Neuro II Lecture 2 - PD/Stroke

Question 1

how to write PT goals?

Answer 1

ABCD

A = Audience - who
B = Behavior - will do what
C = Condition - specific conditions this is to be done under?
D = Degree - how long will it take

Question 2

what are restorative interventions

Answer 2

remediating or improving the patients status in terms of impairments, functional limitations, and recovery of function

Question 3

what are compensatory interventions

Answer 3

promoting optimal function using residual abilities

Question 4

what are preventative interventions

Answer 4

minimizing potential impairments, functional limitations, and disabilities and maintaining health.

Question 5

when do you initiate discharge plan

Answer 5

early in rehab stay, potentially during eval

Question 6

LTGs vs. STGs?

Answer 6

LTGs:
- based on therapy problem list
- 6-8 weeks to discharge

STGs:
- steps along the way to LTG
- basis for tx plans
- 4 weeks

Question 7

What are the 4 common motor symptoms of Parkinson’s disease? What is the acronym you can use to remember this?

Answer 7

TRAP - tremor, rigidity, akinesia/bradykinesia, postural instability

Question 8

T - Tremor presentations

Answer 8

early stages 70% experience slight tremor of hand or foot on ONE side of body. occurs w/ rest and disappears w/ sleep and movement

Question 9

R - Rigidity presentations

Answer 9

resistance to passive movements
cogwheel or lead pipe
asymmetrical early on
proximal muscles first (shoulder/neck) –> face/extremities

Question 10

A - Akinesia/Bradykinesia presentations

Answer 10

• micrographia
• slow movements

Question 11

P - Postural instability presentations

Answer 11

rare in early years (5yrs after dx)
- flexed, stooped posture

Question 12

Non-motor symptoms of PD?

Answer 12

• changes in smell*
• dysphagia
• GI
• mood
• cognition
• sleep disorders

Question 13

how many stages of Hoehn and Yahr?

Answer 13

5

Question 14

Stage I H&Y?

Answer 14

only one side of body affected

Question 15

Stage II H&Y?

Answer 15

sx affect both sides of body

Question 16

Stage III H&Y?

Answer 16

balance and stability become affected

Question 17

Stage IV H&Y?

Answer 17

sx increase, however still able to stand/walk

Question 18

Stage V H&Y?

Answer 18

assistance is required for everyday activities

Question 19

gold standard drug for PD?

Answer 19

Sinemet - attempts to correct essential neurochemical imbalance

Question 20

risk factors for stroke?

Answer 20

smokng, weight, high cholest., diabetes, genetics, age, sex, etc.

Question 21

ct scans are better for what in terms of stroke?

Answer 21

quick results, rules out hemorrhage, poor sensitivity for ischemic

Question 22

MRIs are better for what in terms of stroke?

Answer 22

greater resolution than ct, more sensitive in dx, can pick ishemic up as early as 30min, vascular occlusion within 2-6 hours

Question 23

what are the two thrombolytic therapies for stroke?

Answer 23

tissue plasminogen activator (tPA) & Tenecteplase (TNP)

Question 24

what is tissue plasminogen activer (tPA)?

Answer 24

delivered via IV
time dependent benefits
initiate treatment within 60-90min, possibly up to 3hrs
risks include intracranial hemorrhage, neurosurgery, head trauma

Question 25

what is Tenecteplase (TNP)?

Answer 25

easier to administer, no IV needed after bolus
able to be treated within 4.5 hours
less expensive

Question 26

recovery from stroke is fastest when?

Answer 26

first few weeks after onset, most measureable aprox. 90% within 3 months