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245 - Cardiorespiratory and Complex Conditions > Week 6 > Flashcards

Week 6 Flashcards

1
Q

Amputations

A

Loss or removal of a body part (finger, toe, hand, foot, arm or
leg)

Diabetes is the leading cause of non-traumatic lower extremity
amputations

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2
Q

Lower Limb Amputations: Etiologies

A
  • Diabetes
  • Peripheral vascular disease

Trauma

Infection

Cancer

Congenital

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3
Q

Diabetic Neuropathy

A

High blood sugars can cause damage to the nerves and blood vessels that control the heart, brain and those that are outside of the heart and brain

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4
Q

Peripheral Neuropathy

A

Most common type type of diabetic neuropathy

Affects nerves in the feet and legs

Loss of sensation
Unsteady gait

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5
Q

Decreased circulation: leads to

A

diabetic ulcers,

slower healing of wounds

sometimes amputation

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6
Q

What is a major risk factor for developing type 2 diabetes

A

the amount of processed food and added sugar in the diet

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7
Q

Above Knee Amputation (_______)

Below Knee Amputation (________)

A

Above Knee Amputation (Transfemoral)

Below Knee Amputation(Transtibial)

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8
Q

Two main phases of rehabilitation for amputees

A

1) Pre prosthetic phase

2) Prosthetic phase

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9
Q

Preprosthetic Phase

A

The period between the amputation surgery and the fitting of a prosthesis

–> Wound still healing

–> Leads to increased difficulty to reorient once prosthetic limb is received.

–> Due to the loss of the limb = shifting of centre of gravity over the remaining leg.

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10
Q

Main goals (pre prosthetic phase)

A

Prevention of contractures

Swelling control

Shaping of the residual limb

Desensitizing techniques

Pressure injuries prevention

Strenghtening, ROM, general mobility

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11
Q

Proper caring of the residual limb

A

Regular inspections
(Color change, pain, swelling, drainage)

ADLS: washing/drying
(At night, every day
Mild soap
Pat dry with towel
Moisture (at night))

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12
Q

Low to high functioning

  • What is the lowest functional to highest functional level for getting dressed?
A

1) Getting dressed in bed

2) Getting dressed sitting in chair 

3) Getting dressed standing
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13
Q

Transfer training

A

Transfer training: various types and surfaces

Early rehab: transfers toward the non-affected leg.

As patient progresses: transfers in both directions are included.

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14
Q

Phantom Limb Pain Interventions

A

Mirror box

Exercise to increase circulation

Distraction, change position

Soak in warm bath, massage on residual limb

Pain diary

Relaxation techniques

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15
Q

Prosthetic Phase Interventions

A

Orientation of center of gravity and improve weight bearing on the prosthetic side

Gait re-education Personal Hygiene and Prosthetic Care

​ADL training, including donning/doffing of prosthesis

ADL training: care of prosthesis

iADLS training as patient progresses

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16
Q

2 types of diabetes overview

A

Type I: (AKA insulin-dependent diabetes or juvenile diabete)
–> autoimmune disease that occurs when the pancreas no longer produces any
insulin or produces very little insu

Type 2: (AKA non-insulin-dependent diabetes or adult-onset
diabetes)
–> occurs when the pancreas does not produce enough insulin to meet the body’s
needs and/or the body is unable to respond properly to the actions of insulin
(insulin resistance)

17
Q

diabetes treatment and complications

A

Type I: insulin, meal planning, exercise

Type 2: meal planning, exercise, medication

chronic kidney disease (nephropathy)

foot problems, lower limb (leg, foot, toe, etc.) amputation

eye disease (retinopathy) that can lead to blindness

cardiovascular disease (heart attack, stroke)
nerve damage (neuropathy

18
Q

hypoglycemia vs Hyperglycemia

A

low blood sugar (< 3.9)
- Symptoms: unconsciousness, shaky, hungry, confused
- Should be treated immediatel

vs high blood sugar (> 11)
- Symptoms: increased thirst, urination, blurred vision
- Toxic (ketoacidosis): confusion, SOB, nausea/vomiting,
fruity-swelling breath

19
Q

Neuropathy effects

A
  • Gait imbalances
    ◦ Increased falls risk
    ◦ Increased attention to foot care – proper footwear
20
Q

Exercise tips for diabetes

A
  • Both resistance and aerobic exercise and is optimal to do both

At least 150 minutes per week of aerobic exercise + at least 2 sessions per week of
resistance exercise are
recommended

It is best to avoid prolonged sitting. Try to interrupt sitting time
by getting up briefly every 20 to 30 minutes

being sedentary is associated with far greater
health risks than exercise would be

