CVA tx Flashcards
Based on the AHA/ASA rehab exercise program recommendations, which mode of exercise should you do the most?
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
aerobic
This type of exercise is used to increase functional capacity for walking and ADL’s, reduce motor impairment and improve cognition
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
aerobic
This type of exercise is used to increase the ability to perform ADL’s, leisure, and occupational activities, to reduce cardiac demands during lifting and carrying activities
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
strength and endurance
This type of exercise is used to prevent contractures, increase function and ADL’s
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
flexibility
This type of exercise is used to improve skill acquisition, mobility, and QOL, improve safety in ADL’s and decrease fear of falling
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
neuromuscular
Which type of exercised based on the AHA/ASA rehab exercise program recommendations should be done the least?
a. aerobic
b. strength and endurance
c. flexibility
d. neuromuscular
flexibility
Intervention approaches for stroke should be
a. targeted
b. functional
c. only one mode
d. multi-modal
multi-modal
What intervention has the strongest evidence?
task-oriented approach/task
NDT is better than PNF for stroke patients (true/false)
false
What is the requirement for using constraint-induced therapy?
active finger and wrist extension
Some interventions are better than others (true/false)
false
Intervention to treat CRPS in stroke patients addresses which pillars
a. impairment
b. strategy
c. impairment and strategy
impairment and strategy
Examples of tasks to desensitize the arm and hand to touch
rubbing their hand, pillow, wedge, wraps, gloves
to treat CRPS eliminate
painful exercises
hand edema
How do you reintroduce pain free arm movements in a patient with CRPS?
reestablishing scapular mobility first
Treating edema is addressing which pillar
a. impairment
b. strategy
c. impairment and strategy
impairment
Stage I edema:
a. gelatinous and pitting
b. hard and lumpy
c. soft and fluid
soft and fluid
Stage II edema
a. gelatinous and pitting
b. hard and lumpy
c. soft and fluid
gelatinous and pitting
Stage III edema
a. gelatinous and pitting
b. hard and lumpy
c. soft and fluid
hard and lumpy
Which treatment should be done to treat edema in the first stage?
a. compression
b. retrograde massage and elevation
c. active exercise
d. all of the above
all of the above
Which treatment should be done to treat edema in the second stage?
a. compression
b. transtissue massage and elevation
c. active exercise
d. all of the above
transtissue massage and elevation
Which treatment should be done to treat edema in the third stage?
a. compression
b. transtissue massage and elevation
c. active exercise
d. all of the above
compression
Using strategies to improve sensory and perceptual function addresses which pillar
a. impairment
b. strategy
c. impairment and strategy
impairment and strategy
Safety education tactile and thermal stimulation weight-bearing and approximation intermittent or deep pressure active visual scanning cues to involved side and to cross midline these strategies address a. flexibility b. joint integrity c. sensory and perceptual function d. tone
sensory and perceptual function
Positioning, active motion, ROM and mobilization are used to address
a. flexibility and joint integrity
b. joint integrity
c. sensory and perceptual function
d. tone
flexibility and joint integrity
Improving flexibility and joint integrity is addressing which pillar
a. impairment
b. strategy
c. impairment and strategy
impairment
Positioning goals to increase flexibility and joint integrity
provide support normalize tone prevent shortening of tissues around the joint promote symmetry provide normal sensory input relieve pain and provide comfort
What is the goal of supine positioning?
a. promote symmetry
b. relieve pain and provide comfort
c. most therapeutic position
d. normalize tone
improve symmetry
What is the most therapeutic position for improving flexibility and joint integrity?
a. supine
b. sidelying on involved side
c. sidelying on uninvolved side
d. sitting
sidelying on involved side
Why is sidelying on the involved side the most therapeutic?
deep pressure and weight-bearing helps promote recovery - sensory and messages to brain
Early active movement as an intervention is used to address which pillars?
