LE recovery post stroke

Question 1

What are the primary predictors for walking recovery?

Answer 1

Strength and balance

Question 2

For FAC >= 4-6 months, what needs to be true w/in 72 hours of stroke?

Answer 2

• score = 25 on TCT (sit for 30 sec)
  AND motricity index score of >25 (visible contraction for 3 test items: df, knee extension, hip flexion)

Question 3

What is the TWIST Algorithm

Answer 3

Time to walking independently after stroke
- uses regression to assess what factors predict walking, and found that TCT score (Trunk control) and MRC grade for hip extension were the only 2

Question 4

How to use the TCT to predict walking outcomes?

Answer 4

@ 1 week: >40 = walk at 6 weeks
If <40, if hip ext >= 3 = walk in 12 weeks
If less than 3, it is a maybe

Question 5

What are other determinants of functional recovery in stroke?

Answer 5

• CV fitness
• paretic leg strength
  (strength & bal*)

Question 6

What is in the trunk control test?

Answer 6

• roll to weak side
• roll to strong side
• sit up from lying down
• bal in sitting position on EOB w/ feet off ground for >= 30 sec

Question 7

How to score TCT?

Answer 7

Each item:
0 = unable/needs assist
12 = able but abnormally
25 = normal

THEN: add up score

Question 8

What are the treatment options for LE recovery post stroke?

Answer 8

• overground gait training*****
• strength (If >70% 1RM)
  -VR (if available)
• weight shift/pre-gait (don’t)
• BWSTT (don’t)
• Robotics (don’t)
• exergaming (don’t)

Question 9

What does the VIEWS trial show?

Answer 9

More steps per session correlated to increase speed and walking distance
More time in 60-80 HRR increased speed and walking time

Question 10

What are the three general themes for LE Recovery?

Answer 10

Specific, Repetition, and Intensity