exam 2: stroke rehab interventions & considerations

Question 1

What are some important considerations to make when determining
restoration vs compensation vs prevention: (4)

Answer 1

stage of recovery
task-specific/environment-specific
Patients’ available resources (family support, PLOF, CLOF)
Identify attainable goals (DC Plan)

Question 2

What are the 3 types of interventions:

Answer 2

prevention
remediation
compensation

Question 3

_______ stage of recovery: a period of inflammation and scarring 1 to 7 days post-stroke - spontaneous recovery dominates

Answer 3

acute phase

Question 4

Acute Phase:
Often first encounter with a patient who is in the acute phase is in the _______
-early intervention and ________
-______ hours to begin intervention

Answer 4

ICU
prevention
24-48

Question 5

Which of the neuroplasticity principles are essential in the acute phase

Answer 5

timing matters

Question 6

Benefits of early mobilization in the acute phase:

Answer 6

prevents harmful effects of bed rest
increase patient’s level of A&O
reduce the risk of depression
reduce leaned nonuse of hemi side
tilt table - promote OOB and WB therapy

Question 7

Acute Phase: Goals = _________

Answer 7

prevention

Question 8

List the conditions of prevention during the Acute Phase:

Answer 8

contracture
edema
seizures
infection
UTI
stroke reoccurrence

Question 9

What is the PT’s Role in the Acute Phase:

Answer 9

Early mobilization
Monitor patient’s status and VS
Prevent compensation and learned helplessness

Question 10

Inpatient Acute Care: Role of PT in this setting
-______> walking
-prevention of secondary complications such as ______
-prepare for ______

Answer 10

out of bed
bed sores
discharge

Question 11

True or False:
In the acute phase, you should discharge pt. as early as possible.

Answer 11

False; higher risk of medical complications during subacute rehab or at home

Question 12

Do not initiate _______training during the acute phase
Early ___________ should encouraged
It is important to establish effective _______ due to aphasia or visual neglect

Answer 12

aerobic- CV system is reacclimating
mobilization
communication

Question 13

What are the 3 main focus for PT interventions in the Acute Phase:

Answer 13

Functional mobility/ADL training
ROM/Splinting/Positioning
Family/caregiver education

Question 14

Acute Phase Interventions:
Changes in position can prevent

Answer 14

postural hypotension and skin breakdown

Question 15

Acute Phase Interventions:
Move extremities ______x/day to maintain _________
AROM promotes ________ and prevents ______
______ rule for rolling to prevent ulcers
Ankle contracture boots for flaccid ankle to maintain _____

Answer 15

3-5x/day; tissue extensibility
blood flow; DVT
2- hour
neutral

Question 16

What is the subacute phase:
-peak:
-plateau:

Answer 16

Period of neuroplasticity that starts in the acute phase, peaks in the early subacute phase 7 days to 3 months and plateaus in the late subacute (3 to 6 months)

Question 17

What is the high level of physical rehabilitation a patient can receive compared to SNF, nursing homes, and outpatient therapy services?

Answer 17

Inpatient rehab (IPR)/sub-acute rehab

Question 18

If a patient is considered medically “stable” what stage of recovery are they most likely in?

Answer 18

subacute phase

Question 19

IPR is an intense, multi-disciplinary approach pts. must tolerate:

Answer 19

3 hours of therapy 5 days a week (intensity matters)

Question 20

What are some factors that influence the transition from acute rehab to subacute rehab:

Answer 20

medically stable
severity of cognitive-perceptual deficits
behavior, affect, motivation
patient endurance/activity tolerance
prognosis

Question 21

Subacute facilities can prevent failure at _______ and readmission.

Inpatient rehabilitation (IPR) vs. SNF vs Home:
-_________of service
-_________ tolerance
-pts. available _______

Answer 21

home

intensity
activity
resources

Question 22

What setting houses patients who are unable to care for themselves for both short-term and long-term care?

Answer 22

SNF

Question 23

SNF Qualifications:
less intense compared to______
_____ hour of therapy per day - ____ days a week

Answer 23

IPR
1; 7

Question 24

What is the primary goal for PT in the subacute phase:

Answer 24

return to functional independence
-restoration vs. compensation

Question 25

As a PT when should you start promoting weight bearing through the affected (hemiparetic limb)?
-UE
-LE

Answer 25

the subacute phase
seated weight shifting into UEs
standing weight shifting into LEs

Question 26

Is the following statement true or false?
You may begin aerobic training in the acute phase.

Answer 26

False: subacute

Question 27

What is learned nonuse:

Answer 27

failure to use the limb despite some motor functions remaining intact

Question 28

During learned nonuse, a patient will learn ______ measures to improve function and independence

Answer 28

compensatory

Question 29

PT interventions in Subacute Phase:

Answer 29

postural control and balnce
cont. to progress functional mobility/ADLs
locomotor training
UE limb use

Question 30

Chronic phase:

Answer 30

> 6 months, neuroplastic changes still occur however the rate at which recovery may occur begins to decline

Question 31

6 months poststroke =
-after 2-3 months pts. have now been DC’d from IPR to _______ or ______

Answer 31

chronic
home health or outpatient therapy

Question 32

Chronic Phase: Goals
-cont. to meet goals set in _______, and progress toward independence or lowest level of ______burden
-avoid _________

Answer 32

IPR; caregiver
readmission

Question 33

PT considerations for pts. in the chronic phase:
-goal: (2)
-HEP implementation:

Answer 33

return to participation in roles; assistance in resuming rec activities
edu pt/family prn; daily therapy without PT present