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Lecture 3

Kinesiology 1070A/B Lecture 3: Prehabilitation and Injury

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Western University
Kinesiology 1070A/B
Harry Prapavessis

September 23, 2016 Prehabilitation and Injury Andrei Markov tore his ACL in April 2010. It is possible to play with bracing but he will eventually need surgery o Immediate care would be an assessment then elevation, ice, NSAIDs (nonsteroidal anti inflammatory drugs) then rest if with crutches Because there is a time gap there is time to do something before surgery. There is swelling inflammation, decreased range of motion and loss of mobility. Is there something we can do with these without making these worse? Intensive rehabilitation after surgery would include: physiotherapy exercises, cryotherapy, muscle stimulation, maintain overall fitness (takes up to 6 months to recover) Psychological Reaction to Injury: there are a lot of negative reactions going on, and before positive reactions happens, we have to go through the negative ones. (this is natural) o Injuryrelevant processing: information about pain, extent of injury, how it happened, negative consequences. o Emotional upheaval reactive behaviour: agitation, emotional depletion, isolation, shock, disbelief, denial, selfpity o Positive outlook coping: acceptance, coping efforts, optimism, relief with progress o Identity loss: especially in not longer able to participate o Fear anxiety: recovery? Reinjury? Be replaced? o Lack of conficende: decreased physical status o Performance decrements: less confident, lack of practice, expectations Stress is the substantial imbalance between demand and response capability. Under conditions where failure to meet demands has important consequences. Stress can contribute to injury occurrence because it is a stressor (physical psychological). Rehab can be a stressor as well. Most salient when recovery is less than expectations. The period immediately postinjury is characterized by greatest negative emotion. High stress may lead to poor adjustment (denial, withdrawal, guilt about letting team down) Prerehabilitation: trainingtreatment in preparation for surgery and the anticipated stressor that comes along with it. It can be physical, psychological or a combo of both. o Prehab and non patients start at the same level, prehab increases functioning and non maintains or decreases. o They both have a similar decrease in response to stressor then prehab has a shorter time below the minimal function line. o Similar recovery trajectory, but prehab is quicker to preop level It might work because it can train specific systems that will be affected by the stressor (build muscle strength if the stressor will cause strength loss). Also, it can build up a functional reserve to compensate for depletion by the stressor. Chronic conditions include osteoarthritis (OA), coronary artery bypass grafting (CABG) and cancer. Elective surgery or longer wait times for necessary surgery makes a larger rehab window. Before surgery conditions can get worse, patients become more sedentary and treatment option have been exhausted (to active care, patients feel like they are not doing anything)
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