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presented by Karen L. McCulloch, PhD, PT, MS, NCS(E), FAPTA, FACRM
Financial: Karen McCulloch has past and current grant support for research from the U.S. Department of Defense. She serves as assistant editor for Elsevier, for which she receives royalties. She receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Nonfinancial: Karen serves on editorial boards for Brain Injury, Journal of Neurologic Physical Therapy, and Journal of Head Trauma Rehabilitation. She has no competing nonfinancial interests or relationships with regard to the content presented in this course.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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Karen L. McCulloch, PhD, PT, MS, NCS(E), FAPTA, FACRM
Karen L. McCulloch is a professor in physical therapy in the Division of Physical Therapy, Department of Health Sciences, School of Medicine at University of North Carolina at Chapel Hill, where she has taught entry-level and advanced-level students in neurorehabilitation since 1993. She has served in multiple roles within the Academy of Neurologic Physical Therapy,…
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1. Autonomic Nervous System Dysfunction
The central and peripheral components of the ANS are reviewed with a focus on how these elements interact during postural transitions and during exercise. In addition, the importance of links within the ANS to the limbic system is reviewed, emphasizing the role of perceived threat on sympathetic responses and how this may manifest in neurologic conditions.
2. When Autonomic Dysfunction Is Hypotensive
Neurologic hypotension can commonly occur in spinal cord injury, Parkinson’s disease, and other neurologic conditions. Methods for assessment and self-report of hypotensive responses are reviewed to provide outcome indicators. Intervention approaches are reviewed for postural transitions and during exercise.
3. Paroxysmal Autonomic Responses: Hypertensive Activity
The physiology of abnormal blood pressure responses driven by neurologic dysfunction is reviewed in instances of traumatic brain injury and spinal cord injury. A patient example (Guillain-Barré syndrome) emphasizes the importance of activity-based blood pressure monitoring for patients with neurologic conditions to detect hypertensive responses.
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