Download ACSM's Resources for Clinical Exercise Physiology: by American College of Sports Medicine PDF

By American College of Sports Medicine

This moment version is designed to supply a source for workout clinicians operating with sufferers struggling with a large choice of continual ailments and disabilities past cardiovascular and pulmonary sickness, together with orthopedic, neurologic, metabolic, musculoskeletal, neoplastic, and immunodeficiency stipulations. Following the authors' professional suggestion and illustrative case experiences, readers will methods to paintings with those usually underserved populations by way of supplying them with workout overview, prescription, supervision, schooling, and end result assessment. every one bankruptcy, devoted to a selected sickness or ailment, provides an exceptional realizing of epidemiology, pathophysiology, prognosis, and scientific and surgical treatments.

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Read or Download ACSM's Resources for Clinical Exercise Physiology: Musculoskeletal, Neuromuscular, Neoplastic, Immunologic and Hematologic Conditions (2th Edition) PDF

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Additional info for ACSM's Resources for Clinical Exercise Physiology: Musculoskeletal, Neuromuscular, Neoplastic, Immunologic and Hematologic Conditions (2th Edition)

Sample text

PHYSICAL EXAMINATION In children with CP, movement disorders become apparent as the nervous system matures and new motor skills are learned. This produces what appears to be a progressive rather than a static disorder. The extent of the disorder may not be recognized until the child reaches age 2 or 3 years or even later. A definitive diagnosis of CP is rarely made before age 6 months and many times much later, but certain clinical findings should arouse suspicion of the diagnosis (47). Children with CP commonly exhibit tonal abnormalities, such as hypotonia, hypertonia, or a combination of both.

Exion moment in terminal stance Femoral Rotational Osteotomy In-toeing, genu valgum, tripping •c Femoral anteversion •c Hip internal rotation •T Hip external rotation •c Hip internal rotation throughout gait cycle Medial Hamstring Lengthening Inability to stand up straight, walks with knees bent Anterior knee pain, fatigue with prolonged walking •Straight leg raise limited Ͻ60° •T Popliteal V angle Ͻ130° •Spastic response to fast stretch of hamstrings •c Knee flexion during loading response Rectus Femoris Transfer Stiff knees, toe dragging, tripping (ϩ) prone rectus test (Duncan-Ely) •TDynamic ROM Ͻ80% normal •Delayed and T peak flexion in swing phase •Activation of rectus femoris during midswing •(ϩ) coactivation of vastus lateralis during midswing Gastrocnemius Lengthening Walks on toes, toe dragging, tripping, in-toeing •T Passive ankle dorsiflexion •Clonus •c Achilles DTR •Excessive plantarflexion in stance and swing phase •Disruption of all 3 ankle rockers in stance phase •Absence of internal dorsiflexion moment in loading response •c Internal plantarflexion moment in midstance •Premature activation of the gastrocnemius in stance phase, beginning at initial contact •Variable knee alignment during mid- and terminal stance •T Knee extension in terminal swing •c Internal or external moment during stance •Prolonged medial hamstring activity into midstance DTR, deep tendon reflex; ROM, range of motion.

A definitive diagnosis of CP is rarely made before age 6 months and many times much later, but certain clinical findings should arouse suspicion of the diagnosis (47). Children with CP commonly exhibit tonal abnormalities, such as hypotonia, hypertonia, or a combination of both. Hypotonia may be identified by increased ROM of the shoulders and hips. Hypertonicity of the lower extremities may be present if the infant displays a scissoring posture of the legs. Asymmetry of movement or posture between the right and left sides of the body should be evaluated for possible dysfunction (47).

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