CVA treatment considerations

Question 1

Stage 1 motor recovery following stroke:

Answer 1

initial flaccidity, no voluntary movement

Question 2

Stage 2 motor recovery following stroke::

Answer 2

emergence of spasticity, hyperreflexia synergies (mass patterns of movements)

Question 3

Stage 3 motor recovery following stroke::

Answer 3

voluntary control of movement synergies

spasticity increased and may become severe

Question 4

Stage 4 motor recovery following stroke::

Answer 4

movement combinations that do not follow the paths of either synergy are mastered
spasticity begins to decline

Question 5

Stage 5 motor recovery following stroke::

Answer 5

difficult movement combinations are learned

Question 6

Stage 6 motor recovery following stroke::

Answer 6

disappearance of spasticity, individual joint movements become possible and coordination approaches normal

Question 7

Expressive aphasia

Answer 7

non fluent aphasia
Broca’s motor aphasia
A central language disorder in which speech is typically awkward, restricted, interrupted and produced with effort

Question 8

Expressive aphagia results from what?

Answer 8

lesion involving the 3rd frontal convolution of the left hemisphere

Question 9

Verbal apraxia:

Answer 9

Impairment of volitional articulatory control secondary to a cortical, dominant hemisphere lesion

Question 10

Dysarthria

Answer 10

Impairment of speech production resulting from damage to the central or peripheral nervous system;

Question 11

What does dysarthria cause?

Answer 11

causes weakness, paralysis or incoordination of the motor-speech system (respiration, articulation, phonation and movements of jaw and tongue)

Question 12

Receptive aphasia

Answer 12

fluent aphasia
Wenicke’s aphasia
A central language disorder in which spontaneous speech is preserved and flows smoothly, while auditory comprehension is impaired

Question 13

What is receptive aphagia a result of?

Answer 13

lesion in the posterior first temporal gyrus of the left hemisphere (Wernicke’s area)

Question 14

Global aphasia

Answer 14

Severe aphasia

Examine for marked impairments in comprehension and production of language

Question 15

Pelvis Postural Alignment Deviations:

Answer 15

asymmetrical weight-bearing majority on stronger side
sacral sitting
fear of weight shifting to stronger side
in standing, unilateral retraction and elevation on stronger side

Question 16

Trunk Postural Alignment Deviations:

Answer 16

with sacral sitting, flattened lumbar curve with exaggerated thoracic curve and forward head
lateral flexion with trunk shortening on more affected side

Question 17

Shoulders Postural Alignment Deviations:

Answer 17

unequal heights with more affected shoulder depressed
humeral subluxation
winging

Question 18

Head/Neck Postural Alignment Deviations:

Answer 18

protraction with lateral trunk flexion

lateral flexion of head with rotation away from affected side

Question 19

Upper Extremities Postural Alignment Deviations:

Answer 19

more affected UE flexed, adducted with IR, flexion, pronation, wrist and finger flexion
stronger UE used for postural support

Question 20

Lower Extremities Postural Alignment Deviations:

Answer 20

more affected LE hip abduction and ER with hip and knee flexion
unequal weight bearing on feet

Question 21

Common hip gait deficits:

Answer 21

poor hip position (retracted, flexed, trendelenberg, scissoring, insufficient pelvic rotation)

Question 22

Weak hip flexors during swing

Answer 22

Circumducted gait
External rotation with adduction
Backward leaning of trunk
Exaggerated flexion synergy

Question 23

Weak knee extensors

Answer 23

Compensatory locking of knee in hyperextension

May be caused by spastic knee extensors

Question 24

Ankle

Answer 24

Foot drop
Equinus gait (heel does not touch down)
Varus foot
Equinovarus position

Question 25

What causes pushing?

Answer 25

lesions in the area of the posterolateral thalamus