week 12 part 1 Flashcards
spinal cord injury
obstructs the transmission of neural messages through the spinal cord (loss of somatic and automatic control of the trunk, limds and viscera below the site of the injury
primary injury of SCI
- sudden trauma to the spine
2.acute spinal cord compression, shear stress - acute impact to neurons,glial cells and neural parenchyma
Secondary injury
-involves a cascade of biochemical/ metabolic and mechanical changes within the neural tissue
- secondary injury is a consequence of these downstream effects
autonomic dysreflex
- the uncontrolled outflow of SNS activity due to a stimulus below the SCI
- result in life-threatening sudden hypertension followed by a reflex bradycardia
SCI consideration for exercise
adat exercise based on the ability
- the importance of maintaining/ building strength and maintaining
- consider autonomic limitation that may impact exercise capacity
- consider medication that may impact exercise
multiple sclerosis
- an inflammatory autoimmune disease that affects the conduction of neural impulse
- a chronic degenerative disease
- demyelination of the neuron within the CNS
- Brain, Spinal Cord & Cranial Nerves
- Affects all types: motor, sensory, autonomic
- Diffuse patches of demyelination
throughout the CNS
MS symptoms
this demyelination can occur anywhere in patches within the CNS
- symptoms depend on location, the severity of myelination
characterized by exacerbation and remissions
MS treatment
-disease-modifying drugs minimize frequency of exacerbation, slow progression
-pharmaceuticals to treat the complications
-physio and exercise to maintain strength and mobility
-OT
MS diagnosis
no defintive test but MRI can have useful info
Altered physiological responses to exercise in MS
- Increased Submax VO2 during treadmill walking
- Attenuated Systolic BP during exercise
- Increased body temp
- Earlier skeletal muscle fatigue
Considerations for exercise prescription
- Prescribe within physical limitations
- Consider use of supportive equipment e.g. arm poles for walking
- Variable strength from week to week
- Importance of stretching
- Resist heat stress
- Generally avoid exercise during an exacerbation
Parkinson’s disease
- a disease of synaptic transmission where dopamine release is reduced
-progressive and degenerative - unknown etiology but thought to be a combo of environmental and genetic factors
what is triggers secondary injury
it is triggered by the primary injury due to the acute inflammation
acute phase
- Hemorrhage, inflammation & edema result in local ischemia
- Neural toxicity induces cellular damage
- Demyelination & cell death begins
spinal shock due to the trauma that had occur in the area gets in the way to determine if it can return or not
sub-acute phase
-Further neurotoxicity, inflammation, cell death, scar tissue formation
* Any undamaged tracts begin to resume function (incomplete injury)
* Axonal regrowth and sprouting begins if possible