CVA Impairments Part 1 Flashcards
list some common motor related CVA impairments
- weakness
- impaired motor control, limb synergies
- endurance and CV health
- ataxia, incoordination
- tone abnormalities, primitive reflex emergence
- Cranial nerve involvement
strength deficits from CVA are typically observed ________
contralaterally
except for when the cerebellum is damaged
T/F: CVA strength deficits are normally more proximal than distal
FALSE
observed more distally than proximally
what is the difference between hemiplegia and hemiparesis?
- hemiparesis → mild to moderate weakness on contralateral side
- hemiplegia → severe to profound weakness on contralateral side
- Dense hemiplegia → no active movement observed
T/F: strength deficits are always contralateral to the lesion
FALSE
mild ipsilateral weakness can also be seen
(10-25% of CST descend ipsilaterally → anterior CST)
list some primary neuromuscular impairments
- damage to descending cortical drive
- loss of force production
- loss of motor units
- asynchronous and abnormal motor firing
List some secondary neuromuscular impairments
- increased fatigability
- delayed reaction times
- prolonged movement times
- disuse muscular atrophy
- length-tension changes
It is common to see patterns of weakness between muscle pairs, give some examples
- UE and LE extensors > flexors
- Shoulder and hip ER > IR
- Hip ABD > ADD
- Ankle eversion > inversion
Facial weakness post stroke is due to damage to ________
contralateral corticobulblar (CN VII, XII pathways)
define motor control
- the process of initiating, directing, and grading purposeful voluntary movement
- plan → program → execute
- ability to regulate or direct mechanisms essential to movement
- creates movements that require minimal cognitive load
define motor plan
an idea or plan for purposeful movement that is made up of component motor programs
define motor program
an abstract representation that, when initiated, results in the production of a coordinated movement sequence
define motor learning
a set of internal processes associated with feedback or practice leading to relatively permanent changes in the capability for motor skill
define motor recovery
the reappearance of motor patterns present prior to CNS injury performed in the same manner as prior to injury
define motor compensation
the appearance of new motor patterns resulting from changes to CNS
→adaptation
→substitution
List the 6 stages of motor recovery post CVA
- initial flaccidty, no voluntary movement (cerebral shock)
- emergence of spasticity, hyerreflexia, and stereotypical synergies
- voluntary movement possible, but only in synergies, spasticity strong if present
- voluntary control in isolated joint movements emerging, corresponding decline of spasticity and synergies
- Increasing voluntary control out of synergy; coordination deficits present
- control and coordination near normal