CVA Management Flashcards
What does the NIHSS Measure?
The NIH Stroke Scale measures the severity of symptoms post-stroke in the acute setting
Scoring level on NIHSS
Very severe > 25
Severe 15-24
Mild-mod severe 5-14
Mild 1-5
What is involved in the NIH Stroke scale?
- motor assessment
- limb ataxia
-sensory loss - visual neglect
- dysarthria
- aphasia
What is the Stroke Impact Scale - 16?
It is a self report measure of activity and participation level post-stroke, more appropriate in OP
What are the 4 domains of assessment in the stroke impact scale?
- strength
- hand function
- ADL/IADLs
- mobility
T or F: Stroke Impact Scale -16 assess motor and sensory function
FALSE IT IS ONLY MOTOR
What is the difference b/t SIS and SIS-16
59 items w/8 domains of assessment including non-motor domains vs the 4 domain 16 item motor only scale
What is the postural assessment scale for stroke patients?
A 12 item performance-based scale measuring static posture in sitting, standing, and SLS + changing a posture
When would you use the postural assessment scale for stroke patients?
In the first 3 months post-onset since that is when it is most sensitive
List possible challenges to stroke care?
- perceptual deficits
- aphasia
- apraxia
- sensory impairments
- depression
How to intervene for unilateral spatial neglect?
- increase awareness to the affected side (visual scanning, arousal/activation, feedback for awareness)
- focus on remediation of deficits of position sense or body orientation (eyepatching + hemispatial glasses, TENS, neck vibration, etc)
What are some interventions to improve pusher behaviour?
- self-awareness (use intact visual or vestibular system)
- active correction
- internalize newly learned compensation (perform other tasks while maintaining correct posture)
T or F: Aphasia is sometimes due to damage of the vocal musculature?
False - it is always due to injury of the brain BUT it does not have to be from stroke
How many acute stroke patients have apraxia?
approximately 30%
What lobe of the brain is likely to be affected w/apraxia?
Left parietal lobe
T or F: Apraxia cannot improve
False, it tends to approve over time
Define apraxia
disorder of voluntary mvmt where one cannot eecute willed, purposeful activity despite hte presence of adequate mobility, strength, sensation, coordination, comprehension, and motivation
What are risk factors for depression post-stroke?
- female
- prior depression
- functional limitations or need for assistance w/ADLs
- cognitive deficit
- stroke severity
- social factors
What is true with depression and stroke outcomes?
- more likely to have deterioration in physical functioning, leading to a cycle
