Exam Questions PDF - Exercise and Injuries

BONES EXERCISE IN OSTEOPOROSIS - Multi-component program - Endurance, strength and balance - Progressive loads based on the theoretical MR - Include medium-high impact exercises taking into account the individual state of each person - Avoid generic group workouts - If there is a history...

BONES EXERCISE IN OSTEOPOROSIS - Multi-component program - Endurance, strength and balance - Progressive loads based on the theoretical MR - Include medium-high impact exercises taking into account the individual state of each person - Avoid generic group workouts - If there is a history of osteoporotic fracture, start with very low loads, 6 -8 repetitions and a large number of series — strength and muscular fatigue — no recurrence TREATMENT OF BONE CANCER - Surgery that may include amputation of the affected limb - Chemotherapy and radiotherapy to shrink the tumor - Exercise as an adjuvant before, during and after the treatment: - Aerobic and strength training - Functional exercise according to their motivations - Toning of the residual limb to improve healing, strength and the possibility of walking with a prosthesis - Exercise during the chemotherapy period with direct supervision – mixed units: cardio-oncological rehabilitation. WHAT CAN WE DO AGAINST THESE CHANGES? - Exercise programmes related with their objectives - Functional exercises - Strategies to increase adherence - Take into account characteristics of aging - “Walking is not enough” - “Physical or mental disabilities does not equal no solution” - “Education is equal or more important than the exercise that is done” AND AT THOSE AGES IS USEFUL FOR SOMETHING? - Increase in bone mass density and decrease in osteoporosis - Significative outcomes in balance and muscle strength - Decrease in falls — decrease in fractures - Maintenance of skeletal integrity - In case of fractures — better recovery - Exercise — hormonal balance - Increase quality of life - Fewer hospitalizations — higher cost-effectiveness ARTICULAR CARTILAGE EXERCISE TO PREVENT CARTILAGE DAMAGE - Physical exercise helps to lose weight, and improve the function of the muscle and ligaments, thus preventing wear of articular cartilage - Exercise promotes the growth of muscle fiber volume so help to discharge the joint - Physical activity regulates the joint, helping to balance in the chondroblast and chondrocytes function - Individualized evaluation of the etiopathogenetic biomechanical factors - Generate variability in sport gestures to avoid overuse by repetition - Avoid impact gestures with high load until reaching a high level of physical conditioning EXERCISE TRAINING METHODS FOR OSTEOARTHRITIS - JOINT ACTIVITY TRAINING: - Joint mobility → avoid stiffness - Activity mobility → alleviate tissue adhesion, improve blood circulation, accelerate metabolism, eliminate swelling and pain, and regulate chondrogenic function - AEROBIC EXERCISE: - Improve symptoms like swelling and limited mobility - Promote heart and lung function - It is unclear: swimming and cycling to avoid high joint loads; or running whose impacts promote the repair - AQUATIC EXERCISE THERAPY: - Promote blood circulation, relieve tissue adhesion and reduce the pressure on joints - Low water pressure can promote cartilage self-repair → more research is needed - MUSCLE STRENGTH TRAINING: - Multipoint intermittent isometric → muscle strength and function, without pain - Isotonic → not for acute inflammation phase TENDONS AND LIGAMENTS TREATMENT OF TENDINOPATHIES - Therapeutic exercise programmes supervised by physiotherapists: - 14 weeks - 70 sessions (3 weekly sessions of neuromuscular strength training and 2 weekly sessions of aerobic work) - Intensity: 60% - 75% VO2 MAX - Five stages: - Stage 1: isometric contractions to control symptoms and prepare the neuromuscular system for later phases - Stage 2: isotonic and heavy slow resistance exercises, to improve muscle strength and tendon stiffness - Stage 3: strength training through exercises performed with a velocity loss of 20%, to increase muscle hypertrophy - Stage 4: high-load strength training, to obtain maximal strength benefits due to the hypertrophy and the neural adaptations - Stage 5: plyometric training and jumps to improve the energy storage capacity