Week 2 Async PDF

 Feature Females Males Lower body fat, higher muscle m...

 Feature Females Males Lower body fat, higher muscle mass, Body Composition Higher body fat, lower muscle mass, lower bone mineral density higher bone mineral density Absolute strength is about 2/3 that of men, lower body strength closer to men's than upper Strength Higher absolute strength body strength Lower body strength similar to men's when expressed relative to body weight, differences Relative Strength disappear when expressed relative to fat-free mass No significant difference from men when strength is expressed relative to muscle cross- Muscle Quality sectional area Muscle Fiber Size Smaller muscle fiber cross-sectional area Larger muscle fiber cross-sectional area Power Output Similar to strength, relative power output lower than men's Response to Increase strength at same or faster rate than men, relative increases similar or greater Resistance Training Flexibility Generally more flexible Generally less flexible Factors Affecting Higher levels of estrogen and relaxin, wider pelvis, different muscle attachment sites, greater Higher muscle mass and stiffness Flexibility joint laxity Activities Affecting More likely to participate in activities like dance and gymnastics Flexibility Key Points: While absolute strength and power output are generally lower in females, relative strength and power output are similar to or greater than males when accounting for differences in body composition. Muscle quality is not sex-specific. Females can increase strength at the same or faster rate than males in response to resistance training. Females tend to be more flexible than males due to a variety of hormonal, anatomical, and activity-related factors. Feature How Exercise Affects Older Adults Activity should be defined relative to an individual's fitness using a perceived 10-point exertion scale. Moderate intensity is 5 or 6, and vigorous Intensity intensity is 7 or greater. This differs from younger adults. Fall Risk Resistance training alone does not prevent falls. Balance and flexibility training, along with resistance training, are necessary. Resistance training has a positive effect on bone health. It can offset age-related decline in bone health, maintain or increase bone mineral Bone Health density, and reduce the risk of fractures. Strength and Older adults can significantly improve strength and function with resistance training. This includes gains in gait speed, stair climbing ability, Function balance, and overall activity. Power Resistance training focused on power development can optimize functional abilities in older adults. High-velocity power training may be more Development effective than traditional resistance training. Muscle Resistance training can produce muscle hypertrophy in older adults. Hypertrophy Protein Resistance training has anabolic effects, improving nitrogen retention and protein metabolism. Metabolism Energy Resistance training increases resting metabolic rate. Balance Training Consider pre-existing medical conditions, training history, and nutrition. Older adults should gradually progress from low to higher training Considerations volumes and intensities. Adequate rest periods are essential. Prioritize proper technique over intensity. Adequate protein intake is crucial for muscle hypertrophy. Sufficient intake of macronutrients and micronutrients is important for overall health Nutrition and recovery. Key Points: Individualized Approach: Exercise programs for older adults should be tailored to their individual fitness levels, health conditions, and goals. Multimodal Training: Combine resistance training with balance and flexibility exercises to address multiple aspects of fitness and reduce fall risk. Gradual Progression: Start with lower intensity and volume, gradually increasing as tolerated and as fitness improves. Proper Nutrition: Ensure adequate protein intake to support muscle growth and overall health.  Here's a table summarizing the key differences in youth when they exercise, based on the information from the source: Feature How Exercise Affects Youth Maturity Level Youth are physically less mature than adults, with variations in growth and development rates. Anaerobic Significantly lower than adults, limiting their ability to perform sustained vigorous-intensity exercise. Capacity Immature skeletons, particularly in prepubescent children. Growth cartilage is vulnerable to trauma and overuse, especially during peak Skeletal Maturity height velocity. Strength Boys and girls have equal strength before puberty. Hormonal changes during puberty accelerate strength gains in boys and cause a plateau in Development girls. Peak strength is attained around age 20 in untrained women and between ages 20-30 in untrained men. Nervous System Myelination of nerve fibers is incomplete until sexual maturation, affecting motor skill development and strength/power expression. Development Immature thermoregulatory systems make youth more susceptible to heat stress. They should avoid sustained heavy exercise in hot/humid Thermoregulation environments. Resistance Safe