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APENS!
Due dates coming in March (15th) for the AAHPERD test date and
in April (15th) for the June 1st test date.
APPLY TODAY AND BECOME A CAPE!
To assist you in this process, here's a review of the latest information
(published in our October 1, 2001 newsletter):
APENS! What is it? What's the purpose? How can I be certified?
New
certification options you won't want to miss!
a. "APENS" refers to the Adapted Physical Education National
Standards.
b. The purpose of the Adapted Physical Education National Standards
(APENS) Project is to ensure that physical education instruction
for students with disabilities is provided by qualified physical
education instructors. To achieve this end, the project has developed
national standards for the profession and a national certification
examination to measure knowledge of these standards.
c. New information, beginning this year, the examination and certification
application has been divided into a 2-part process. Part One (Examination
Application) is now a shorter application requesting the basic information
necessary to sit for the examination. Part Two (Certification Application)
consists of the remainder of the application process, which is necessary
in order to receive certification after passing the examination.
Dividing the application process makes it both easier and quicker
for individuals to complete the process necessary to take the examination.
Individuals may wait until receiving their examination results before
submitting Part Two, or submit both Part One and Part Two together,
prior to the examination, if desired. Application materials for
the June 1, 2002 examination must be received prior to April 15,
2002 to be processed for that year. Applications received after
the April 15th deadline will only be processed for the following
year's examination. For additional examination opportunities and
deadlines visit the Common Questions
Page of the website
Also beginning this year, there are two additional options for
individuals who want a non-examination option to become a Certified
Adapted Physical Educator (CAPE) or do not meet our current examination
and certification criteria.
-- One of these options is for General Physical Educators and
the other;
-- Professionals in Higher Education, Agencies, and/or Organizations.
These individuals can apply to become a Certified Adapted Physical
Educator (CAPE) without taking the examination IF they meet the
alternative criteria described in Section #2 of each of the applications.
Both of these options will only be available from 2001-2005.
If you have any questions concerning the various applications or
eligibility criteria, please contact the APENS toll free message
phone at 1-888-APENS-EXam (1-888-273-6739) or email us at apens@twu.edu.
Be sure to leave a detailed message, which includes a phone number
and the best time to return your call.
Chris Stopka
University of Florida
Adapted Section Editor
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| If you have ideas, comments, letters to share, or questions
about particular topics, please email one of the following Adapted
PE Section Editors: |
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Five Physical/Medical
Disabilities for School-age Children
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1. CEREBRAL PALSY
"Cerebral palsy" refers to several types of neuromuscular
disorders, observed during the first years of life, caused by injury
to the brain. The damage can occur during the last stages of pregnancy,
during childbirth, or at any time prior to the second year of life.
Cerebral palsy is permanent with no possibility of brain tissue recovery,
however, undamaged nerve cells and nerve cell pathways can partially
compensate for the affected tissue. Therefore, early intervention
strategies, including exercise therapy, are critical to optimize the
situation. Physical and occupational therapy, as well as psychological,
speech and nutritional therapy are needed for a child to learn to
cope with the various emotional, physical, psycho-social and educational
challenges. Symptomatic severity for those afflicted with cerebral
palsy varies from fine motor task problems, to balance and walking
difficulties and involuntary movements such as spasticity. Contrary
to popular opinion, new research concerning resistance training in
persons with cerebral palsy concludes that resistance training does
not cause an exacerbation of spasticity. Indeed, resistance training,
taken through the full range of motion, addresses the need for improved
strength, endurance and flexibility. This helps improve activities
of daily living; for example, gait problems associated with cerebral
palsy also require a greater oxygen expenditure; an increase in aerobic
fitness addresses this need.
2. NEURAL TUBE DEFECTS
Some of the more commonly seen neural tube defects are encephalocele
(where the brain is formed outside of the skull; which is nearly always
fatal) and spina bifida (or cleft spine), where all or some of the
spinal cord and its associated tissue are formed external to the spinal
canal (myelomeningocele and meningocele), or spinal bifida occulta
(which is fortunately benign as the name implies, and simply consists
of a vertebral spinous process or two which did not fully close).
Thus, spina bifida is a birth defect in which there is a defective
closure of the vertebral column during prenatal development. The nerve
damage (in the more serious myelomeningocele or meningocele types
of spina bifida) is permanent even though it is possible to surgically
repair the spinal opening shortly after birth, and some cases, shortly
before birth. The nerve damage varies in severity, but usually results
in varying degrees of paralyses to the lower limbs. There may actually
be no open lesion, but damaged vertebrae, and associated paralyses.
Problems related to spina bifida may be bowel or bladder complications,
and hydrocephalus. The child with spina bifida may have a number of
surgical procedures throughout their lifetime. They may require assistive
devices such as wheelchairs, braces, or crutches. Sufficient ingestion
of folic acid by the parents before conception now believed to be
a significant prophylaxis for preventing, and lessening the severity
of, neural tube defects. Thankfully, more foods are being fortified
with this vitamin. Although exercise capacity is limited with myelomeningocele,
a well rounded exercise therapy program, including physical fitness
activities, should be encouraged. A decreased VO2 max should be anticipated
and adjusted for in goal setting for children with neural tube defects.
