES)
- Uses electrical current to cause muscle contraction
- Restores function in upper extremity, lower extremity, and truncal muscles paralyzed by upper motor neuron lesions
- Also used to restore bladder and respiratory function and prevent pressure ulcers
Exercise Heart Rate Response in SCI
- Peak exercise heart rate response varies by location of the injury
- Autonomic dysreflexia can cause a sudden and severe rise in blood pressure
Contraindications for Exercise in SCI
- Acute phases of injury should not involve heavy lifting on the inflamed joint
- Joint manipulation can cause further injury and increase risk for contractures
Aquatic Exercise in Arthritis
- Reduces pain, specifically on knee joints
- Increases blood circulation due to blood vessels dilating
- Drawbacks: tolerance to chemicals (chlorine), affects people with rheumatoid arthritis
Fibromyalgia Chronic Pain Syndrome
- Not a form of arthritis, but a chronic pain syndrome
- Affects about 5 million adult Americans, women more than men (7:1)
- Characterized by widespread pain in combination with tenderness at 19 specific tender point sites
- May also have problems with thinking/remembering, poor sleep quality/insomnia, depression, fatigue, and lower than normal pain threshold
- Benefits from aerobic exercise, which can improve aerobic capacity and physical function
- Minimizing pain with strength training includes limiting eccentric exercise, performing upper and lower extremity training on alternate days, and resting between reps.
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Description
Test your knowledge on autonomic dysreflexia (AD) symptoms, which include a sudden and severe rise in blood pressure due to a noxious afferent stimulus below the level of the spinal cord lesion. Understand the risks associated with AD and how it affects individuals, especially those with spinal cord injuries.
