CVA Interventions Flashcards
what should you do when strength program is initiated
monitor BP, HR, RPE, RR and breathing patterns closely
indications for immediate cessation of exercise program
- lightheadedness
- dizziness
- chest heaviness, pain or tightness; angina
- heart palpitations or irregular heart beat
- sudden SOB not due to increase activity
- volitional fatigue and exhaustion
what exercises are beneficial for LE strengthening
closed chain
neuromuscular facilitation -
- manual resistance
- tapping
- joint approximation
- joint traction
- quick stretch
- aid in promoting required lead-up activities required for tasks
- good for pt’s with more significant weakness
PNF aids in what -
- aid in promoting required lead-up activities required for tasks
- good for pt’s with more significant weakness
motor learning techniques relies heavily on what
- actual practice, mental practice and feedback
- best relearned when practice within context of the actual desired activity
- pt should demonstrate some recovery of isloated movement
gross grasp
something that is in contact with your palm
prehension patterns
- palmar grip
- lateral grip
what exercises are beneficial for UE strengthening
- majority of ADLs are open but both are beneficial
constraint induced movement therapy (CIMT)
response to learned nonuse by instead promoting forced use of involved extremity
limitations of CIMT
- patient compliance
- staffing at therapy clinics
- reimbursement
when should exercise begin after stroke
within 24 hrs of first onset of symptoms
acute endurance recommendations: goal
prevent deconditioning, orthostatic intolerance, depression
acute endurance recommendations
- < 11-12 RPE (3-4 mRPE)
- resting HR + 10-20 bpm
- interval approach
- mode: walking, ADLs, standing activities
IP rehab & outpatient endurance recommendations: goal
- increased walking speed & efficiency
- improve exercise tolerance
- increase independence ADLs
- reduce motor impairment
- improve cognition
- improve vascular health
IP rehab & outpatient endurance recommendations
- 11-14 RPE (3-5/6 mRPE)
- 40-70% VO2 reserve or HR reserve; 55-80% HRmax
- 20-60 min/session, 3-5x week + adequate warm up/cool down
- mode: large muscle activities
management of painful and/or subluxed shoulder
- strengthening high rep of RTC, deltoid and scapula
- KT tape
- NMES
- slings
- positioning
what are shoulder slings used for
work to withstand gravity
neoprene sleeve
- comfortable
- gentle compression
- stretchy
- not always best option
alimed sling
- hard shell
- adjusts how much pull on shoulder
givmohr sling
- cradles elbow and hand
- better accounts for whole arm
- takes hand fxn away
shoulder saddle sling
- risk for contracture
- no use of hand
hypotonic, and what are the functional implications
- floppy movements
- injury risk
- power movements are impaired
- resist gravity
- increased stress on joint
- balance impaired
- fatigue
- lack of postural control
- clumsy, incoordinated movements
what are the functional implications of stroke
- contractures
- skin breakdown
- pain
- abnormal posture
- abnormal movement patterns
- impaired balance
what is the main management of spasticity
medication: baclofen
side effects of baclofen
decreased muscle strength and lethargy
when is med appropriate for spasticity pt’s?
- spasticity is interfering with fxn
- clonus present –> skin breakdown
- pain
what are you monitoring with tone present
- clonus
- impact on functional tasks
- evidence of contractures
what are you managing with tone present
- stretching program –> joint mobs
- positioning of limbs to avoid shortening positions of spastic muscles
- e-stim can be used for short term effects
