What is a Stroke?

A stroke occurs when blood flow to the brain is cut off due to a blood clot.1 When the blood flow is cut off the brain cells become deprived of oxygen and begin to die.1 A stroke is similar to a heart attack but it occurs in the brain, a “brain attack”.1 How a person is affected by the stroke depends on where the blood clot occurred and how long the brain is damaged.1 There are two different strokes that can occur; a hemorrhagic stroke and an ischemic stroke.1  

Hemorrhagic strokes are the least common of strokes and only account for 15% of all strokes.1 A hemorrhagic stroke is either a brain aneurism burst of weakened vessel leak.1 An intracerebal hemorrhagic stroke occurs when a diseased blood vessel within the brain bust allowing the blood to leak inside the brain.2 A subarachnoid hemorrhagic stroke occurs when a blood vessel just outside the brain ruptures allowing blood to fill around the brain.2 Although a hemorrhagic stroke only accounts for 15% of strokes, they are responsible for about 40% of all stroke deaths.1

An ischemic stroke occurs when a blood vessel carrying blood to the brain is blocked by a blood clot.1 Ischemic strokes account for 87% of all stroke incidents.1 There are two different types of ischemic strokes. An embolic stroke occurs when a blood clot or plaque fragment forms somewhere in the body and travels to the brain.1 About 15% of embolic strokes occur in people with atrial fibrillation.1 A thrombotic stroke occurs when a blood forms inside one of the arteries supplying blood to the brain.1 This type of stroke is more prevalent in people with high cholesterol.1

A stroke is similar to a heart attack in the aspects of living a healthy lifestyle can help prevent or lower your odds of suffering a stroke. Some statistics on strokes include:

·      Each year 800,000 people experience a new or recurrent stroke.1

·      A stroke happens every 40 seconds.1

·      Stroke is the fifth leading cause of death in the U.S.1

·      Every 4 minutes someone dies from a stroke.1

·      Up to 80 percent of strokes can be prevented.1

·      Strokes are the leading cause of disability in the U.S.1

Take the extra cautions and steps of a healthy diet, exercise and annual check ups at your doctor to prevent yourself or someone you love from suffering from a stroke.

1What is stroke? (2014, July 16). Retrieved November 23, 2015, from http://www.stroke.org/understand-stroke/what-stroke

2The Internet Stroke Center. (n.d.). Retrieved November 23, 2015, from http://www.strokecenter.org/patients/about-stroke/ischemic-stroke/

Elbow Injuries in Volleyball Players

As mentioned in my blogs throughout this semester, we have noticed how the knee and the shoulder take quite a bit of brutality throughout the sport of volleyball. The majority of the workloads are centered on those two joints, but an area of the body that we don’t give enough credit to is the elbow. This joint actually takes a lot of the brute force to provide the shoulder the energy it needs to provide a powerful kill shot.

A hinge joint just like the knee, the elbow only flexes and extends which is supported by multiple ligaments on either side of the joint. When the elbow is forced past its normal range of motion of flexion or extension, as well as injured from either side of those ligaments, damage can be done; tendons or muscles can also be strained due to injury.1,2

The injury discussed in this blog today is lateral epicondylitis, otherwise known as tennis elbow. This is a chronic injury that comes from overuse of the elbow; tendon damage occurs where the forearm muscles attach to the lateral epicondyle of the elbow.1 Signs and symptoms of this injury are pain on the outside of the elbow, strength deficits when lifting or grasping objects, and radiating pain down the arm.1,2,3 Direct impact or overuse of the forearm muscles are the more common causes of this injury occurring.1

Treatment options focus on the acronym RICE: which stands for rest, ice, compression, and elevation.1 Anti-inflammatory medicine such as ibuprofen can be prescribed to decrease the swelling and pain within the joint.1 Also, elbow braces can be used to put pressure on the distal end of the elbow to release the tension from the forearm muscles.1 Lastly, physical therapy can be extremely beneficial in the recovery process so that modalities such as ultrasound can be used to alleviate pain and strengthen muscles surrounding the joint.1

In conclusion, lateral epicondylitis is a very nagging-like injury that typically won’t go away on its own. It takes time, rest, and rehabilitation to truly resolve the pain.

References:

1.      Quinn, E. (2015, August 27). Do You Have Tennis Elbow? Retrieved November 6, 2015, from http://sportsmedicine.about.com/cs/elbow/a/elbow2.htm

2.      Elbow Injuries and Elbow Pain. (2014). Retrieved November 6, 2015, from http://softtissuecenter.com/elbow-injuries-and-elbow-pain/

3.      Volleyball is played by an estimated 800 million people in 130 countries. (2009). Retrieved November 6, 2015, from http://www.armrehab.com/non_surgical_sports_medicine_volleyball.html

Popping Pills for Weight Loss (and other unhealthy ideas)

Brace yourselves. There is a new pill on the market called Vysera CLS that was recently approved by the FDA. But given the FDA’s history for allowing harmful products to be introduced to the American people, we should move with certain caution. Once again, a pill is being touted as the “miracle pill,” the pill that can transform a body in 30-days! In a way that imitates a gastric bypass, the pill reportedly reduces the stomach. 

