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Questions and Answers
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?
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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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?
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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.
