Management of the Hemi UE Flashcards
Which artery is the most commonly affected in a stroke?
MCA (which supply UE)
Prognosis of UE recovery following CVA
early use (amount @ 1 month) = further recovery
lesion location, size and type
Can the FIM score be used to rate UE recovery?
no, FIM score may be high b/c they learned how to use the unaffected arm for all tasks.
Should PT teach the patient to compensate following stroke? What are the factors?
Yes if:
- long time since injury
- go home alone, safe to do so with both hands?
- behavior (low tolerance)
- pt goal
On a neural level, explain learned non-use
cortical remapping occurs and the unaffected arm will take over the area of the unused arms
Why is there less recovery in the UE compare to LE following a stroke?
Patient does not use it because:
- it is weak
- decrease attention to the UE in rehab
- early remapping on both sides of the brain => learned nonuse
Which body region becomes a frequent problem following CVA? Why?
Shoulder
- Weak RTC mm => sublux => impingement
- immobility => adhesive capsulitis
- spasticity & immobility => shorten mm
- trauma
- impact of stroke severity
How is the shoulder subluxation quantified in CVA?
Finger Breath (FB#)
where # = the number of finger fitting into the sublux
Edema of the UE is common in patients with _____ UE, why?
flaccid UE
dependent position, loss of muscle pump
When is a sling commonly used in patient with CVA?
flaccid limb
Types of slings used with CVA patients
Regular arm sling
Cuff sling
Giv-Mohr sling
Ottobock Sling
Cuff Slings
pro/con
Hold humerous up into the glenoid fossa
hard to get on/off
GivMohr Sling
pro/con
easy to put on/off
arm is place in flexion with arm into the fossa
Why should we not put an arm into a traditional sling? When should we consider using it?
b/c it puts the arm into a position of disuse
used for pain management & far out when no active motion present
Which shoulder mm are FES in pt with CVA?
surpraspinatus
deltoid
