Physical Impairments and Contraindications

Question 1

What is a contraindication?

Answer 1

A contraindication is a condition, symptom, or factor that serves as a reason to withhold treatment, a procedure, or physical activity due to the harm that it may cause.

Question 2

What are the two types of contraindications?

Answer 2

relative and absolute

Question 2

What are some things to consider when pre-screening individuals for physical activity?

Answer 2

level of impairment, secondary conditions, medications, environment, cognitive impairment, and contraindications.

Question 3

What are some common contraindications to exercise?

Answer 3

contractures, autonomic dysreflexia, shunts, seizures, pressure sores, and blood clots.

Question 4

What are contractures?

Answer 4

Contractures are the permanent tightening of a muscle, tendon, or ligament that significantly reduces range of motion.

Question 5

What should be avoided when working with someone who has contractures?

Answer 5

avoid motions that require full range of motion of the affected joint, heavy resistance training, and pressure on the affected joint(s).

Question 6

What is autonomic dysreflexia?

Answer 6

Autonomic dysreflexia is a condition unique to spinal cord injuries (SCI). Symptoms include shock-like sensations, increased blood pressure, and decreased heart rate.

Question 7

What should be avoided when working with someone with autonomic dysreflexia?

Answer 7

Avoid exercising in an uncomfortable position, putting pressure on a catheter or collection bag, and tightly strapping limbs to equipment.

Question 8

What is a shunt, and what should be avoided when working with someone who has one?

Answer 8

A shunt is a device used to drain excess cerebrospinal fluid from the brain. Individuals with shunts should avoid high-impact sports, heavy activity near the shunt, and activity with the head below the body.

Question 9

What are some things to consider when working with someone who has seizures?

Answer 9

When working with someone who has seizures, it’s essential to have a safety protocol, select equipment carefully, and avoid temperature fluctuations, light shows, and exercises with a high risk of falling

Question 10

What are pressure sores, and how can they affect exercise?

Answer 10

Pressure sores are common on the tailbone, shoulder blades, and back of arms/legs. While exercise is important to increase blood flow, avoid any activity that puts pressure on the affected area.

Question 11

What is a spinal cord injury (SCI)?

Answer 11

damage to the spinal cord that temporarily or permanently changes its function. It can be traumatic or non-traumatic, complete or incomplete.

Question 12

Define the following terms: Tetraplegia, Paraplegia, and Hemiplegia.

Answer 12

• Tetraplegia: A cervical lesion affecting sensory and motor function in all limbs, trunk, bladder, bowel, and sex organs, with potential respiratory dysfunction.
• Paraplegia: A thoracic or lumbar lesion affecting sensory and motor function in the trunk, lower limbs, bladder, bowel, and sex organs.
• Hemiplegia: A lesion affecting one side of the spinal cord.

Question 13

What are some common secondary health considerations associated with SCI?

Answer 13

Some common secondary health considerations include psychological impacts, pressure sores, skin bruising, bladder infections, muscle spasms, bowel concerns, obesity, and fatigue.

Question 14

What are the different types of stroke?

Answer 14

○ Ischemic: Caused by a blood clot impeding blood flow to the brain, including thrombotic (clot in the brain) and embolic (clot travels to the brain).
○ Hemorrhagic: Caused by uncontrolled bleeding in the brain.
○ Transient Ischemic Attack (TIA): A “mini-stroke” with a short-term lack of blood supply to the brain.

Question 15

What are amputations?

Answer 15

Amputations are the loss of an entire limb or limb segment, which can be congenital or acquired, with below-knee amputation being the most common.

Question 16

What are some considerations for physical activity with amputations?

Answer 16

Individuals with leg amputations may have lower aerobic functioning. Swimming, cycling, rowing, or wheelchair sports are recommended. Training all possible muscles, including those around the amputation, is important.

Question 17

What is Cerebral Palsy (CP)?

Answer 17

CP is a chronic neurological disorder of movement and posture caused by a brain lesion in early development, accompanied by associated dysfunctions.

Question 18

What are some common symptoms associated with CP?

Answer 18

cognitive impairment, epilepsy, changes in sensation, speech impairment, visual impairment, hearing impairment, feeding/swallowing difficulties, and bowel and bladder control issues.

Question 19

What are some recommendations for physical activity for individuals with CP?

Answer 19

Cardiorespiratory fitness and muscular strength and endurance are often barriers to functional movements. While physical activity is recommended, there’s no clear guidance on frequency, intensity, time, and type for optimal health benefits.

Question 20

What are some potential considerations when working with someone with CP?

Answer 20

Considerations include muscle weakness, limb dominance, lack of coordination between limbs, inconsistent balance or control, limited range of motion, braces, splints, orthotics, assistive devices (wheelchairs, walkers, canes), and medication.

Question 21

What is Spina Bifida?

Answer 21

a congenital, non-traumatic spinal cord injury resulting from the neural tube failing to close completely during early fetal development.

Question 22

What is Poliomyelitis (Polio)?

Answer 22

a viral infection affecting motor cells in the spinal cord, now rare due to vaccination. Post-polio syndrome can occur 35-40 years later, with recurring symptoms.