of the tendon. TRAINING IN TENDINOPATHIES PREVENTION: - Progressive resistance training in athletes at risk. Example: jumping athlete - Avoid very explosive gestures in non-usual sport customers (“weekend athletes”) - Include balance training in relation to the specific sport activity - Not cause overuse of the upper limb in load above the horizontal TREATMENT: - Adapt the mechanical stimuli to the phase of the tendinopathy we are in - Include eccentrics but adapting the load → they are beneficial but risky at the same time - Design long-term programmes → slow progression in load and neural adaptations TRAINING AFTER TENDON RUPTURE PREVENTION: - Warm-up period → to increase temperature of tissue and extensibility of the fibers - Previous training with eccentric strengthening → to prepare the tissue for the mechanical stimuli - Ask to the customers if they are under any pharmacological treatment TREATMENT: - Proprioceptive training → to recover the body awareness - Take into account factors that caused the injury to avoid them in the first instance, and make a safe readaptation to the injury mechanism. TRAINING IN SPRAINS PREVENTION: - Analyze the laxity of the ligaments before prescribing exercise → to “play” with the range of motion - Include proprioceptive training → especially in people with background of sprain - Bet on neuromuscular coordination → dual tasks TREATMENT: - Use functional bandage or braces to return to play but do not abuse of these tools - Include exercises for quick changes of direction when the customer has enough strength and motor control - Work on impact exercises progressively TRAINING IN LIGAMENTS RUPTURES PREVENTION: - Include exercises focused on body awareness and motor control at the hip, knee and ankle - Neuromuscular training (quadriceps and hamstrings) on pre-season and during the season TREATMENT: - Bet on exercises focused on restoring technical skills - Progression from controlled slow pro-planned movements to highly chaotic reactive sport-specific movements - Ensure that the patient is psychologically prepared for each new challenge. TREATMENT UN JOINT INSTABILITY - Immediate medical treatment aimed at reducing the dislocation - Immobilization of the joint to ensure healing of the damaged tissues - Therapeutic exercise programme supervised by a physiotherapist: - 12 weeks - 36 sessions (3 weekly sessions) - Intensity: 60% - 85% MR - Progression: strength from isometric to isotonic – hypertrophy – neural adaptation (without velocity loss) – functional readaptation - If the conservative approach doesn’t work or the structural damage is enough → surgical approach: labral-anchored capsulorrhaphy or ligamentoplasty MUSCLES TRAINING IN MUSCLE INJURY PREVENTION - Biarticular muscles → maximum strength exercises cannot be performed on one end of the muscle if the other end is in maximum stretch - Fatigue → we have to know how to “play with the fatigue”, we cannot prescribe the most demanding exercise in a state of maximum muscle fatigue. - Do not make explosive gestures without a warm-up TREATMENT - Recovery is long and training without the supervision of a healthcare professional should not be included until the last phase (maximum safe) - Be careful with the eccentric contractions NERVES TRAINING IN NERVE INJURIES NERVE INTERRUPTION - Work a lot on proprioception - If there is sensitive disorder, working with different textures and adequate the environment to the person - If there is motor disorder, set very simple goals so that the person does not get frustrated NEUROPATHY - Look for the cause (cancer, diabetes…) and focus efforts on adapting the training to improve that cause - Be careful with the sensitivity disorders - To include neuropedagogy of pain and strategies of dual tasks in cases of great pain. HUMAN MOVEMENT WARNING SIGNS OF MOTOR DEVELOPMENT - Persistence of archaic reflexes, or abnormal muscle reflexes - Hypotonia or hypertonia - Tremors, seizures, clonus, hypokinesia - Anomalous postures with asymmetrics; and walking on tiptoes, ataxic of hemiparetic - Language problems - Behavioral disorders: hyperactivity, negativity or irritability - Sleep disorders - Strabismus, nystagmus, or gaze deviation - Several months delay in developmental milestones according the chronological age