CVA Flashcards
what is CVA or stroke
sudden loss of neurological function d/t interruption of BF to brain
neuro deficits for at least 24 hrs
RIND can resolve spontaneously _____
when brain swelling subsides - w/in 3 wks
stroke is the leading cause of _____ worldwide and ____ cause of death in PH
stroke is the leading cause of disability worldwide and 2nd cause of death in PH
TIA
deficit is < 24 hrs
general impairments post-stroke
sensation
motor function
postural control and balance
speech, language and swallowing
perception and cognition
emotional status
impairments in (L) hemisphere damage
(R) hemiplegia
diff communication and sequential/linear processing
cautious, anxious, disorganized and hesitant
realistic appraisal of prob
impairments in (R) hemisphere damage
(L) hemiplegia
diff spatial-perceptual tasks, grasping whole idea
quick and impulsive
overestimates abilities
inc safety bcs poor judgement
more feedback
MSK complications
LOM
contractures
atrophy and weakness
osteoporosis complications
loss of bone mass per unit volume
from disuse and poor nutrition
neurological complications
seizures and hydrocephalus
timeline of hyperacute or acute phase
0-24 hrs
timeline of early rehabilitation phase
24 hrs to 3 mo.
timeline of late rehabilitation phase
3-6 mo.
timeline of chronic rehabilitation phase
> 6 mo.
problems in hyperacute or acute phase and early rehab phase
orthostatic hypotension
cognitive deficits
contractures
abnormal tone
dep on transfers and ADLs
bed sores
hemiplegia
dec balance and tolerance
goals in hyperacute or acute phase and early rehab phase
maintain ROM
prevent
- bed sores
- atrophy
- hemineglect
inc balance and tolerance
get out of bed ASAP
maintain or inc strength
interventions in hyperacute or acute phase and early rehab phase
GBREs
proper breathing, pos and turning
ROM ex and light PREs
sitting and standing balance and tolerance
functional training
true or false
early mob w/in 24 hrs is recommended
false dapat medically stable muna
true or false
admission in ward is usual in stroke pt
false dapat stroke unit
once medically stable what is the recommended PT duration
2x day for 45-60 mins
problems in late rehab phase
balance prob
incoordination
diff in bed mob and transfers
diff walking
abnormal tone
hemiplegia
tightness and contractures
shoulder subluxation
goals in late rehab phase
inc ROM
dec shoulder subluxation
improve bed mob and transfers
inc balance control
inc coordination
inc walking ability
inc strength
interventions in late rehab phase
static and dynamic balance training
strength and functional activities
proper bed mob and transfers
ES for muscle re-educ
stretching and flexibility ex
AROM, PNF, coordination ex
gait training
true or false
strength has no adverse effect on spasticity
true
true or false
home based is no as effective in hospital based outpatient
false - equally effective
late rehab phase ex duration
45 mins to 3 hrs for 3-5 days per week
why is overhead pulley no recommended
inc jamming in shoulder or subluxation
NMES guidelines in late rehab phase
NMES for shoulder subluxation but not pain
US for pain
problems in chronic phase
hemiplegic arm and hemiplegia
dep ADLs
risk for falls
sensory deficits
poor endurance
postural and gait dev
risk for stroke
tightness/contractures
balance prob
goals in chronic phase
inc use of hemiplegic arm
inc endurance
inc gait
inc muscle strength
fall prevention
correct posture
inc indep function
attain functional ROM
interventions in chronic phase
CIMT
stretching and ROM ex
strength and functional training
postural control strategies
fall prevention strats and balance training
sensory re-educ
gait training
pt educ and lifestyle change
CIMT is endorsed if
10° active finger ext
20° active wrist ext
limited sensory and balance prob
intact cognition
true or false
task-specific training is only indicated for balance training
false- VR can also be used
FES guidelines in chronic phase
FES on wrist and forearm to reduce motor impairment and improve functional recovery
can improve gait, strength and function but not sustained
true or false
chronic phase emphasizes on community reintegration
true