and effective when properly supervised and progressed. Can increase strength above and beyond normal growth and maturation. Training Training Strength gains in pre-adolescents are primarily due to neural factors. Muscle hypertrophy occurs during and after puberty due to hormonal Adaptations influences. Program Design Focus on proper form and technique, gradual progression of loads (5-10% increases), and age-appropriate exercises. Training Volume Start with low to moderate intensities and gradually progress. Avoid excessive amounts of vigorous-intensity exercise, particularly in and Intensity prepubescent children. Recovery Ensure adequate rest and recovery between training sessions. Key Points: Individualized Approach: Exercise programs for youth should be individualized considering biological age, maturity level, training experience, and goals. Safety and Proper Technique: Prioritize proper exercise technique and gradual progression of loads to minimize the risk of injury to growth cartilage. Age-Appropriateness: Select activities and exercises that are developmentally appropriate, enjoyable, and engaging. Incorporate unstructured active play for younger children. Supervised Training: Resistance training should be supervised by qualified professionals who can provide proper instruction and monitor progress. Balanced Development: Encourage participation in various activities to promote overall physical literacy and well-rounded development. Here is a table summarizing the neuromuscular, endocrine, and cardiovascular responses to aerobic and anaerobic exercise: System Response to Aerobic Exercise Response to Anaerobic Exercise Increased motor unit recruitment (especially Type I fibers) Enhanced Increased motor unit recruitment (especially Type II fibers) synchronization of motor units Improved firing rates of motor neurons Enhanced synchronization of motor units Improved firing rates of Increased efficiency of neuromuscular junctions Reduced co-contraction motor neurons Increased efficiency of neuromuscular junctions Neuromuscular of antagonist muscles Increased activation of agonist muscles Reduced co-contraction of antagonist muscles Increased activation Improved intermuscular coordination Enhanced reflex responses of agonist muscles Improved intermuscular coordination Adaptations in the central nervous system, such as increased cortical Adaptations in the central nervous system, such as increased cortical activity and changes in the spinal cord activity and changes in the spinal cord Increased secretion of hormones such as testosterone, insulin-like growth factors, and growth hormone, particularly at maximal exercise Chronic changes in resting hormone concentrations are unlikely Endocrine intensity Reduced hormonal responses to submaximal exercise in Resting hormone concentrations likely reflect the current state of trained athletes Increased net protein breakdown during exercise, but net muscle tissue and nutritional factors protein synthesis may occur in trained athletes Acute Responses: Increased cardiac output, stroke volume, heart rate, Acute Responses: Increased cardiac output, stroke volume, heart oxygen uptake, systolic blood pressure, and blood flow to active muscles rate, oxygen uptake, systolic blood pressure, and blood flow to active Diastolic blood pressure remains stable or slightly decreases Increased muscles Increased ventilation rate Chronic Adaptations: Cardiovascular ventilation rate Chronic Adaptations: Increased maximal cardiac Reduced cardiovascular response to an acute bout of resistance output Increased stroke volume Reduced heart rate at rest and during exercise Ventilatory response is either unaffected or only submaximal exercise Increased muscle fiber capillary density moderately improved Key Points: Both aerobic and anaerobic exercise elicit significant neuromuscular, endocrine, and cardiovascular responses. Aerobic exercise primarily targets the cardiovascular and respiratory systems, leading to adaptations that improve oxygen delivery and utilization. Anaerobic exercise primarily targets the neuromuscular system, resulting in adaptations that increase strength, power, and muscle mass. Hormonal responses to exercise play a key role in regulating metabolism, promoting tissue growth and repair, and supporting the body's adaptations to training. The specific adaptations to exercise depend on the type, intensity, and duration of training, as well as individual factors such as genetics and training experience. Here is a table summarizing the different pain theories discussed in the source: Pain Theory Key Concepts Limitations Cannot explain phantom limb pain, persistence of pain after lesioning Specificity Separate nerve endings for each sensation (cold, touch, warmth, pain) central pain pathways, allodynia (touch eliciting pain), and continued Theory Pain receptors, when stimulated, always produce pain and only pain pain after removal of noxious stimuli. Specialized nerve endings (nociceptors) are modulated in the spinal Oversimplification. Several tenets have not held up: Nociceptors cord’s dorsal horn. Large-diameter afferents (non-painful) and small- are not tonically active but fire in response to noxious stimuli. Gate diameter afferents (nociceptors) are gated in the spinal cord. Substantia Nociceptors are excitatory, not inhibitory, to the SG cell. SG neurons Control Gelatinosa (SG) in dorsal horn inhibits T cells, which initiate pain exist that respond only to noxious stimuli (no input from large- Theory responses (motor, sensory, autonomic). Increasing large-diameter fiber diameter fibers). Relied heavily on presynaptic inhibition (evidence input closes the gate, reducing pain. Supraspinal sites can further for postsynaptic inhibition exists). Central nervous system both modulate the system. facilitates and inhibits pain at the spinal cord. Evolved from the Gate Control Theory. Proposes a widespread network of neurons integrating the thalamus, cortex, and limbic system (“body-self neuromatrix”). This network is genetically determined and shaped by Neuromatrix external inputs. Produces a characteristic output (“neurosignature”) No specific limitations were identified in the source. Theory projected to brain areas for pain awareness and motor output. Neurosignature is modulated by sensory inputs and cognitive events, resulting in an individualized response to stimuli. Key Points: Early pain theories, like the Specificity Theory, were limited in their ability to explain the complexity of pain. The Gate Control Theory introduced the concept of modulation and gating mechanisms in the spinal cord, influencing pain perception. While some aspects haven't held up to scientific scrutiny, it laid the groundwork for understanding central pain processing. The Neuromatrix Theory expands on the Gate Control Theory, proposing a complex network of brain regions involved in pain perception, highlighting the role of individual experiences and the dynamic nature of pain processing. The sources describe three main types of pain: nociceptive pain, nocioplastic pain, and neuropathic pain. Nociceptive Pain: Occurs due to the activation of nociceptors, which are specialized sensory receptors that detect potentially harmful stimuli, such as heat, cold, pressure, or chemical irritants. Usually described as sharp, aching, or throbbing. Typically well-localized meaning the pain is felt directly at the site of injury or tissue damage. Serves a protective function, signaling potential or actual tissue damage and prompting a response to avoid further harm. Example: An ankle sprain, where nociceptors in the ligaments are activated by the stretching or tearing of tissue. Nocioplastic Pain: Characterized by disturbances in central pain processing, often involving central sensitization. Central sensitization refers to an increased responsiveness of the central nervous system to pain signals, leading to an amplified pain experience. May be experienced as more widespread and diffuse compared to nociceptive pain. Often chronic in nature and can persist even in the absence of ongoing tissue damage. Example: Fibromyalgia, a condition associated with widespread musculoskeletal pain, fatigue, and other symptoms. Neuropathic Pain: Results from a lesion or disease affecting the somatosensory system. Can be caused by direct nerve injury (e.g., carpal tunnel syndrome) or systemic diseases that affect nerve function (e.g., diabetes). Often described as burning, tingling, shooting, or electric shock-like. May be experienced as pain in areas where there is no actual tissue damage (e.g., phantom limb pain). Example: Diabetic neuropathy, a condition where high blood sugar levels damage nerves, leading to pain, numbness, and tingling in the hands and feet. It's important to note that these pain types are not always mutually exclusive. Some individuals may experience a combination of nociceptive, nocioplastic, and/or neuropathic pain. Understanding the different mechanisms underlying pain is crucial for effective pain management. Here's a table comparing developmental stages between boys and girls, based on the information provided in the sources: Developmental Boys Girls Feature Typically begins between 9 and 15 years of Puberty Onset Typically begins between 8 and 13 years of age. age. Puberty Timing Starts about 2 years later than girls. Starts about 2 years earlier than boys. Markers of Sexual Appearance of pubic hair, facial hair, Onset of menstruation. Maturity deepening of the voice. Peak Height Around age 14. Around age 12. Velocity Muscle Mass Marked increase in muscle mass and shoulder Increased body fat deposition, breast development, and hip widening due to Changes During widening due to increased testosterone increased estrogen production. Muscle mass increases at a slower rate than in Puberty production. boys. Peak Muscle Mass Between 18 and 25 years of age. Between 16 and 20 years of age. Achieve full bone maturity about 2 to 3 years Bone Maturity Achieve full bone maturity about 2 to 3 years earlier than boys. later than girls. Strength Experience accelerated strength gains during Strength development plateaus during adolescence due to hormonal Development puberty due to hormonal influences. differences. Peak Strength Between 