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CHAPTER OBJECTIVES

CHAPTER OBJECTIVES

At the completion of this chapter, the reader will be able to:

  1. Discuss the physical therapy role with a variety of orthopaedic subtypes and the challenges each present.

  2. Describe the various pathologies of these populations regarding the presentation and the role that physical therapy plays.

  3. Define the differences between the various acquired and congenital conditions that can impact the pediatric population.

  4. Describe the normal aging process as it relates to orthopaedics.

  5. Outline the various theories of aging.

  6. Describe the common pathological conditions and functional limitations associated with the geriatric population.

  7. Describe some of the conditions that can affect women’s health.

  8. Describe the physiologic changes that occur during pregnancy within the various bodily systems.

  9. Describe the physical therapy interventions for pregnancy-related dysfunctions.

  10. Describe the complications related to breast cancer-related lymphedema.

  11. Describe the common pathological conditions associated with some popular sports including swimming, rowing, throwing, tennis, and running.

OVERVIEW

OVERVIEW

There are some population subtypes that require special consideration regarding the orthopaedic examination and intervention. These include pediatrics and geriatrics, and the whole spectrum of women’s health. Each of these populations is described in this chapter.

THE PEDIATRIC ATHLETE

The term pediatric refers to the 0- to 21-year age range during which an individual undergoes many changes while aging, evolving, and maturing. The health risks such as obesity, low levels of physical activity, poor nutrition, and alcohol and drug use in this population have been the topic of public health campaigns for over a decade.1–4 While research frequently acknowledges the link between musculoskeletal pain and other health risks or chronic diseases (e.g., cardiovascular disease and diabetes) in the adult population, there are very few investigations that examine the extent to which pain may be a risk or prognostic factor for health risks (e.g., weight gain, inactivity, substance use) and chronic disease in the pediatric population.5 Delivery of more integrative services, and development of better links between existing clinical and public health programs, has the potential to reduce the impact of musculoskeletal pain and chronic disease in children and adolescents.5

During the preschool years, physical growth, neurologic growth, and maturation are quite rapid and apparent, with new skills being acquired at a quick pace.6 This process continues throughout the middle years (ages 6–11) at a somewhat slower pace. As a child enters puberty, the rapid development of physical and sexual characteristics becomes more apparent and is accompanied by important psychosocial development. It is important to remember that chronologic age does not necessarily correlate well with many physiologic and somatic changes.

CLINICAL PEARL

A typical adult has a smaller surface area-to-mass ratio and a lower metabolic rate than a child. These discrepancies result in a greater transfer of heat and a greater challenge to the thermoregulatory system, respectively, in the pediatric population.

The major characteristics of ...

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