Exercise therapy involves the use of physical activities to enable patients to recuperate from diseases that hinder their motor activity. It focuses on minimizing risk, averting impairment, optimizing function, and enhancing physical fitness. This paper identifies the etiologies of spasticity in patients with cerebrovascular accidents and discusses various aspects of exercise health, such as the applicability of exercise in multiple sclerosis.
SPASTICITY IN CLIENTS WITH CEREBROVASCULAR ACCIDENTS
Spasticity refers to muscle stiffness hence impaired fluid movement. In this state, muscle contraction is inhibited (Charsouei 2). Various aspects requiring motor function, such as speech and movement, are impaired. Damage to the central nervous system regions responsible for regulating motor reflexes causes spasticity. Notably, the cerebellum and brainstem are important for controlling motor reflexes and message transmission to the spinal cord, respectively (Gart and Adkinson 5). Accordingly, the transmission of inhibitory and excitatory messages to the muscle is inhibited, and this causes stiffness. Spasticity is observed in conditions such as cerebrovascular accidents and those with acquired brain injury (Charsouei 2).
INTERVENTIONS WHEN A CLIENT HAS SEIZURES
A specialist in exercise therapy should take various interventions when a client is having seizures. The specialist should loosen any clothing that can impede proper breathing (Girirajan et al. 5). Such clothing includes ties neck scarves or masks. The second intervention is easing the client to the floor and avoiding holding them down (Girirajan et al. 5). The third intervention is gently running the client on one side to avoid airway blockage (Girirajan et al. 5). The fourth intervention is upholding the safety of the client by removing any object in the vicinity that can cause injury (Girirajan et al. 5). The fifth intervention is the prevention of head injury by introducing materials below the head. The specialist should not insert any objects into the client’s mouth. Finally, the specialist should contact the emergency services if the client’s seizure persists beyond five minutes.
BENEFITS OF EXERCISE IN MULTIPLE SCLEROSIS
Multiple sclerosis (MS) presents with signs and symptoms such as impaired cognition, depression, spasticity, abnormal motor reflexes, and weak muscles (Kalb et al. 3). Studies indicate that well-planned repetitive exercise is the best non-pharmacological intervention for multiple sclerosis (Kalb et al. 1). Exercise can help to improve mobility, and cognition, reduce fatigue and depression and increase the patient’s quality of life (Kalb et al. 2).
Exercise can improve the physical mobility of patients with MS via two mechanisms. The peripheral nervous system mechanism entails improvement in the cardiorespiratory mechanics and muscle strength (Kalb et al. 3). The central nervous system mechanism involves enhanced integrity of subcortical and cortical areas (Kalb et al. 3). In these scenarios, the exercise is well scheduled, and patients are compliant with the plan. Both peripheral and central nervous system mechanisms contribute to the improvement of balance in patients with MS. Studies indicate that aerobic exercise can improve cognition in patients with MS. The cognitive functions likely to be enhanced by exercise are the executive roles and long-term memory.
Preliminary findings indicate that exercise that minimizes fatigue and depression is common in patients with MS. This can be attributed to neuroprotection and increased activity caused by exercise (Kalb et al. 2). Overall, exercise increases the quality of life in patients with MS (Kalb et al. 3). This is because it improves movement, balance, and flexibility and lowers fatigue and the manifestation of depression.
PARKINSON’S DISEASE AND EXERCISE
Parkinson’s disease (PD) is a neurologic disorder that primarily presents with bradykinesia, rigidity, impaired balance, and tremors (Xu et al. 2). Exercise is beneficial in patients suffering from this disease. Exercise improves flexibility, cardiorespiratory capacity, gait, and the patient’s balance (Xu et al. 4). This helps to address the motor signs and symptoms that are the primary manifestations of the disease. Studies have indicated that patients with Parkinson’s disease benefit from exercises such as treadmilling, dancing, martial arts, and cueing (Xu et al. 4). Notably, the four exercises increase balance, flexibility, and mobility (Xu et al. 6). Findings reveal that none of the exercises is superior to the other in terms of improving the primary manifestations of PD.
Exercise has a neuroprotective effect, which may be beneficial in patients with PD. Studies indicate that intense exercise in mid-life can minimize the likelihood of developing PD over the person’s lifespan. Furthermore, studies have revealed that exercise increases plasma levels of brain-derived neurotrophic factors, which has a neuroprotective role (Xu et al. 5). The plasma levels of this neuroprotective factor are directly proportional to exercise intensity (Xu et al. 4). This factor is diminished in patients with PD.
