CVA Management

Question 1

What does the NIHSS Measure?

Answer 1

The NIH Stroke Scale measures the severity of symptoms post-stroke in the acute setting

Question 2

Scoring level on NIHSS

Answer 2

Very severe > 25
Severe 15-24
Mild-mod severe 5-14
Mild 1-5

Question 3

What is involved in the NIH Stroke scale?

Answer 3

• motor assessment
• limb ataxia
  -sensory loss
• visual neglect
• dysarthria
• aphasia

Question 4

What is the Stroke Impact Scale - 16?

Answer 4

It is a self report measure of activity and participation level post-stroke, more appropriate in OP

Question 5

What are the 4 domains of assessment in the stroke impact scale?

Answer 5

• strength
• hand function
• ADL/IADLs
• mobility

Question 6

T or F: Stroke Impact Scale -16 assess motor and sensory function

Answer 6

FALSE IT IS ONLY MOTOR

Question 7

What is the difference b/t SIS and SIS-16

Answer 7

59 items w/8 domains of assessment including non-motor domains vs the 4 domain 16 item motor only scale

Question 8

What is the postural assessment scale for stroke patients?

Answer 8

A 12 item performance-based scale measuring static posture in sitting, standing, and SLS + changing a posture

Question 9

When would you use the postural assessment scale for stroke patients?

Answer 9

In the first 3 months post-onset since that is when it is most sensitive

Question 10

List possible challenges to stroke care?

Answer 10

• perceptual deficits
• aphasia
• apraxia
• sensory impairments
• depression

Question 11

How to intervene for unilateral spatial neglect?

Answer 11

• 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)

Question 12

What are some interventions to improve pusher behaviour?

Answer 12

• self-awareness (use intact visual or vestibular system)
• active correction
• internalize newly learned compensation (perform other tasks while maintaining correct posture)

Question 13

T or F: Aphasia is sometimes due to damage of the vocal musculature?

Answer 13

False - it is always due to injury of the brain BUT it does not have to be from stroke

Question 14

How many acute stroke patients have apraxia?

Answer 14

approximately 30%

Question 15

What lobe of the brain is likely to be affected w/apraxia?

Answer 15

Left parietal lobe

Question 16

T or F: Apraxia cannot improve

Answer 16

False, it tends to approve over time

Question 17

Define apraxia

Answer 17

disorder of voluntary mvmt where one cannot eecute willed, purposeful activity despite hte presence of adequate mobility, strength, sensation, coordination, comprehension, and motivation

Question 18

What are risk factors for depression post-stroke?

Answer 18

• female
• prior depression
• functional limitations or need for assistance w/ADLs
• cognitive deficit
• stroke severity
• social factors

Question 19

What is true with depression and stroke outcomes?

Answer 19

• more likely to have deterioration in physical functioning, leading to a cycle