For those using assistive devices, a relationship between muscular
endurance and wheelchair propulsion improves with endurance and resistance
training for children with both cerebral palsy and myelomeningocele.
3. SPINAL CORD INJURY
Damage to the spinal cord can occur from either a traumatic injury,
or from a disease to the vertebral column. The spinal cord can be
bruised, or even torn as a result of injury. Injuries prevent the
spinal cord from relaying messages between the brain and various parts
of the body. The degree to which the body is affected varies according
to the individual and the type of injury sustained. There are levels
of injury determined by the place on the spinal column that the damage
occurred. There may be a decrease or absence of feeling at the sensory
level, and/or movement at the motor level. Quadriplegia is a condition
of a person whose injury is from the level C1 to T1 of the spinal
cord. The effected areas are the head, neck, shoulders, arms and/or
upper chest. Paraplegia is a condition of a person whose injury is
from T2 to S5 of the spinal cord. The affected areas are the chest,
stomach, hips, legs and feet. The amount of feeling or movement loss
that a person experiences will depend on weather the injury is complete
or incomplete. The term "complete" means that there is no
sensory or motor function below the lesion level; conversely, "incomplete"
implies there is some residual function, as some spinal communication
remains intact. Realistic goals must be set for the specific level
of injury sustained by the individual. An exercise prescription must
be designed specifically for the amount of motor and sensory function
possessed by the individual. Affected limbs can be stretched passively
with assistance to avoid joint contractures.
(rest of article continued in next column) |
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CEREBRAL PALSY
Fowler, EG, et al. (2001) The effect of quadriceps femora's muscle
strengthening exercises on spasticity in children with cerebral
palsy. Physical Therapy, 81(6) : 1215-23.
Unnithan, VB. (1999). Role of mechanical power estimates in the
O2 cost of walking in children with cerebral palsy. Medicine Science
Sports Exercise, 32(12): 1703-8.
NEURAL TUBE DEFECTS
Sherman, MS. et al. (1997). Pulmonary dysfunction and reduced exercise
capacity in patients with myelomeningocele. Journal Pediatrics.
131(3): 413-8.
O'Connell DG, et al. (1992). Muscular endurance and wheelchair
propulsion in children with cerebral palsy or myelomeningocele.
Archives Physical Medical Rehabilitation. 73(8): 709-11.
SPINAL CORD INJURY
MUSCULAR DYSTROPHY
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Questions to Ask, or
Thoughts to Share?
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Five Physical/Medical
Disabilities for School-age Children Cont'd
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4. MUSCULAR DYSTROPHY
Muscular dystrophies are genetic disorders characterized by progressive
muscle wasting and weakness that begin with microscopic changes
in the muscle. Duchenne's muscular dystrophy begins as early as
age two or three in boys. The disease gradually degenerates the
skeletal and voluntary muscles in the arms, legs, and the trunk.
During the early teens the heart and lungs may also be affected.
The disease usually claims its victims by age 20. Becker's muscular
dystrophy is a milder form of DMD. The onset is usually later in
the teens or early adulthood, and the progression is slower. There
is no set age expectation for death, and lifespan depends on the
health of the individual coupled with the severity of the disease.
There is no cure for the disease. Diagnosis is done through clinical
tests, blood tests, biopsies, and now genetic testing. DMD occurs
when a particular gene on the X chromosome fails to make the protein
dystrophin. BMD results from a different mutation on the same gene.
Those with MD progress through a definitive course of stages which
gradually require the use of more intensive assistive devices such
as, braces and crutches; manual wheelchairs; electric wheelchairs,
lifts, respirators, etc., until death occurs, usually due to apnea,
pneumonia, or heart failure. Despite the prognosis of this disease,
the quality of life for the child with MD can be drastically improved
by regular exercise and recreational therapy.
5. DIABETES
Although increasingly more cases of adult-onset diabetes (Type II)
are occurring in children as young as age nine (due to lack of enough
exercise and obesity), most children with diabetes have Type I diabetes.
Type I is considered an autoimmune disease because the immune system
attacks and destroys the cells of the pancreas. (In Type II, a decreased
amount of insulin is still produced, coupled with it being less
effective). The Beta-cells of the pancreas produce the hormone insulin.
Without insulin the body cannot convert glucose into energy. Insulin
replacement for Type I diabetes is done by injection. Some children
may have an insulin pump. A strict treatment plan must be followed
to have an optimum quality of life. Otherwise the child with diabetes
can do most of the same activities as the other non-diabetic children.
Children who take insulin may have episodes of low blood sugar or
hypoglycemia. This can occur when they have not eaten their snacks
or meals, taking too much insulin, or have exercised more than usual
without compensating with a snack. Loss of consciousness can occur
if the blood sugar continues to drop. Conversely hyperglycemia or
high blood sugar can also be a problem for children with diabetes.
This can be caused by overeating, not getting enough insulin, or
by illness. Symptoms include nausea, vomiting, fruity odor to breath,
rapid, deep breathing, lethargy and sluggishness. Exercise increases
insulin sensitivity (the ability of target cells to process it),
and thus is an invaluable treatment for this disease. |
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