20 and 30 years of age. Around 20 years of age. (Untrained) Key Points: Hormonal Differences: The distinct hormonal profiles of boys and girls (testosterone vs. estrogen) drive significant differences in muscle mass development, skeletal growth, and strength gains during puberty. Timing of Maturity: Girls generally mature physically earlier than boys, with puberty onset, peak height velocity, and bone maturity occurring at younger ages. Individual Variability: It's essential to recognize that there is considerable individual variability in growth and development patterns within each sex. Chronological age may not accurately reflect biological maturity. Okay, here is the completed "TI Handout to Collect Ideas" worksheet, drawing on information from the sources and our conversation history: Therapeutic Interventions: Adaptations to Training Acute Adaptations to Aerobic Body System Adaptations to Anaerobic Training Chronic Adaptations to Aerobic Training Training Cardiac output ↑, Stroke volume ↑, Cardiac output ↑, Stroke volume ↑, Heart rate ↑, Heart rate ↑, Oxygen uptake ↑, Cardiac output ↑, Stroke volume ↑, Heart Cardiovascular Oxygen uptake ↑, Systolic blood pressure ↑, Blood Systolic blood pressure ↑, Diastolic rate ↓ at rest and submax exercise, Oxygen System flow to active muscles ↑ blood pressure at resting level or slight uptake ↑, Muscle fiber capillary density ↑, ↓, Blood flow to active muscles ↑ Tidal volume ↑, Ventilation rate ↑ with Ventilation rate ↑, Increased minute max exercise, ↓with submax exercise, Respiratory Ventilation rate None to slight ↑, Tidal volume and ventilation due to increased depth and/ breathing frequency is often reduced while System breathing frequencyincrease with maximal exercise. or frequency of breathing. tidal volume is increased during submaximal activity. Muscular strength ↑, Muscular endurance ↑ for high Muscular strength No change, Muscular Muscular endurance ↑ for low power power output, Stored ATP ↑, Stored creatine endurance ↑ for low power output, Muscular output, Stored creatine phosphate ↑, phosphate ↑, Stored glycogen ↑, Stored triglycerides Selective hypertrophy of Type I muscle System Stored glycogen ↑, Stored May ↑, Positive shift in muscle fiber types, Increased fibers, Increased mitochondria size and triglycerides ↑ muscle fiber size, Increased pennation angle number, increased myoglobin content. Endocrine System Adaptations to Exercise Hormone Function of Hormone Adaptation to Exercise compara Insulin Blood glucose control Increased sensitivity and reduced levels. Glucagon Blood glucose control Increased levels. Epinephrine & Increased secretion during exercise, improved regulation, concentrations increase Fight or flight response and alertness Norepinephrine with short high intensity exercise Integrity of muscles, bones, and connective tissues, Growth Hormone Increased secretion during exercise, although resting concentrations may not change. maintaining metabolism Increased secretion during exercise, improved regulation. Net protein breakdown Cortisol Stress hormone from muscle may occur with aerobic training. Integrity of muscles, bones, and connective tissues, Increased levels in response to resistance training, although resting concentrations Testosterone maintaining metabolism may not change. Thyroid Hormones Regulation of metabolism, energy production Enhanced regulation, potential slight increases Endorphins Pain relief, feelings of well-being Increased levels in response to high-intensity exercise Pain Assessments and Brief Pros/Cons Pain Description Pros Cons Assessment Numeric Pain Simple, quick, easily recorded, good for Only measures pain intensity, may not Patient rates pain on a scale from 0 (no pain) to 10 Rating Scale sequential evaluations, excellent inter-rater reflect the full pain experience. Requires (worst pain) (NPRS) reliability cognitive ability to self-report. Simple way to gain graphical representation of Does not capture pain intensity or quality, Body Patient draws the location of their pain on a body pain location, can help determine if pain is relies on patient's ability to accurately depict Diagrams diagram localized or widespread. pain location. Assesses sensory, affective, and evaluative Multidimensional assessment of pain, uses McGill Pain Longer to administer, may be too much for components of pain using pain descriptors, a body standard pain-related words, can help identify Questionnaire some situations. diagram, and pain intensity ratings specific pain characteristics. Assesses pain severity and how pain interferes with Assesses the functional impact of pain, May not be as comprehensive as other pain Brief Pain daily life using visual analog scales and numeric measures pain interference with different questionnaires like the McGill Pain Inventory scales. activities. Questionnaire. Detects neuropathic pain components through a Detects neuropathic pain, does not require Limited to neuropathic pain, may not be painDETECT self-administered questionnaire. physical eval, can be used by non-specialists. appropriate for all pain conditions. AROM, AAROM, and PROM Type of