DAMAGE TO THE LEFT BRAIN
Damage to the left side of the brain is characterized by aphasia, dysarthria, dysphagia, hemiparesis, and computational and thought problems (Schaffer et al. 1). Aphasia refers to the inability to form and comprehend speech (Schaffer et al. 1). This can also involve the inability to read and write. Dysarthria refers to slurred speech, whereas dysphagia refers to difficulty in swallowing (Schaffer et al. 2). Hemiparesis refers to weakness on the right side of the body (Schaffer et al. 1). This can manifest as the inability to lift the right arm.
As a trainer, I can modify my teaching to address the person’s needs with a damaged left brain hemisphere. The first strategy is to modify communication (Schaffer et al. 6.). This involves speaking slowly, avoiding jargon and verbose, and avoiding interruptions. The second strategy is avoiding noisy environments. The next strategy is active participation in their planning and problem-solving process. Furthermore, embracing empathy can make the person feel that they are understood, and this will enhance the learning process.
Charsouei, Saeid. Evaluation of Post-Stroke Spasticity and Its Relationship with Age, Gender, Type of Stroke, and Lesion Location: A Systematic Review. No. 2, 2021.
Gart, Michael S., and Joshua M. Adkinson. “Considerations in the Management of Upper Extremity Spasticity.” Hand Clinics, vol. 34, no. 4, Elsevier Inc, 2018, pp. 465–71, doi:10.1016/j.hcl.2018.06.004.
Girirajan, S. et al. “Just In Time: Challenges and Opportunities of First Aid Care Information Sharing for Supporting Epileptic Seizure Response.” Physiology & Behavior, vol. 176, no. 5, 2021, pp. 139–48, doi:10.1145/3449187.Just.
Kalb, Rosalind, et al. “Exercise and Lifestyle Physical Activity Recommendations for People with Multiple Sclerosis throughout the Disease Course.” Multiple Sclerosis Journal, vol. 26, no. 12, 2020, pp. 1459–69, doi:10.1177/1352458520915629.
Schaffer, Jacob E., et al. “Left Hemisphere Damage Produces Deficits in Predictive Control of Bilateral Coordination.” Experimental Brain Research, vol. 238, no. 12, Springer Berlin Heidelberg, 2020, pp. 2733–44, doi:10.1007/s00221-020-05928-2.
Xu, Xiaojiao, et al. “Exercise and Parkinson’s Disease.” International Review of Neurobiology, 1st ed., vol. 147, Elsevier Inc., 2019, doi:10.1016/bs.irn.2019.06.003.
We’ll write everything from scratch
1. Describe what causes “spasticity” in CVA/ABI clients.
2. List what things a Specialist in Exercise Therapy should do if a client is having a seizure.
3. Describe how exercise can benefit someone with Multiple Sclerosis. What should they avoid doing?
4. What are the primary characteristics of Parkinson’s Disease and how can exercise help?
5. What are some of the characteristics of someone with damage to the left brain? How might you, as a trainer, alter your teaching process to accompany this person’s learning ability?
Reading Assignment: Chapter 11
Exercise Therapy Third Edition
Karl G. Knoof, EdD
The National Institute of Neurological Disorders and Stroke (NINDS) – This site contains information about brain and nervous system disorders, current clinical trail and research being conducted, as well as additional resource links.
http://www.ninds.nih.gov/ (Links to an external site.)
CVA or Stroke: http://www.ninds.nih.gov/disorders/stroke/stroke.htm (Links to an external site.)
Epilepsy: http://www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm (Links to an external site.)
Multiple Sclerosis: https://www.ninds.nih.gov/disorders/all-disorders/multiple-sclerosis-information-page (Links to an external site.) (Links to an external site.)
Parkinson’s Disease: https://www.ninds.nih.gov/Disorders/All-Disorders/Parkinsons-Disease-Information-Page (Links to an external site.)
Epilepsy care – proper care and comfort for individuals with epilepsy
http://www.epilepsy.com/get-help/seizure-first-aid/care-and-comfort-first-aid (Links to an external site.)
Brain anatomy – interactive anatomy of the brain with definitions of structures
https://www.koshland-science-museum.org/explore-the-science/interactives/brain-anatomy (Links to an external site.)
Flashcards to learn neurological disorders (free) –
http://www.flashcardmachine.com/14-neurological-disorders.html (Links to an external site.)
Flashcards to learn neurological conditions/other topics (paid) –
https://www.brainscape.com/packs/neurological-conditions-8776380 (Links to an external site.)
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