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Lecture 4

Lecture 4 - Exercise Health and Technology

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Health Sciences
Health Sciences 2000A/B
Leichelle Little

LECTURE 4: EXERCISE HEALTH AND TECHNOLOGY Stroke • Cardiovascular disease • Interruption of blood flow in arteries leading to or within the brain o Lack of oxygen leads to loss of brain functioning o Severity depends on site of injury and how much was damaged • Types o Ischemic  80% of strokes  Due to clot in vessel • Atherosclerosis, thrombotic, embolic  Hemorrhagic • 20% of stroke • Uncontrolled bleeding reduces flow, compresses tissue • Aneurysm • Intracerebral, subarachnoid Stroke: Symptoms/Deficits • Diagnosis o FAST signs – face, arms, speech time o Weakness – unilateral paralysis o Headache – unusual headache o Vision – blurred or double vision o Dizziness – loss of balance or coordination o Trouble speaking – loss of speech or trouble understanding speech • Regions of the brain affected based on: o Where blockage or damage occurred • Motor, sensory and perceptual symptoms: o Hemiplegia/hemiparesis o Aphasia o Balance control problems o Gait disorders o Poor upper limb function o Loss of sensation o Neglect • Right side lesion: o Left neglect, impulsive behavior, deficits in error recognition in memory, unable to comprehend or produce emotional content of speech • Left side lesion: o Language or speech disorders, dysarthria, cautious behavior, difficulty in understanding and producing speech • Hemiparesis can occur on either side • Hemiplegia/Hemiparesis o Limb or muscle weakness on the contralateral side of the body  Specific region based on where lesion occurred • One of the most common symptoms of stroke • Why on the contralateral side? o Crossing fibres • Balance control o Very common, increases fall risk o Can be related to weakness, sensory problems, perceptual problems 1. Stance symmetry 2. Inadequate compensatory reactions  Slow balance reactions with paretic limb, dyscoordination • Gait problems o Most commonly reported challenge/limitation (>60%) o Can be related to:  Weakness, spasticity, sensory loss, balance problems o Hemiparetic gait  Slow velocity, asymmetric, poor swing clearance, foot drop • Neglect o Neglecting or ignoring space on one side of the body  Ex. will only eat half of the food on their plate o More commonly ignore left side after ride side lesions o Can resolve itself over weeks/months o Assessment  Picture copying  Line bisection test  Line cancellation test • Post-stroke physiology o Muscle wasting (atrophy)  Lower oxygen capacity for exercise  More fatigue prone o Decreased endurance o Higher insulin resistance • Vicious cycle – deficits in cardiorespiratory fitness are also risk factors for stroke • What strategies could you employ for someone dealing with neglect that will help with ADLs? • Because of the many differences in symptoms between patients, impossible to create one program for patients • Rehab team must create individual program for each patient based on goals and present deficits Stroke: Exercise • Cardiovascular system o Severe deconditioning after stroke • Exercise will help battle deconditioning and help prevent second stroke in future • The problem: o Many deficits prevent adequate exercise performance immediately following stroke • We must addre
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