Interventions for Stroke Flashcards
A sensory retraining programs may include? (4)
- mirror therapy
- repetitive sensory discrimination activities
- bilateral simultaneous movements
- repetitive task practice
Give (3) examples of sensory stimulation interventions.
- compression techniques (weight bearing, manual compression)
- mobilizations
- electrical stimulation
This therapeutic intervention is effective for some patients during early motor training to improve motor function using visual feedback, what am I?
- mirror therapy
- (shown to improve DF in stoke pts and UE distal motor function/recovery from semi neglect.)
Patients with hemianopsia demonstrate a lack of what?
- lack of awareness of the hemiparetic side
Teaching a patient active visual scanning by turning head and trunk to involved side, wearing a ribbon on hemiparetic wrist, or using functional activities to encourage bilateral interaction are all examples of training strategies for what type of patient?
- hemianopsia or unilateral neglect
- encourage awareness and use of hemiparetic side/extremities.
What (3) interventions can be performed to improve flexibility, prevent contractors and maintain your patients joint integrity?
- soft tissue/joint mob’s (initiated early with ROM)
- PROM and AROM (when possible) with terminal stretch (daily, more frequent if contracture is developing)
- positioning limb out of abnormal synergist pattern
Upper Extremity PROM of the shoulder requires careful attention to?
- external rotation and distraction of humorous, especially ranges of 90 degrees or more.
When mobilizing the scapula which (2) directions should be emphasized to prevent soft tissue impingement?
- upward rotation
- protraction
When positioning your patient in a wheelchair what position should their paretic arm/limb be at?
- shoulder in 5° abduction and flexion, neutral rotation
- elbow in 90° flexion and slightly forward
- forearm pronated, hand in resting position
For many stoke patients, voluntary movements of the foot and ankle are limited due to?
- PF spasticity and/or DF weakness
What (3) strength training interventions are indicated if your stroke patient is very weak (
- gravity-minimized exercises using powder boards
- sling suspension
- aquatic exercise
How many days per week should your patient be resistance training, how many sets/reps?
- 2/3 times per week; 3 sets of 8-12 reps
Give (3) example of combining resistance training with task-oriented functional activities.
- repeating functional mobility tasks to fatigue
- add weight/resistance to sit to stands
- add weight/resistance to reaching activities
Name (5) exercise precautions and (2) general contraindications for stroke patients listed in the notes.
- If pt has poor hand function, specially designed gloves may be necessary.
- Pt’s with impaired sensation are at increase risk for injury and should be monitored closely.
- Pt’s with postural deficits should be safely positioned to prevent falls.
- Dynamic exercise performed in upright position (sitting) produce less elevations in BP than supine exercises.
- Ensure warm-up and cool-down are adequate and overall exercise program is gradual.
- High-intensity exercise (sustained max effort) is generally contraindicated in pt’s with recent stroke and unstable BP.
- Isometric exercise that is accompanied with Valsalva maneuver and increased BP is also contraindicated.
What techniques (7) can be used for managing spasticity?
- early mobilization and daily stretching
- rhythmic rotation (to gain initial range)
- rhythmic initiation combined with trunk rotation
- prolonged positioning and weight-bearing with muscle in lengthened position.
- active exercise focused on activation of the weak antagonist muscle
- Functional Electric Stimulation (FES) to target weak antagonist muscle
- Orthotic devices to maintain spastic muscle in lengthened position.
During initial training to improve movement control the therapist should focus on what?
- dissociation of different body segments and selective movement patterns (out of synergy)
____ can be helpful for patients with limited voluntary motor control.
PNF
What is the main focus of the rehabilitation program for improving movement control?
- repetitive task-specific training
What is commonly used to protect a patient with hypotonia (flaccid) shoulder?
- sling
Interventions for improving bed mobility include (4)?
- practice rolling to both sides
- make sure pt does not leave more affected UE behind
- rolling onto more affected side and into side-lying on elbow to promote early weight-bearing.
- practice moving from supinesit leading with both sides.
Bridging helps develop trunk and hip extensor control for what (4) ADL’s?
- use of bed pan
- relief of pressure from buttocks
- initial bed mobility (scooting)
- sit to stand transfers
Common goals for improving sitting posture include (2)?
- symmetrical posture with spine and pelvic alignment
- pelvic neutral, spine straight with feet flat on floor
The focus for improving sit-to-standing transfers is (3)?
- symmetrical weight-bearing
- coordinated movements
- adequate timing
What are the two phases in the sit-to-stand transfer?
- flexion momentum/pre-extension phase (shift the body mass)
- extension phase (move upright)