Here’s how: The pill dissolves in the stomach cavity, leaving a balloon which can be will with fluid in an outpatient procedure. Enlarged to the size of a grapefruit, there is little room for food and patients reportedly felt full, thus the weight loss. After six months, the balloon is deflated and removed through the mouth.

Pros

• ReShape, the company of the miracle pill, released amazing results in which subjects lost up to 25% of their body weight. Enthusiastic early reports backed by the British Journal of Nutrition and Obesity Surgery found that improvement in liver function, insulin resistance, triglycerides and A1c levels, in addition to the weight loss. Even more amazing are the claims that ReShape melts away fat on those trouble spots – hips, thighs, buttocks, belly, and love handles, while the patient can consume up to 2,000 calories per day.

Cons

• While the product was aggressively pushed for approval, there is little known about the pill other than seven out of eight subjects who received the balloon experienced nausea and five vomited in the first week. Of the 264 subjects, 15% asked to have the balloon removed early due to the continued discomfort.
• The cost is estimated to be between $5,000 to $10,000. And with unknown long-term effects, this is a pricey “miracle” for many.
• Too many professionals with a vested interest in the price tag that comes with this “miracle” are endorsing the product without further research and results.

Reality

• We must not judge or berate those suffering with obesity looking for a medical help. Instead, we must change general attitudes about healthy living and losing weight which includes identifying marketing gimmicks that may be unhealthy, even dangerous and reintroduce the once tried-and -true solution – fitness and nutrition.
• The statistics of failed gastric bypass procedures is incomplete as many patients are too embarrassed or frustrated to report their results but we know that there is a significant increase in failure following five to ten years following the procedure. Similarly, sleeve gastrectomy have poorer long-term results throwing further red flags for "miracle" promises.
• With instant results and no effort, none of these procedures can be effective long-term. It is a lifestyle change that requires commitment to exercise, healthy eating, learning to cook, downsizing meals while still maintaining good nutrition that will ultimately bring success and happiness.

What is Adaptive Physical Education? And Why Do We Need it in the School System Today??

Adapted Physical Education (APE) is a specially designed physical education program which uses accommodations and modifications to meet the needs of students who require developmental or corrective instruction in PE. For example, a game of catch can be adapted in multiple ways based on the needs of a student. A ball with a bumpy texture or with a bell inside can be used for students with tactile or auditory needs, the distance the ball is thrown or bounced can be decreased for students , or a scarf could be used for students who do not have full ability of their arms.

In the school systems that I have been in there has seemed to be a shortage in APE teachers and programs. For example, in the Stephenville schools I have noticed that students with special needs or disabilities are basically getting pushed to the back of the line. This is by no means right in any way at all. Congress enacted a law in 1975 that gave all children with disabilities the opportunity to receive a free public education just like normal children. This was to be called IDEA, “Individuals with Disabilities Act”.(1)  Over the last year and half while substituting for schools in Erath County,it seemed  that the APE program did not exist at all. I did notice that from the 6th grade and below there was a small amount of PE or recess time for these students. Then once the students were between 7-12th grade there was no PE or recess for them. The students in the high school only go outside for 30 minutes a day, otherwise they stay inside the school the entire day. During PE class they attend normal PE however the students who are confined to wheelchairs just sit off to the side with the teachers. The students who are able to walk/run on their own are basically just told to walk around the outside of the basketball court. None of the students with disabilities get any sort of physical activity that.

The national standards for APE are set by the Adaptive Physical Education National Standards APENS.(2) Federal law mandates free and appropriate public education services for all children with disabilities. Subsequently, the law mandated that these services be provided by qualified professionals. The definition of special education within this law included the discipline of physical education.

Adaptive Physical Education Standards

“APENS”

At the end of my last blog “The Need to have Adaptive Physical Education in the School Systems”, I ended by giving a brief introduction to APENS. Federal law mandates free and appropriate public education services for all children with disabilities. Subsequently, the law mandated that these services be provided by qualified professionals.Within this law, the definition of special education included the discipline of physical education.(3) In the United States there are only 14 states that have defined an endorsement or certification in adapted physical education. The worst thing,in my opinion,  is that 36 states don’t do not recognize nor endorse the certification their teachers need to provide adequate adapted physical education to the students with disabilities.

The sole purpose of APENS is to ensure that physical education is taught to students with disabilities by a certified and qualified teacher of physical education. The APENS devised a set of 15 National Standards that must be met in order to become a qualified adaptive physical education teacher. Along with this APENS established a national certification exam to measure specialized content.

