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SCS > Special Populations > Flashcards

Special Populations Flashcards

1
Q

Warning Signs To Terminate Exercise While Pregnant

A
  1. Vaginal bleeding
  2. Dyspnea (SOB) before exertion
  3. Dizziness
  4. Headache
  5. Chest Pain
  6. Muscle Weakness
  7. Calf pain or swelling (need to rule out thrombophlebitis)
  8. Preterm labor
  9. Decreased fetal movement
  10. Amniotic fluid leakage
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2
Q

Sports not recommended to play during pregnancy? Sports To Be Cautious With?

A
  1. Contact sports
  2. Scuba diving

Cautious: increased joint stress (running) and risk of falling

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3
Q

Exercise recommendations for pregnant women?

A

Same as for normal people:

Moderate intensity exercise most/all days of the week for 30+ minutes; more intense exercise for 20-60 minute sessions 3-5 days a week will result in higher physical fitness.

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4
Q

Changes in women’s bodies during pregnancy?

A
  1. Increased lumbar lordosis
  2. Increased ligament laxity (from estrogen and relaxin)
  3. Increased blood volume, HR, stroke volume, cardiac output, RR.
  4. Decrease in systemic vascular resistance
  5. Increased resting oxygen requirements but increased work of breathing from pressure on the diaphragm (from enlarged uterus) so decreased availability of oxygen during aerobic exercise
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5
Q

Does strenuous exercise contribute to preterm labor?

A

Only anecdotal reports, nothing else. Nonetheless, a physically active woman with history of, or risk of, preterm labor should be advised to reduce activity in 2nd/3rd trimesters.

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6
Q

Supine postures?

A

After the 1st trimester, the supine position results in relative obstruction of venous return. There is no absolute contraindication to supine exercise but if symptomatic it should be avoided.

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7
Q

Birth Weight and Exercise

A

Birth weight not affected by exercise in women who have adequate energy intake.

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8
Q

Can women start exercising at any time during pregnancy?

A

A thorough clinical evaluation of each pregnant woman should be conducted before starting an exercise program.

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9
Q

Strenuous Resistance Training and Pregnancy?

A

No evidence to suggest this shouldn’t be done, no evidence in healthy female that this causes any problems.

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10
Q

How to calculate target HR?

A

220 - age = MHR
MHR - HR = HRR
HRR x Percent Intensity + HR = Number you want

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11
Q

Calculating Exercise Intensity During Pregnancy?

A

There is much variability in maternal HR response to exercise and target HR cannot be used to monitor intensity. Use RPE.

Moderate (somewhat hard) = 12-14 (6-20 scale)

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12
Q

Exercise Postpartum

A

Many of the changes of pregnancy persist for 4-6 weeks postpartum. Exercise routines can be resumed gradually after physically and medically safe.

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13
Q

Functional classification system for disabled athletes?

A
  1. WC athletes
  2. Amputees
  3. Athletes with CP
  4. Visual impairment
  5. Intellectual impairment
  6. Les autres (all others)

After being placed in a category they are further subdivided according to levels of impairment.

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14
Q

Autonomic Dysreflexia

A

Medical emergency. Usually seen with SCI at/above T6. Results in uncontrolled sympathetic response precipitated by some noxious stimulus below SCI level.

Symptoms include HA, HTN, flushing, sweating, slow HR.

Treat: Sit upright to promote orthostatic decrease in BP and removing noxious stimulus (distended bladder, fecal mass, sharp object)

If systolic BP above 150 then need antihypertensive agent (nifedipine or nitrates).

Some athletes attempt to do “boosting” and induce this. Results in increased BP/cardiac output for improved racing study.

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15
Q

Thermoregulation and SCI?

A

Athletes have difficulty regulating temperature in warm or cold environments due to paralysis of muscles and loss of ANS control (impaired sweating and peripheral blood flow)

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16
Q

Areas most susceptible to pressure sores? Risk factors?

A

Sacrum and ischial tuberosities. Sport wheelchairs that keep knees higher than the hips increase the risk.

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17
Q

Neurogenic Bladder?

A

Result of SCI. Bladder dysfunction predisposes individuals to UTI’s from incomplete voiding and catheter use.

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18
Q

Premature Osteoporosis

A

Happens with the area not being used for those with SCI. Assisted standing can assist with reducing this.

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19
Q

Risk of shoulder injury with sports for wheelchair athletes?

A

Participation of sports does not increase or decrease risk of shoulder pain. Some studies have reported that no athletic wheelchair users actually have a higher risk of shoulder pain.

