Chpt.1 CVA accident (shoulder) Flashcards
What are 5 Progressive Neurological Conditions
- MS
- PD
- Dementia
- ALS
- MD (muscular dystrophy)
What are 3 Non-progressive Neurological Conditions
- CVA
- TBI
- Spina Bifida
What are 5 affects/deficits from Neurological conditions
- Motor
- Neglect
- Aphasia
- Visual deficits
- LOC (level of consciousness)
What are 6 OT goals for CVA patients?
- Properly positioning
- Maximize AROM, PROM, strength + coordination
- Trying to get back Cognitive + perceptual deficits
- Maximize MOBILITY
- Develop adaptation
- Prevention of deformity + contracture
*****What are 4 deficits after having a LEFT- CVA (Right- Hemi)
- depressed/quiet/cautious/
- aphasia (language;speaking)
- Decreased mathematical ability
- apraxia (motor planning prob)
**What are 4 deficits after having a RIGHT- CVA (Left- Hemi)
- impulsive behaviour
- visual deficits
- Anosognosia (lack of insight of impairments)
- spacial (proprioceptive) deficits
TIA?
mini stroke
**Brain Stem Strokes, depending on the severity, can affect what side of your body?
-both sides
“Locked-state”; can’t move or speak, but are still AWARE
A Cerebellar stroke can damage and cause what?
- cause Ataxia (lack of balance + coordination)
- cause Dysarthria (slurred speech)
**What are the 2 possible causes for Shoulder pain?
- IMPINGEMENT; when trauma to shoulder
Cause: improper handling/poor positioning - IMMOBILITY; by NOT doing something, can result in tissue tightness + loss of ROM
**What are 3 symptoms in SHOULDER-HAND SYNDROME in CVA
- limited ROM in shoulder
- swollen, shiny hand w/ limited finger ROM
- pain in wrist extension
A Hemiplegic shoulder must be handled ___ to prevent development of _____
- correctly
- Pain Syndrome
What kind of rhythm is this;
For every 60 degrees Abduction of your Humerus your Scapula moves 30 degrees
Scapula-Humeral Rhythm
What can occur because of the Scapula-Humeral Rhythm
Impingment
*****What are 6 ways to protect Hemiplegic Shoulder
- Never PULL shoulder (to change position/transfer)
- Dont HOLD and PULL-UP to support person
- Dont put your arms under their arms to re-position
- Dont force painful ROM
- Dont raise Arm ins flexion/abdution psat 90 degrees without SCAPULA GLIDING
- Dont raise the arm in flexion/abduction without some EXTERNAL ROTATION of humerus
What are 2 devices to avoid when working with a Hemiplegic Shoulder
- avoid using SLINGS
- never use overhead OVERHEAD-PULLEYS
What are some (6) Principle Treatments in OTA
- make sure client is comfortable (proper positioning prior starting)
- feet flat on floor
- respect PAIN
- Proximal-> Distal (dont open hand before mobilizing shoulder first)
- Monitor for Fatigue and frustration
- On going EDUCATION
What percentage of people develop spasticity after a stroke
40%
What is CIT and what is it?
-Constraint Induced Therapy; forces movement of the affected side by: restraining unaffected side to overcome using unaffected side and start using the affected side
When is Constraint Induced Therapy most effective
-if there is SOME movement of shoulder/wrist and not completely spastic/ flaccid
What is the Mirror Box Therapy?
-gives illusion of affected hand moving as normal as unaffected limb
3 ways how to incorprate the non-functional arm:
- As a weight-bearing stabilizer
- Guided Movement (“hand-over-hand” to guide movement-eliminates verbal cues)
- Bilaterally: using both hands at the same time (ex. pick up leg to put on footrest)
Who would achieve self-care INDEPENDENCE earlier; someone with Left or Right CVA?
CVA on left (R. Hemisphere)
What is one specific POST stroke complication?
Glenohumeral subluxation (GHS) -shoulder is hanging down