21
Q

symptoms of kidney disease

A

Symptoms range from
- none to tired,
- poor appetite,
- nausea,
- difficulty breathing,
- extreme itchines

22
Q

Kidney disease treatment

A
  • monitoring blood levels
    ◦ Dialysis
    ◦ transplant
23
Q

Exercise benefits on renal failure

A

◦ Improved muscle function

◦ Better BP control

◦ Lowered cholesterol and triglyceride levels

◦ Improved sleep

◦ Better control of body weigh

24
Q

Renal failure exercise tips

A
  • choose aerobic exercises where you continuously move
    large muscle groups (walking, swimming, dancing, skiing)
  • choose low level strength training
  • choose to exercise 3 days/week on non-consecutive days
25
Q

Hemodialysis

A

“cleaning the blood”

26
Q

Dialysis on Renal failure - pros and cons

A

Pros
- Relieves symptoms of uremia
* Works quickly and efficiently
* Requires at least three treatments a week, each four to
eight hour

Cons
- You will have to take medications, learn new food
choices, and restrict your intake of fluids
* You must plan your week around your hemodialysis
schedule
* You may need to travel some distance to the
hemodialysis unit

27
Q

Vascular Injury

A

Traumatic or complication from vascular disease

Peripheral artery disease (narrowing or blockage in
the arteries that supply blood to the leg)

Disease that develops in the peripheral arteries and veins,
usually lower extremities

Can cause you to start walking slowly and have difficulty keeping
up from fatigue, weakness, or discomfort/cramping.

28
Q

Vascular Injury Risk factors + Treatment

A

Risk factors
Male
◦ Non-Caucasian
◦ Smoking
◦ High blood sugar, cholesterol , pressure

Treatment
- Bypass surgery, stenting
◦ Amputation

29
Q

Exercise Prescription PAD (Peripheral artery disease)

A

Outcome Measures:
6MWT (6 minute walk test)
◦ TUG (timed up and go)

Supervised Treadmill Walking or Nordic Walking

Intensity 40%–60%

Session duration 30–50 min

Frequency 3 times per week supervise

Program duration At least 12 wk

Progression Every 1–2 wk: increase duration of training session

30
Q

Rehab for amputees

A
  • strength training: LE, UE and CORE!!
  • endurance training
  • ROM
  • balance

Other things to consider:
- wound management
- proper positioning

31
Q

Potential exercises for amputees

A

work from gravity assisted to again gravity

  • inner range quads
  • resisted hip adduction
  • static glutes
  • hip flexor stretching
  • bridging
  • hip flexion and extension
  • hip abduction

more advanced:
pelvic tilts (anterior/posterior, lateral)
- trunk rotation
- reaching outside BOS
- unilateral hip flexion
- bridging
- core roll-outs
- knee extension,
- throwing/catching
- supine hand/foot passes
- crunches

32
Q

Normal Responses to Acute
Aerobic Exercise

A

Heart rate (HR) increases

Blood flow increases. At rest, 15-20% of the cardiac output goes to muscle but during exercise
80-85% is distributed to working muscle and shunted away from the viscera.

Blood pressure: Systolic Blood Pressure (SBP) increases, Diastolic Blood Pressure (DBP) slightly
increases (less than 15mm Hg from resting value).

Pulmonary ventilation increases. Rate and depth of breathing increase the amount of air

exchanged/minute
Respiratory Rate increases

33
Q

Abnormal Responses
to Aerobic Exercise

A

No rise in heart rate with increased intensity

Failure to rise, or a decrease in systolic blood pressure (SBP)

Increase in diastolic blood pressure (DBP)

34
Q

Pediatric Perspectives

A

Children are less mechanically efficient than adults.

Children lose more energy than adults when performing
the same activity.

Children have a poorer ability to dissipate heat than adults
when exercising in hot environments.

35
Q

HIIT and CHRONIC Conditions

A

HIIT = High Intensity Interval Training

-Intervals of higher intensity training (80-95% of peak
HR) mixed with lower intervals or rest

Intervals can be as short as 30 sec and up to 4 min

36
Q

Nordic Walking

A

Combines aerobic & muscle endurance exercise

Ideal for those with chronic conditions and/or lower
Levels of mobility (esp HF

37
Q

Benefits of Nordic walking

A

Simultaneously conditions the upper and lower body, abdominal and back
muscles

Increased oxygen consumption and caloric expenditure (20%);

Increased heart rate and blood pressure (5-10%);

Increased stride length and walking speed (5-10%);

No increase in RPE level;

Provides stability and aids in balance

245 - Cardiorespiratory and Complex Conditions (7 decks)

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