20
Q

Shoulder Exercise For Shoudler Pain In WC Athletes?

A

Abduction tends to be very strong. Usually have weakness in adductors, ER/IR’s, and scapulothoracic muscles.

21
Q

Common Pains With CP Athletes?

A

Knee injuries (commonly patellofemoral) due to spasm of muscles around the joint.

Foot/ankle problems from foot/ankle deformities.

22
Q

Tips to reduce stump injuries for amputees?

A

Use talcum powder and cool clothing to combat sweating.

23
Q

Deficits Commonly Seen in Those With Intellectual Disabilities?

A

Ocular and visual defects; congenital heart disease, AA instability.

If AA instability on lateral radiographs you’ll want to restrict participation in sports with excessive neck flexion or extension.

24
Q

What is the female athlete triad?

A

Inter-relationship among:
1. Energy availability
2. Menstrual function
3. Bone mineral density

25
Q

Primary, secondary, tertiary prevention?

A

Primary = preventing a condition
Secondary = decreasing duration/severity of disease
Tertiary = restoring function in a patient dealing with chronic illness/disability

26
Q

When does humerus, clavicle fully fuse during growth?

A

Humerus
14-17 for girls
16-18 for boys

Clavicle (Medial Physis)
22-25

27
Q

Recurrence rate for pediatric patients after anterior shoulder dislocation?

A

Despite conservative therapy, recurrence rate is very high (83-90% younger than 20 and nearly 100% with open phases)

28
Q

How long to avoid sports after clavicle fracture for pediatric patients?

A

6-8 weeks.

29
Q

Injuries to AC and SC regions in pediatric patients?

A

They are physical injuries until proven otherwise.

30
Q

Little Leaguer’s Shoulder

A

Growth plate injury in proximal humerus.

31
Q

Phases of Swimming Stroke

A

Pull phase and recovery phase (arm out of water).

32
Q

Benefits of Physical Activity During Pregnancy? Things it’s not associated with?

A

Benefits
1. Fewer newborn complications
2. Maternal health benefits

Not Associated With:
- Miscarriage
- Stillbirth
- Neonatal death
- Premature birth
- Low birth weight
- Birth defects
- Induction of labor

33
Q

REDS

A

Relative energy deficiency in sports

34
Q

Symptoms of REDS?

A

Loss of menstruation is actually happening later on. You may have some other indicators such as anxiety, fogginess, fatigue, and changes in menstrual status (either MORE FREQUENT or less frequent).

35
Q

Menstrual dysfunction times/terminology?

A

Oligomenorrhea = cycle > 35 days
Amenorrhea = absence for > 3 months

Primary amenorrhea = delay until after the age of 15 years old
Secondary amenorrhea = when you have a delay later in life (after puberty when you first start menstruating)

36
Q

When should DEXA scan be performed on athlete?

A
  1. History of repetitive or multiple stress fractures
  2. Altered eating habits for a total of 6 months
  3. Equal/> 1 high risk triad risk factors
  4. Equal/> 2 moderate risk triad risk factors
37
Q

Females and concussions (compared to males)?

A

In sports with the same rules, reported rates of concussions are higher in females.

Females often report more symptoms at baseline and after compared to males.

38
Q

Major determinant of adult bone mineral density?

A

Bone mass achieved during adolescence and young adulthood. Peak bone mass is attained between 20-30, 90% of which is accrued by the end of adolescence (creating a window of opportunity to maximize bone mass).

39
Q

Z-scores that are concerning in the presence of oligo/amenorrhea?

A

Z-scores between -1.0 and -2.0 are defined as low bone mass and less than -2.0 may be indicative of osteoporosis.

40
Q

When should pharmacological interventions for increasing bone mineral density and reducing fracture risk be implemented?

A

Only if nonpharmocological measures are not successful after at least 1 year. Initially want to try increasing EA and optimizing intake of bone-building nutrients (vitamin D and calcium).

41
Q

When does menarche usually occur?

A

Age 11-14

42
Q

Consequences of menstrual dysfunction?

A
  1. Suppression of reproductive hormones
  2. Infertility
  3. Low BMD
  4. Higher incidence of BSI
  5. Altered CV risk factors (lipid profile, endothelial function)
43
Q

Pregnancy increases nutritional needs of what?

A
  1. Calories
  2. Iron
  3. Calcium
  4. Folic acid
44
Q

What range of exercises does not raise core temperature?

A

60-70% VO2max

45
Q

Meniscal problems in the immature athlete?

A

These are unusual but generally associated with a discoid lateral meniscus with a painless “clonking” noise before the tear.

SCS (27 decks)

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