CVA Labs Flashcards
6 core tasks for task analysis
Sitting
Sit to Stand
Standing
Walking
Steps
Reach/manipulate
Sensory Retaining techniques include:
- Mirror therapy
- Bilateral simultaneous movements
-Repetitive sensory discrimination activities
-Repetitive task practice.
Mirror therapy:
-What is it?
-What does anatomy does it target?
- visual imagery targeting proprioception
- PREMOTOR cortex (MIRROR NEURONS)
What is the theory behind bilateral arm training?
activates intact hemisphere to facilitate activation of the damaged hemisphere via CORPUS CALLOSUM
Repetitive sensory discrimination targets what anatomy?
somatosensory association cortex
What are potential interventions for inattention?
- functional training + cognitive rehabilitation
- Mental imagery
- Prism glasses/eye patching
- Virtual Reality
The lighthouse strategy for inattention uses three different methods:
- Anchors
- Guides
- Turns
Anchors
using target to visually seek on neglected side
Guides
using body or finger to direct eyes toward neglected side
Turns
turning eyes and head towards neglected side
Mental Imagery
a technique that is convenient, cost effective and safe for neglect, but has limited evidence.
What are therapy options for dysconjugate gaze?
AROM activities
Brock string
Eye patch
The goals for choosing strength/endurance exercises:
combo of resistance training with task-oriented functional activities
Indications for immediate cessation of exercise program
-lightheadedness
-dizziness
-chest-heaviness, pain, or tightness, angina
- Heart palpitations, irregular heart beat
- Sudden SOB not due to increased activity
-Volitional fatigue and exhaustion
Management of a sublimed shoulder includes:
- strengthening
- KT taping
- NMES
- Slings
- Pt positioning
Primary intervention for spasticity
baclofen
Mechanisms of neuromuscular facilitation
- tapping
-joint approximation - joint traction
- quick stretch
- manual resistance
ROM Inclusion criteria for constraint-induced movement therapy
10º wrist extension
10º active thumb abduction
10º active extension of any other two digits
Apraxia training includes
- strategy training (compensation) with internal strategies
- External Strategies, signage, mirror therapist cues, sensory stimulation, etc.
Your patient is only able to sit EOB, what outcome measures could be used?
FIST
TIS
A patient can sit and stand - what outcome measures could be used?
Fugl-Meyer
PASS
Your patient is ambulatory and can negotiate stairs what outcome measure can you use with them?
Orpington Prognostic Scale (ambulation)
STREAM (both)
Major prognostic considerations for CVA
- Time to medical intervention
- Type of medical intervention/complications
- Initial NIHSS score
- Age
- Education level /SES
- PLOF
- Ambulatory on eval at IP rehab (ANY degree)
Prognostic considerations between hemorrhagic and ischemic strokes
Hemorrhagic: higher mortality rates acutely, but better prognosis for neuro-recovery long-term
Ischemic: lower mortality rate, but then to demonstrate slower and less recovery
Most-Least disability of functional outcomes by vascular territory
- Multiple vascular territories
- MCA
- ACA
- PCA
- B/s
- Small vessel stroke
- Cerebellar
Prognostic Considerations of UE
Shoulder Abduction, Finger Extension (SAFE) = 98% probability of achieving some dexterity at 6 months
What is the PREP2 algorithm?
predicts UE motor recovery based on SAFE, age, and neuro diagnostic testing
Positive prognostic indicators for return to ambulation
- *ambulation on eval (IRF)
-
balance scores on eval (IRF), Berg Balance Scale Considerations (29/56) - community level ambulation
-Min loss of LE strength + somatosensory function
-Min to no evidence of perceptual visual +/- cognitive deficits - Healthy BMI
- Younger age (<65)
