1 Stroke Recovery Prognostic Factors

Question 1

What is the general prognostic factor of a hemmorhagic stroke?

Answer 1

50% mortality rate but if person survives, the morbidity rate is lower

Question 2

What is the general prognosis for ischemic stroke?

Answer 2

• Slowly developing lesions
• Low mortality but HIGH morbidity

Question 3

Describe the lesion size and position’s affect on outcomes

Answer 3

• Size is less important than area of the brain
• Large lesion = more deficits
• Frontal/temportal lesions have poorer outcomes
• Temportal lesions result in ahpasia have poor outcomes (less % discharged home)

Question 4

How does time affect outcome?

Answer 4

• Better functiona otucome with earlier rehabilitation
• watch for aggressive rehab
• early avoid heavy effort until day 5 with larger lesion
• Uninvolved side can inhibit damaged side
  
  • Compensation = poor quality of recovery for UE and LE but god for muscles

Question 5

How does the lesion extension affect treament?

Answer 5

• Watch for too early rehab intensity post CVA
• Increased brain temp can lead to use of O2
  
  • Balance damage with cooling device to reduce demand of O2 to brain

Question 6

What is the age prognosis?

Answer 6

• best <35
• ok up to 55
• Poor 75+
• infants and todlers have better prognosis than children

Question 7

What are the PERIPHERAL affects of CNS lesions?

Answer 7

• Paralysis leads to stiff muscles
• fast twich convert to slow twitch (high fatigue)
• # functional motor units decreases by have 2-6 months after stroke
• Secondary problems such as loss of ROM associated with muscle fibers changes

Question 8

What is genetic polymorphism?

Answer 8

• Not disease-causing but can impact underlying systems, espcialy when interacting with certain other genetic variations
• impacts individual response to neuroplasticity and interventions
• The person

Question 9

What is BDNF?

Answer 9

• Neurotrophic important for neuroprotenction and genesis and neuroplasticity
• Enhances synaptic transmission and facilitating logn term potentiation that supports learning
• Activity dependant

Question 10

What is BDNF’s relationship with exercise? + dosage?

Answer 10

• Bike better than treadmill (aerobic exercise)
• Intensity matters (higher)
• Primes system for motor training
  
  • skilled and challenging
• Dosage:
  
  • 3 x weekly 30 min
  • only last 1 hour after ex