a. impairment
b. strategy
c. impairment and strategy
impairment and strategy
Casts should be used on patients with low tone (true/false)
false
Early, active movement positioning weight-bearing through long bones daily stretching and ROM splints casts rotation these are interventions to treat a. flexibility b. abnormal tone c. joint integrity d. poor posture
abnormal tone
To implement a long-lasting effect on abnormal tone, the intervention must address
weakness and/or improper activation
What is the best intervention for treating abnormal tone?
active engagement from the patient
What intervention can be used to temporarily reduce high tone?
rotation of lower trunk with the patient lying supine
Rotation to decrease tone is addressing which pillar
a. impairment
b. strategy
c. impairment and strategy
impairment
Isolated strengthening exercises carry over to function (true/false)
false
Strengthening as an intervention addresses which pillar
a. impairment
b. strategy
c. impairment and strategy
impairment
Motor control and relearning address which pillars
a. impairment, strategy and adaptation
b. strategy
c. impairment and strategy
d. adaptation
impairment, strategy, and adaptation
Using motor control and relearning as an intervention should promote (3)
postural control
voluntary movement
functional use of extremities
Promoting postural control
anticipatory control requires hands free
To promote voluntary movement for motor control and relearning it is key to
move out of synergy
Priming for the intervention
primes for neuroplastciity
increases BDNF
high-intensity aerobic training
Aerobic exercise alone does not promote neuroplasticity. It enhances the environment to promote neuroplasticity when doing functional training (true/false)
true
What are important walking recovery concepts?
patient motivation to walk
task-specific
time matters
What are locomotor training principles?
maximize weight bearing on the legs
optimize sensory cues
optimize kinematics for each motor task
maximize recovery strategies, minimize compensation strategies
This locomotor training uses an assistive device and often an inefficient pattern, uses multiple therapists potentially
a. conventional PT
b. bodyweight support treadmill training
c. BWS overground
conventional PT
This type of locomotor training allows very early whole part practice, can focus on gait pattern and there is less physical demand on the therapist
a. conventional PT
b. bodyweight support treadmill training
c. BWS overground
body weight support treadmill training
This type of locomotor training reduces the fall risk, no device is needed, most functional and least demand on the PT
a. conventional PT
b. bodyweight support treadmill training
c. BWS overground
BWS overground
the most functional locomotor training method is
a. conventional PT
b. bodyweight support treadmill training
c. BWS overground
BWS overground
What is the recommended locomotor training intensity and timing?
12 sessions of BWSTT
2x/week for 6 weeks
20-30 mins at 2.0 mph
60 min total PT session
What concept is key with locomotor training?
intensity and time
Locomotor training produces long term changes in walking _ and _
velocity
distance
List 4 areas of progression for locomotor training
endurance
speed
weight-bearing
independence
General physical activity post stroke can prevent
future cardiovascular episode
post-stroke depression
_ is not required for general physical activity post stroke
task-specific
Bimanual movements is defined as
when both upper limbs move simultaneously
Which bimanual movement should be done first?
a. hands separated, symmetrical movements
b. hands separated, asymmetrical movements
c. hands clasped, arms move together
hands clasped, arms move together
When can you start having a patient complete bimanual UE movements?
once they can self-assist
What is the benefit of bilateral UE movements in comparison to unilateral?
increase in muscle activation and longer post-training carry over of improvement with repetitive task
Equipment can be used for
a. as compensation
b. adaptation
c. only for safety reasons
d. remediation assistance, safety or compensation
remediation assistance, safety or compensation
When using a sling, avoid one that puts the arm into
IR and adduction
Which type of AD should be avoided in a stroke patient?
quad cane
What needs to be considered for an orthotic with a stroke patient?
rate or phase of recovery prognosis hypertonicity sensory loss and boney structure dexterity to don/doff orthosis + shoe
Early mobilization to prevent complications and learned nonuse is a goal for which setting
acute care
The evidence is in favor of which interventions
NDT
PNF
constraint-induced therapy
gait/locomotor training
A patient experiencing contraversive lateropulsion may also show signs of _ neglect
spatial and sensory neglect
To get a long lasting effect on improving abnormal tone, it is important to address what underlying cause?
weakness and/or improper activation
atypical movement patterns develop because
as a consequence of primary and secondary impairments
