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The Principles of Training (Exercise)

In this article, we will discuss the Principles of Training and The FITT Principle of Prescribing Aerobic Exercise. So, let’s get started.

Principles

Overload principle: An exercise overload specific to the activity must be applied to enhance the physiological improvement and bring a training response e.g. athletes, cardiac patient training program.

Specificity principle: Specific adaptations bring specific training effects e.g. swimming, bicycling, running, etc.

Individual difference principle: A person’s relative fitness level is important at the start of training and it is unrealistic to expect the same outcome for everyone with particular training.

Reversibility principle: Detraining occurs if a person terminates exercise program.

The FITT Principle of Prescribing Aerobic Exercise

Frequency: Number of days per week dedicated to exercise sessions.

Intensity: It determines how hard a person works in order to do then activity. It can be defined on the basis of either absolute or a relative scale. Absolute intensity refers to the amount of energy expended per min of activity while relative intensity takes a person’s level of exercise capacity or cardiorespiratory fitness into consideration to assess the level of effort.

Time: The length of time in which an activity or exercise is performed. Duration is generally expressed in minutes.

Type: The mode of exercise performed.

 

 

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Pathology and Clinical Features of Acute Empyema Thoracis

In this article, we will discuss the Pathology and Clinical Features of Acute Empyema Thoracis. So, let’s get started.

Pathology

In acute empyema, there is accumulation of large amount of pleural fluid with many polymorphs, bacteria, and cellular debris. Fibrin gets deposited on both layers of pleura (visceral and parietal) and there is a tendency towards loculation. Later, as the disease progresses (empyema becomes chronic), fibroblasts grow from both the layers into the exudate resulting in adhesions of both the surfaces of pleura and form an inelastic membrane called thickened pleura or pleural peel.

Clinical Features

Patients with aerobic infection (parapneumonic pleural effusion) present with acute onset of fever with chills, productive cough with mucopurulent expectoration (bronchopleural fistula), dyspnea and chest discomfort.

Patients with anaerobic infection present with subacute illness with non-specific signs and symptoms such as weight loss, leucocytosis, mild anemia and history of predisposing factor for aspiration from the oral cavity. Tubercular empyema presents with long-standing (for weeks and months) low-grade fever along with weakness and cough.

In acute phase, there are signs of toxemia such as fever, tachypnea, tachycardia, and pleural effusion. Presence of tenderness on percussion with some edema of the chest wall. Clubbing of fingers and toes are usually seen. Rarely there is a sign of empyema necessitans (empyema may track into the subcutaneous tissue of chest wall and presents as a localized swelling with positive cough impulse, and is mostly seen with actinomycotic infections).

Chronic cases present with pleural thickening and loculation of pus will show significant deformity with retraction of chest on the same side of empyema and even scoliosis. The signs will be dull percussion note with diminished breath sounds. extensive pleural calcification may occur. Tubercular empyema is often chronic and present with thickened pleura.

Gastrectomy

In this article, we will discuss the general points about Gastrectomy. So, let’s get started.

Gastrectomy

  • It is defined as the removal of the whole or part of the stomach.
  • It is mostly indicated for stomach/duodenal ulcers; however, recently it is used primarily for gastric adenocarcinomas, primary gastric lymphomas or leiomyosarcomas.
  • Gastrectomy is either partial, total or sleeve.
  • Antrectomy, a limited form of gastrectomy in which the antrum(part of the stomach) is removed.
  • Gastrectomy can either be performed via open surgery or laparoscopic surgery.
  • Risks include acid reflux, diarrhea, gastric dumping syndrome, infection, internal bleeding (hemorrhage), leakage from the site of incision (operation), nausea, vomiting, stomach acid leaking into the esophagus causing scarring, narrowing or constriction (stricture), vitamin deficiency, weight loss, dyspnea, pneumonia or damage to the adjacent structures.
  • Vitamin and mineral supplementation is necessary post gastrectomy.

 

Modified Ashworth Scale

In this article, we will discuss the Modified Ashworth Scale. So, let’s get started.

Modified Ashworth Scale

Modified Ashworth Scale is used as a simple measure of Spasticity (muscle tone).

0 – No increase in muscle tone

1 – Slight increase in muscle tone, manifested by a catch or by minimal resistance at the end range of motion when the affected part moves in flexion or extension.

1+ – Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder range of motion.

2 – More marked increase in muscle tone through most of the range of motion, but the affected part/parts easily moved.

3 – Considerable increase in muscle tone, passive movement becomes difficult

4 – Affected part/parts rigid in flexion or extension.

Pathophysiology of Chronic Obstructive Pulmonary Disease (COPD)

In this article, we will discuss the Pathophysiology of Chronic Obstructive Pulmonary (COPD). So, let’s get started.

Pathophysiology

Airflow obstruction (both large and small airways), hyperinflation due to air-trapping resulting in large voluminous lungs and inadequate gas exchange leading to hypoxemia and hypercapnia which are the most frequently encountered changes that constitute the clinical picture of COPD. A persistent reduction in the expiratory flow rate is the hallmark of COPD. An increase in residual volume, ratio of residual volume to total lung capacity, uneven ventilation, and ventilation-perfusion mismatch occur in COPD. Changes in the large airways (bronchitis) produce cough and sputum while changes in the small airways and alveoli are responsible for hypoxemia and hypercapnia. In most cases both bronchitis and emphysema are present but their relative contribution to obstruction varies from person to person.

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