Chapter 11 Neurological Diseases/Conditions

neurogenesis

growth and development of nervous tissue associated with learning, memory, cognition and mood states

neurodegenerative disease

atrophy and deterioration of brain

refer

exercise professionals should __ not diagnose individuals with anxiety and depression

for those with anxiety and depression, submax exercise tests are

recommended

symptoms that appear physical

pretest anxiety can influence testing results due to

benzos

reduce plasma catecholamine response to exercise

• cause dressiness and poor coordination

impaired BP

individuals with anxiety have mildly ___ response to exercise

lower

GAD results in modulation of cardiac activity - manifests as __ HR variability during stress

ischemia

females with anxiety disorders and without CAD have increased __ risk during testing

profound

effects of aerobic exercise are __ among individuals who are clinically depressed

panic attack

exercise can induce physiological symptoms that are similar to a ___

• individuals with disorders should be advised to expect these symptoms

maintained, mix of aerobic and resistance

ExRx for depressed individuals should finds PAs that will be ___ and include

suicidality

involves ideation, plans or actions to end ones life

do not alter, decrease attempts

exercise and suicidal ideation

rewards

reduced sensitivity to __ in individuals with depressive disorders can create additional challenge

self regulation

individuals can benefit from supplementing exercise with support for

ADHD

neurodevelopmental disorder characterized by inattention hyperactivity and impulsivity

attention and inhibition

two dimensions of cognition improved by PA in those with ADHD

moderate, not necessary

individuals with ADHD can start __ intensity program without medical screening and considering exercise testing is ___

stimulants

exercise can enhance the effects of __ on clinical symptoms in those with ADHD

day and short term

in ADHD, goals that are defined, specific and measurable for

A

activities of type _ are preferable for autistic individuals with motor deficits

Intellectual disability

neurodevelopment disorders that begin in childhood and characterized by difficulties in conceptual, social or practical areas of living

mild

ID category - live independently with minimum levels of support

moderate

ID category - independent living may be achieved with moderate levels of support

severe

ID category- individual requires daily assistance with self-care activities and safety supervision

profound

ID category - individuals requires 24 hour care

heart disease

leading cause of death in people with ID

documented medical clearance

may be necessary for exercise participation in people with ID

familiarity of any individual

__ with testing protocol should be considered prior to testing in people with ID

familiarization session

each protocol should hav its own __ for people with ID

overestimate, 30bpm below

general population estimates tend to ___ HR in people with ID

• peak HR in individuals with ID/DS are typically __ expected

discontinuous

__ treadmill protocols have been utilized in people with ID and demonstrate plateau of VO2peak

chronotropic incompetence or inability to increase HR

autonomic dysfunction associated with ID

weight gain/loss

individuals with ID can be prescribed meds that present difficulties with

short-term

individuals with ID have deficits in __ memory

food based

avoid __ reward systems in people with ID

cerebral palsy

group of permanent disorders of development of movement and posture causing activity limitation that are attributed to nonprogressive disturbances in the developing fetal or infant brain

I and II

levels __ indicate children with the ability to walk with CP

3-5

levels __ reflect individuals with CP who use assistive devices

osteoporosis and fractures, arms/cycle ergometry

individuals with CP have a higher risk for

• may be useful

short interval

__ sessions may be more effective for individuals with CP

early

new skills for CP are introduced __ in session

AD

characterized by early and progressive declines in learning and memory as well as other cognitive processes

AD

increased depressive symptoms, behavioral problems and sleep disturbances

age

greatest risk factor for AD

2 decades

plaques and tangles associated with AD can accumulate in the brain up to __ before development of symptoms

second

stage of AD characterized by presence of pathology and neurodegeneration

independently perform ADLs

final stage of AD is characterized by more significant impairments such as inability to

consultation with physician

all exercise testing for AD should be done

morning

__ hours may be more beneficial for individuals with AD due to lowest severity of symptoms

parkinsons

chronic, progressive, neurological disorder characterized by signs of bradykinesia, tremor, righty, postural instability

Parkinsonism

clinical syndrome including other neurodegerative disorders such as multiple systems atrophy, progressive supra nuclear palsy and corticobasal degeneration

nonmotor ADLs (cognition, depression, sleep, fatigue and hallucinations)

MDS-UPDRS - part 1 assesses

stage 1

stage of PD - unilateral involvement only, minimal or no functional impairment

stage 2

stage of PD - bilateral or midline involvement without impairment of balance

stage 3

stage of PD - first sign of impaired right reflexes

stage 3

stage of PD - somewhat restricted in activities, physically capable of living independently and disability is mild to moderate

• unsteadiness as turning or pushed from standing equilibrium

stage 4

stage of PD - full developed, severely disabled, person is still able to walk and stand but is markedly incapacitated

stage 5

stage of PD - confined to bed or wheelchair unless aided

perception of ability

MDS-UPDRS - part 2 assesses person’s

motor evaluation

MDS-UPDRS - part 3 assesses

• rigidity, bradykinesia (slowness), postural stability,

motor complications

MDS-UPDRS - part 4 assesses

• dyskinesias (involuntary movement) or dystonia (painful cramps)

bradykinesia

primary feature of PD is

stooped

patients with PD may have __ posture

prodromal stage

individuals have PD for several years before given diagnosis

levodopa and carbidopa

most prescribed drugs for management of PD

DBS

stimulates the brain at high frequencies and replaces abnormal high and variable neuronal firing with consistent patterns to treat bradykinesia, tremor and rigidity

day to day

patients with PD experience fluctuations with motor symptoms from

orthostatic hypotension

individuals with PD may experience ___ as related to disease or drugs

balance, gait, mobility and aerobic capacity

test of __ are recommended before exercise testing is performed in people with PD

truncal, hamstring, hip flexor

assessments for flexibility in PD should focus on __ posture, flexibility and length

6MWT

aerobic capacity in people with PD can be assessed with

1-2

treadmill protocols can be used in people with PD stages

gait belt

__ should be worn during treadmill test for ppl with PD

symptom limited

alternative to HR limited exercise testing for people with PD

peak effect

GXT should be done in people w PD when meds are

bruce

treadmill protocol for stage 3 PD

interferes with ECG

in PD, signal from DBS

RPE

used to monitor exertion during testing for people with PD

slow progression and reduce signs

for PD, long term aerobic training can

1-2

high intensity endurance exercise (80-85HRmax) can safely be prescribed to stage __ PD

autonomic dysfunction

individuals with stage >3 should check with physician if they have __ before high intensity aerobic exercise

rhythmic

exercises that include __ tasks have been shown to improve some motor characteristics of PD

blunted HR

a ___ response during exercise testing may be observed in people with CI for PD

bradycardia and transient peak dose tachycardia/dyskinesia

levodopa/carbidopa may cause __ during exercise in those with PD

FOG

intermittent feeling of feet being stuck when trying to walk in people with PD

• exercise does not necessary alleviate