NSCA CPT H22

results in the impairment or loss of motor function or sensory function in the trunk or limbs due to irreversible damage to the neural tissues within the spinal canal

if the injury occurs between the highest thoracic (T-1) and highest cervical (C-1) segments of the spine, impairment of arms, trunk, legs AND pelvic organs occur (quadriplegia= tetraplegia)
T-2 to T-12 causes impairment of trunk, legs OR pelvic organs or in more than one of these (paraplegia)

injury to the spinal cord has been only partial, some sensation or motor function at least partially intact below the level of injury

*T-3/T-4 and above are prone to symptomatic bradycardia (low HR), primary cardiac arrest and serious cardiac conduction disturbances

Omdraaien

Orthostatic hypotension, autonomic dysreflexia (AD), impaired transmission of cardiogenic pain (T-4 and above), quadriplegic cardiac atrophy (loss of left ventricular mass), loss of reflex cardiac acceleration (T-1 through T-4 and above), atrial fibrillation and other cardiac conduction disorders, congestive heart failure, pseudomyocardial infarction (abnormal ST-wave changes), sudden death due to asystole (stilstaan hart), ahterosclerosis and its manifestations of angina pectoris (hart kramp) and myocardial infarction

Omdraaien

results from noxious stimuli such as distended. bladder or bowel, constricted clothing and infections that cause heightened sympathetic nervous system activity resulting in the sudden onset of hypertension (AD can be lifetreathening)

**beschadiging van het ruggenmerg boven het niveau van de middelste borstwervels. Door deze beschadiging is er overactiviteit van het sympathische deel van het autonome zenuwstelsel resulterend in hypertensie

Omdraaien

shoulders, wrists and elbows

disorders of temperature regulation, unable to adequately thermoregulate through sweating or shivering
- wet suit in cool pool, cool water when hot, adequate hydration, good nutrition and fluid intake, loose fitting/lightweight/breathable materials, cool water/sport drinks, beware of burns of cold- and heat packs

venous return, particularly ni seated or upright posture due to lower limb venous pooling secondary to lack of sympathetic tone and absence of the venous muscle pump, limits degree of cardiovascular trainability and can result in HYPOTENSION during exercise
- training supine posture (improve upperbody arm exercise), use gradient style compression hosiery (prevent swelling lower extremities)

Omdraaien

- metabolic disturbances: insulin resistance and hyperinsulinemia
- frequencies of dyslipidemia, hypertension and CVD
- tetraplegia; atrophy of cardiac muscle; cardiac dysfunction, impairing exercise tolerance and increasing risk for congestive heart failure
- shortness of breath, excessive sweating, fatigue, light-headedness or sensation of fainting and palpitations

Omdraaien

- reduce the capacity to support high rates of breathing frequency, HR, cardiac output and metabolism

- arm crank ergometer, because of high risk of cardiovascular impairment (maximal testing only in medical setting), submaximal cardiorespiratory fitness testing, wheelchair ergometers

- above T-6 (tetraplegia) reduced cardiorespiratory fitness; tetraplegia problems for cardiorespiratory training in upright posture, peak HR 120-130

Omdraaien

upper body peripheral vasodilation during exercise is not compensated adequately by concomitant lower limb vasoconstriction; reduces central circulatory volume and thereby limits hemodynamic responses to exercise

total volume of air forcefully exhaled

Omdraaien

- 40-60% of maximal oxygen uptake, 10-20 minutes, 3 days/week or every other day
- 8-12 exercises, 40-70% of 1RM, 2-3 sets, 8-12 reps, 1-2 minutes of rest between sets

minimum of 30 minutes or more of physical activity on most of all days of the week

spasticity (exaggerated muscle tone and reflexes which can impair the ability to exercise; w-up with systematic, progressive increase in intensity and slow-paced muscle action during RT can limit spasticity

Omdraaien