Neuromuscular Disease Learning Objectives (L30) Flashcards
What are the two roles for exercise in NM disorders
- To assess/monitor function
- As intervention/therapy
In individuals with NM disease, what qualities should exercise programs target?
Strength, endurance, balance, speed, coordination, agility, CR Fitness/CV Fitness
What is an appropriate type of exercise for people with NM disorders if you are concerned with falls?
Cycling (less concern with balance and falls)
What is an appropriate type of exercise for people with NM disorders if you want to asses function.
Walking tests
Should exercise be target to affected areas or non-affected areas in individuals with NM dysfunction?
Both
Why is aerobic exercise more difficult in people with MS? What are some consequences of exercise?
MS damages the myelin sheath that covers nerve fibres, this can cause:
- Motor dysfunction and coordination issues
- Fatigue that doesn’t improve with rest (Post-exercise fatigue can be overwhelming)
- Abnormalities in CV system including BP
- Heat sensitivity
What do we aim to improve in individuals with MS when subjecting them to an exercise regieme?
– strength
– capacity to perform ADLs
– mobility
- (regular exercise may reduce post-PA fatigue)
Why might people with MS greatly suffer from the effects of hot environments during exercise
- Higher sensitivity to heat
- (bonus answer) Bladder dysfunction may discourage MS sufferers from appropriate hydration for exercise, dehydration might impact thermoregulation (via decreased blood volume & increases in core temperature, further exacerbating sensitivity to heat)
For individuals with MS, what is generally a consequence of the pathology that limits the scope of activity that might be recommended?
Sensory deficits and coordination problems may limit scope of activities
What is the biggest exercise safety consideration for individuals with MS that might otherwise not affect a healthy individual? What do we need to do pre-exercise?
Balance may be impaired and influences safety of exercise. Balance should be assessed pre-exercise (e.g., Berg’s balance scale)
Stroke is an example of a) a progressive NM disorder, or b) a non-progressive NM disorder?
B
Name two type of aerobic tests we can do to assess fitness post-stroke
Walking tests
- Speed: 10m fastest walk and usual walk
- Endurance: 6 Minute Walk Test (30m)
Progressive Exercise Tests
- Cycle ergometer testing preferred
– Ramp / 10W incremental protocol
- Treadmill tests
– Most well recovered or safety harness available
- Shuttle walk test
– Analogous to a Beep test
– 10m walkway means much turning
Name a test we can perform to assess limb performance post-stroke
Unilateral strength testing
– Assess and compare limb performances
– Shown to be reliable after stroke
– Spasticity can compromise hemiparetic side
Name a observational test we can perform to assess CVD post-stroke
Body composition
– Waist circumference important indicator
What contributes to further deconditioning of stroke patients?
Fear (of falls and of another stroke)
Insufficient mobility
Fatigue
Inability to ambulate in community
Lack of information about physical activity post-stroke
These factors lead to an increase in SA/sedentary lifestyle which intern increase disability and increase risk of recurrent stroke.
