L vs R hemi Flashcards
Right Hemi - LCVA
Good concentration Slow movement time Good performance Good carryover effect Realistic attitude mood: Liable, depressed, anxious
Right Hemi - LCVA 2
speech: Dysarthria,
aphasia,
dyscalculia,
dyslexia,
dysgraphia
receptive speech/understanding - ability to understand info: poor
other: Perseveration (motor and speech - repetition of a particular repsonse)
Left Hemi - 2
speech: Dysarthria or fine
receptive speech/understanding: Good - Lack insight to their condition
sensory: Poor JPS, Extinction to L side
Asterognosis (can’t recognise object with touch)
Autopagnosis (difficulty orientating part of body)
Unilateral neglect
Inattention/extinction
other: Agnosis ,Body image deficits, Motor impersistence - inability to sustain simple acts eg keep eyes closed or tongue out
Left Hemi - RCVA 1
Poor concentration Fast, impulsive movement Unpredictable, erratic speed Poor carryover effect Unrealistic attitude Liable, unmotivated apraxia: Constructional, dressing
Apraxia Notes (LCVA) - Ideomotor
- Unable to perform on external command, but able to perform automatically
- Provide an object with meaning
- Train task as a whole
- Encourage spontaneous movement, use real life events, purposeful requests
Apraxia Notes (LCVA) - Ideational
Unable to complete task on command or automatically
- Doesn’t improve with object
- Break down task and use gestures
- Lead through sequence and copy other limb (upper limb in particular)
Electrical stimulation
• FES improves gait speed
• Improves subluxation
a. 70Hz
b. 1.5-6hrs, daily for 6 weeks
- Limited evidence for UL function return,dexterity
- Does increase strength of WEAK/smaller muscles
- RECOMMENDED TO USE WITH PROGRESSIVE RESISTANCE TRAINING
Resistance Strength Training
- Strength training does not increase spasticity or reduce ROM
- Progressive – no friction (bedex, slide boatds, skateboards) -> increase friction
- Strength training must be functional/task orientated, strength training alone does not improve function
UL neglect
UNILATERAL NEGLECT (UN)
Definition:
The failure to report, respond or orient
To novel or meaningful stimuli
Presented to the side opposite a brain lesion
When this failure cannot be attributed to either sensory or motor Impairments
• LEFT NEGLECT FOLLOWING RIGHT CVA IS MOST COMMON (17 – 80% FOLLOWING)
• Can also be non-lateralised impairments of attention.
• Increased neglect with longer length os stay and poorer functional outcomes post stroke
neg hemis
RIGHT VS LEFT HEMI:
RIGHT HEMI LESION: Attention to both hemispheres. Attention is directed primarily to the right hemispace and hence neglect of the left hemispace.
LEFT HEMI LESION: Attention to right hemisphere. Doesn’t usual result in UN. Intact right hemisphere can direct attention to both hemispheres.
Types of Negelct
Sensory
- decreased awareness of sensory stimulation in the contralesional hemispace
- despite intact primary sensory cortical area and sensory pathways
Types of Negelct
Action Orientated Disorder (motor neglect)
- decreased ability to move in contralesional hemispace
- still aware of stimulus in that space so not a deficit of the motor pathway
eg. Eg balling coming at face, can see it but can catch it and get hit
Types of Negelct
Memory and representational deficits (spatial)
- disorder of memory and extrapersonal space
eg. Forget topographically where we are - eg where to go