Description Indications Contraindications ROM Movement of a segment within the Acute, inflamed tissue, patient not able to actively move, post- Motion is disruptive to the healing Passive unrestricted ROM produced entirely by surgical repair when active motion is contraindicated, to maintain process, patient response or condition is ROM an external force; little to no voluntary joint and connective tissue mobility, assist circulation, enhance life-threatening, patient is conscious and (PROM) muscle contraction. synovial movement, inhibit pain, healing process. able to resist or assist the motion. Movement of a segment within the When able to contract muscles and move a segment with or When motion is disruptive to the healing Active unrestricted ROM produced by active without assistance, weak musculature and unable to move a joint process, patient response or condition is ROM contraction of the muscles crossing that through the desired range, to relieve stress from sustained life-threatening, not for strong muscles (AROM) joint. postures, for aerobic conditioning. to increase strength. Active- A type of AROM in which assistance is Weak muscles, unable to move through desired range, assistance When motion is disruptive to the healing Assistive provided manually or mechanically to needed to complete motion , a transition between PROM and process, patient response or condition is ROM help complete the motion when prime AROM. life-threatening. (AAROM) mover muscles need assistance. Age-Related Differences and Implications for Exercise—Youth Christina Wisdom, PT, DPT, EdD Board Certified Specialist in Orthopaedic Physical Therapy Certified Lymphedema Specialist Objectives 1. Summarize variations in physiologic response to exercise based on various factors, such as age. 2. Describe considerations for youth when planning resistance training programs. Youth Exercise Training: Potential Benefits 1. Increased a. Muscular strength b. Cardiometabolic risk factors c. Weight control d. Bone strength e. Psychological well-being 3. May help prevent sports-related injuries 4. Positively associated with a. Cognition b. Academic achievement Youth Resistance Training: Potential Benefits 1. Increased a. Muscular strength, power, and endurance b. Psychosocial parameters c. Motor skills and sport performance d. Insulin sensitivity and cardiac function e. Bone mineral density 2. Decreased a. Body fat b. Injury Tres to - pre-seasons injey  VARIABLE RESPONSE Absolute oxygen uptake Lower Relative oxygen uptake Higher Heart rate Higher Physiologic Responses Cardiac output Lower to Acute Exercise in Youth Stroke volume Lower Compared to Adults Systolic blood pressure Lower 1. Similar to adults qualitative) Diastolic blood pressure Lower · bodymass muchness Respiratory rate Higher Quantitative differences Tidal volume Lower 2. neisht · - Minute ventilation Lower should Not participate ligh intensity · Respiratory exchange ratio Lower in excessive due to Skeleton innaturity Anaerobic capacity Lower  Dippi Chronological Age vs Biological Age Height 1. Substantial interindividual differences in physical development at any given chronological age Onset of Puboly 2. Biological age: can be measured in terms of skeletal age, somatic (physique) maturity, or sexual maturation Ye 3. Degree of maturation is related to measures of fitness, including muscular strength and motor skill performance 4. No scientific evidence that physical training delays or accelerates growth or maturation in youth  >2 Cuntrained) - 20 % Peaksteg Birth mess 209 Muscle and Bone Growth Adultsuol 20-30 Peak mus de mass 16-209 18 25 - of BonsPormation indiapligles Fullbore valuy aeoe of  Special Considerations in Youth Physical activity in young children should include unstructured active play Youth should avoid sustained, heavy exercise in exceptionally hot humid environments Gorinates - Youth Resistance Training 1. Resistance exercise can be a safe and effective method of conditioning 2. Can increase muscular strength above and beyond that accompanying growth and maturation alone, if the intensity and volume of training are adequate 3. Variability in strength gain normal 4. Potential for an increase in strength owing to neural factors, such as increases in motor unit activation and synchronization, enhanced motor unit recruitment and firing frequency 5. Multiple-modality approach is recommended Developmental Factors Related to Potential for Muscle Strength Adaptations Youth Resistance Training Guidelines 1. Low to moderate intensities for 6–15 repetitions, 1–4 sets per exercise a. 1–3 sets of 3–6 repetitions for upper and lower body power exercises 2. 2–3 nonconsecutive days per week 3. Gradual increase to higher intensities or loads (by 5%–10%) as technique improves 4. Single- and multi-joint exercises including weightlifting derivatives 5. Multiple-modality approach is recommended, with free weights, machines, and associated equipment Resistance Training: Risks and Concerns Relatively safe when compared with other sports and activities in which children and adolescents regularly participate IRM :S Supe ! Resistance Training Program Design: Considerations for Youth Primary focus must be on developing proper form, technique Correct feedback, delivered at the correct time and in the correct manner Regular evaluation of technical performance by a trained observer Rate of progression References 1. Liguori G, senior editor. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription, 11th ed. Lippincott Williams & Wilkins; 2022. 2. Haff GG, Triplett NT, editors. Essentials of Strength Training and Conditioning, 4th ed. Human Kinetics; 2016. 3. Adobe Stock. Images. © All rights reserved. Age-Related Differences and Implications for Exercise—Older Adults Christina Wisdom, PT, DPT, EdD Board Certified Specialist in Orthopaedic Physical Therapy Certified Lymphedema Specialist Objectives 1. Summarize variations in physiologic response to exercise based on various factors, such as age. 2. Describe considerations for older adults when planning resistance training programs.  · after 30 ↓ cross sectivel nuch Older Adults and Exercise mont then of 1. Physiologic aging does not occur uniformly across the population a. Individuals of similar chronological age may differ in their response to exercise 2. Health and functional status are often better indicators · loss of bone of ability to engage in PA than chronological age integrity/fragility · bonemin content deteriorate wist , spire  for mods3-S Are. younger T less] Gret Older Adults and Exercise Prescription 1. General principles of exercise prescription apply 2. A distinction should be made relative to intensity a. For older adults, activities should be defined relative to an individual’s physical fitness within the context of a perceived physical exertion scale b. Moderate intensity St older- rods % vigorous Physiology: Aging and Impact of Resistance Training Effect of Physical or Physiological Variable Effect of Aging Resistance Training Muscular strength ↓ ↑ Muscular power ↓ ↑ Muscular endurance ↓ ↑ Muscle mass ↓ ↑ Muscle fiber size ↓ ↑ Muscular metabolic capacity ↓ ↑ Resting metabolic rate ↓ ↑ Body fat ↑ ↓ * Bone mineral density ↓ ↑ Physical function ↓ ↑ Resistance Training for Older Adults Optimal training protocol for improving muscular strength and power in seniors is not known 1. Dose–response relationship between training intensity and improvements in muscular strength and power a. Higher-intensity resistance training being more effective in developing maximal muscle strength than moderate- or low-intensity training  · pre-existing · netrition Program Considerations for Older Adults 1. As able, should use free weight, multi-joint resistance training exercises a. Resistance machines may be used in early stages due to balance and flexibility limitations · should no p rewets when appropriate 2. Avoid performing the Valsalva maneuver during resistance training to avoid an abnormal increase in BP 3. Should be allowed 48—72 hours of recovery between exercise sessions Program Considerations for Older Adults 1. Gradually progress from 1 set of 8 to 12 repetitions at relatively low intensity; e.g., 40%–50% 1RM, to higher training volumes and intensities; e.g., 3 sets per exercise with 60%–80% of 1RM 2. High-velocity power exercises can be gradually incorporated 3. 1-3 sets per exercise with a light to moderate load; 40%–60% 1RM, for 6 to 10 repetitions with high repetition velocity References 1. Liguori G, senior editor. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription, 11th ed. Lippincott Williams and Wilkins; 2022. 2. Haff GG, Triplett NT, editors. Essentials of Strength Training and Conditioning, 4th ed. Human Kinetics; 2016. 3. Adobe Stock. Images. © All rights reserved. © All rights reserved. A ir2 stegth · of (absolut strength) - power · Relative Stenh · strengt exprelative tonucle cross-sectional area - ecc. sinitar when comp to, cone. · : Upperbody strength concern (knee) · prevention of sports maries ↑ Flexible · estrogen relaxin joint Plexibility ↓ esp-during pregnates · Hip mobility (pregnancy ) Endocrine Response Adaptationto Stress -Alarm Resistace Exhaistion  Aerobre ex ↑ hormonal circulation + changes at receptor les · Unilater trazing-Streyth incentrained line > - cross education Poin seeks medical attention # leason a person · 10 % nud pan · 11 % Servere pain Dincusions of peon descriptiv sensory · · sensation , location , quality Mutivabund effective How much it bothers the patient ·  · Cognitive Evaluatio · probut outcome pt beliefs.. chrome 3-6 postinury · - pan no. - butvaries  · Hyperalyze =↑ sens Hypoalgess sysens Allodyne : partion non-nocicepte source · · Referred Pain outside of pan may ·  Pan Mechauns NociceptinA · Nuciplastic Central pain · · Neurupathr · Fibromyalgi · diabetes Psychosoc · specicityTheor sep - No needings for each sensation Gate Control Theoy specialized neverendings · nociceptors gated · Soi sinhibitory ↳ 156 , Jess pan Neuronati theory Input Output · Pan Assessment Questionnais · McWill Dan Questonwere dimensions (sensing evaluative , , discrivative of words · Groups Briep Pan Inventory · functional · 0-10  PanDGTGICT ncurpathe pan · · Outuf 35 · - 1 = 35 = la neuropathic = sep-eficacy scale · ROM