CVA Flashcards
What are some general goals for CVA?
- Prevent deformity and contracture
- Prevent injury
- Encourage posture and movement patterns
- Max. AROM and PROM
- MAx. mobility skills
Symptoms of CVA on left (R-hemi)
verbal problems, motor planning (apraxia), cautious
Symptoms of CVA on right (L-hemi)
visual deficits, difficulty with tasks, neglect left side, fairly good verbal skills, impulsive behaviour
A brain stem stroke can cause:
Locked in state. (can also affect both sides).
Cerebellar stroke:
can cause lack of balance and coordination (ataxia) and slurring of speech (dysarthria)
What can learned non-use syndrome lead to?
It is avoidance using hand.
Leads to:
decreased strength, ROM, Fine motor skills
How is learned non use syndrome treated?
With constraint induced therapy (client not allowed to use strong hand)
7 stages of recovery ( Brunnstrom)
- Flaccidity
- Movement synergies
- Spasticity peaks
- Spasticity declines
- Difficult movement mastered
- Individual joints mastered
- Motor function restored
Typical pattern of U/E in CVA?
scapular retraction, shoulder depression, elbow and wrist flexion
What is an glenohumeral subluxation (GHS) ?
most common after stroke, may have no pain. Humerus is coming out of shoulder socket
2 Possible causes of GHS?
Impingement: trauma to the joint (poor handling and positioning)
Immobility: caused by not doing anything
Signs of shoulder hand syndrome:
limited shoulder ROM, swollen shiny hand and pain in wrist extension.
How to protect a hemiplegic shoulder or GHS
- Never pull on shoulder
- Never hold on to arm to support person
- Avoid repositioning by putting your arms under theirs
- No forceful ROM
Treatments to prevent shoulder and hand-shoulder syndrome:
Bed positioning on hemiplegic side and laying on scapula with it in full protraction.
Reduce edema : ice, active ROM
Some principles of treatment:
Client comfortable
Feet flat on floor
Work proximal to distal