15 National Standards:(4)

1. Human Development
2. Motor Behavior
3. Exercise Science
4. Measurement and Evaluation
5. History and Philosophy
6. UNIQUE ATTRIBUTES OF LEARNERS
7. CURRICULUM THEORY AND DEVELOPMENT
8. ASSESSMENT
9. INSTRUCTIONAL DESIGN AND PLANNING
10. Teaching
11. CONSULTATION AND STAFF DEVELOPMENT
12. STUDENT AND PROGRAM EVALUATION
13. CONTINUING EDUCATION
14. Ethics
15. COMMUNICATION

To see all of the standards in their full description you can acquire the guide Adapted Physical Education National Standards Guide.(5)

The goal of APENS is to promote a nationally certified Adapted Physical Educator (CAPE) – the one qualified person who can make meaningful decisions for children with disabilities in physical education – within every school district in the country.(4)

How to become an Adaptive Physical Education Teacher

Adapted physical education teachers are physical education teachers that are trained to evaluate and assess motor competence, physical fitness, play, recreation, leisure, and sports skills. Adapted physical education teachers are then capable of developing and implementing an IEP program based on the findings of their assessment.

APE teachers must have knowledge and competencies in the following areas: (6)

• Developmental teaching methods in physical and motor fitness, fundamental motor skills, and skills in individual sports and other activities, as well as group sports and games
• Knowledge of motor control for teaching physical education to individuals with disabilities
• Knowledge of developmental sequences and motor characteristics associated with a number of disabilities
• Skills in a number of physical education techniques and procedures for developing individualized education programs in PE

APE teachers are not occupational therapists (OT) or physical therapists (PT). OT’s are trained to address skills associated with activities of daily living, work activities, and play and leisure activities. PT’s are trained to provide services that address mobility assistance, range of motion, gait therapy, and other interventions. Both OT’s and PT’s provide their services through a physician’s prescriptions to address medical conditions, as opposed to working with students in a physical education environment.

If specially designed instruction, such as adapted physical education (APE), is required in a student's Individual Education Program (IEP), then the services must be provided by a qualified teacher. A certified physical educator is legally qualified to provide adapted physical education for students who require specialized physical education as defined in the IEP. Adapted Physical Education certification is not required in Colorado. However, it is suggested that the teacher providing APE services become Nationally Certified through the National Consortium for Physical Education and Recreation for Individuals with Disabilities, earning a CAPE (Certified Adapted Physical Education) certification. Course work in APE is strongly recommended and additional education and/or experience in special education would be beneficial. (7)

Reference:

1. http://www.parentcenterhub.org/repository/idea/
2. http://www.apens.org/national_standard.html
3. http://www.apens.org/national_standard.html
4. http://tsukinegradprogram.blogspot.com/2015/09/the-need-to-have-adaptive-physical.html
5. http://www.humankinetics.com/home
6. http://www.peteacheredu.org/adapted-physical-education/  
7. https://www.cde.state.co.us/cdesped/ape

Can You Work Out Too Much? Muscle Hypertrophy

I see the way people look at me the first time they walk into my fitness classes. I don’t fit the fitness mold. I’m solidly built. I’m over 140 lbs. So when I get that ‘how good can you be’ look I chuckle to myself. I’ll see you in six minutes when you’re licking the floor and I’m still counting!

My background is powerlifting, martial arts, competitive fighting, US women’s bobsled team, and (briefly) women’s professional football. While on the bobsled team, it was my lifting that made the history books because I was pregnant at the time. Upon retirement, my goal was to lean out but it proved impossible. Couldn’t do it. No diet, no shake, no training could transform my body back to what it once was. So I did what any other sane person would do. I tripled the work. It worked for bobsled, why not real life? One example: While training for a marathon and teaching fitness classes, I was logging more than 30-40 miles of running per week with 10 hours of fitness classes (kickbox, boxing, bootcamp, cardio, and Pilates), and weightlifting yet the scale never budged. People would openly ask how it was I wasn’t a size 0 or why I wasn’t “skinny.” My diet was critiqued. My thyroid was pondered. My dedication was questioned. It sucked.

While pregnant on the bobsled team, researchers at Case Western documented my workouts and so I returned almost two decades later to ask why I was stuck in my present state. I have studied and know all about plateaus. Would I die in a perpetual state of bobsled plateau or was something else going on? That was when I learned about muscular hypertrophy and it all made sense. In essence, my workloads exceeded pre-existing capacity of the muscle fiber.

My what exceeded what? It goes like this: When you work out there is cell/muscle injury causing cell swelling. It is the recovery that then helps the muscle mend and, in response, swell but with hypertrophy the enlarged muscle cells perform at a far greater level of activity. The muscle breakdown does not occur (or certainly, not as much), each muscle fiber manages the workload more easily and, to the frustrated athlete working harder and harder and harder, physical results are fewer and fewer and fewer. The good news was my body was handling the workload like a champ. The bad news was my champ body resembled a Russian wrestler on steroids.

The diagnosis is in. I have muscular hypertrophy. For the first time in almost two decades of being the hardest working woman in a gym (or trying to be), I am redesigning my workouts for less intensity, more stretching, and muscle confusion.

Please be on the lookout for what’s next: Is Muscle Confusion Even a Thing?