Exercise in Impaired Neuromuscular Systems Flashcards
Aerobic Fitness in Stroke
40% worse than sedentary peers
VO2 peak averages 15-18 ml/kg/min - out of breath walking to fridge
CVD and CVA - primary mortality causes
Stroke Considerations
Hemiparesis Atrophy Dyscoordination Balance impairments Visual perception/cognitive impairments *Fall Risk
Stroke Considerations
Hemodynamic abnormalities Fatigue Depression Pain Increase energy expenditure
Aerobic Stroke Goals
Improve or maintain CV function and functional ability
Reduce CV risk
Resistance Stroke Goals
Improve or maintain functional capacity
Reduce falls
Flexibility Stroke Goals
Improve or maintain ROM/prevent contracture
Aerobic Stroke Training
20-60 min
3-5x/wk
Low to moderate (40-70% peak VO2)
Strength Stroke Training
2-3x/wk
Low to moderate (3 x 8-10 reps)
Emphasize functional and core strength
Parkinson’s
Progressive loss of dopaminergic cells in substantial nigra
Onset @ 50-60 years
Affects 2% over 65
Parkinson’s Characteristics
Rigidity Resting tremor Bradykinesia Gait/postural disturbances Cognitive/affective disturbances
PD Considerations
Autonomic fluctuation
Impaired thermoregulation/sweating
Want to exercise at similar time every day
Orthostatic hypotension
PD Aerobic Goals
Be able to continue walking
Improve or maintain cardiovascular function and functional ability
PD Resistance Goals
Improve or maintain functional capacity
Reduce risk of falls
PD Flexibility Goals
Improve or maintain ROM/prevent contracture
PD Aerobic Training
Up to 60 min
At least 3x per week
Low to moderate (40-80% peak VO2 or HR)
PD Walking Training
20-30 min per day
4-6x per week
Self-selected pace
PD Resistance Training
At least 3x per week
Low intensity (1 x 8/12)
Exaggerate movements
Emphasis on extensor/core musculature
PD Flexibility Training
Gentle, static stretching
Emphasis on chest expansion
1-3x per week
PD Training Considerations
Increase slowly
RPE can be hard to interpret
Monitor medication changes, sweating and painful dystonia
Multiple Sclerosis
Chronic, demyelination of CNS
Onset @ 20-40 years
MS Considerations
Spasticity Dysfunction of ANS Cardioacceleration Blunted BP response Heat sensitivity
MS Considerations
Agonist/antagonist imbalance
Thermoregulation
Incontinence
Exacerbation/remission
MS Aerobic Goals
Improve or maintain CV function
MS Resistance Goals
Improve or maintain functional capacity
Reduce risk of falls
MS Flexibility Goals
Improve or maintain ROM/prevent contracture
MS Aerobic Training
30 min (fatigue easy)
At least 3x per week
Low to moderate (50-75% VO2) - typically low side
MS Resistance Training
Isotonic
Isokinetic
Perform aerobic and resistance on different days
MS Flexibility Training
Gentle, static stretching
5-7x per week
Prior to exercising
MS Training Considerations
Morning is optimal but don’t overdue
Hydration critical
Motor Neuron Diseases
Affect upper/lower motor neurons
Inherited or sporadic
Progressive
MND Considerations
Weakness
Atrophy
Respiratory Dysfunction
Cognitive disturbances - inappropriate response to situation
MND Considerations
Mild-moderate intensity aerobic and/or resistance training likely beneficial
