Neuro II Lecture 2 - PD/Stroke Flashcards
how to write PT goals?
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
what are restorative interventions
remediating or improving the patients status in terms of impairments, functional limitations, and recovery of function
what are compensatory interventions
promoting optimal function using residual abilities
what are preventative interventions
minimizing potential impairments, functional limitations, and disabilities and maintaining health.
when do you initiate discharge plan
early in rehab stay, potentially during eval
LTGs vs. STGs?
LTGs:
- based on therapy problem list
- 6-8 weeks to discharge
STGs:
- steps along the way to LTG
- basis for tx plans
- 4 weeks
What are the 4 common motor symptoms of Parkinson’s disease? What is the acronym you can use to remember this?
TRAP - tremor, rigidity, akinesia/bradykinesia, postural instability
T - Tremor presentations
early stages 70% experience slight tremor of hand or foot on ONE side of body. occurs w/ rest and disappears w/ sleep and movement
R - Rigidity presentations
resistance to passive movements
cogwheel or lead pipe
asymmetrical early on
proximal muscles first (shoulder/neck) –> face/extremities
A - Akinesia/Bradykinesia presentations
- micrographia
- slow movements
P - Postural instability presentations
rare in early years (5yrs after dx)
- flexed, stooped posture
Non-motor symptoms of PD?
- changes in smell*
- dysphagia
- GI
- mood
- cognition
- sleep disorders
how many stages of Hoehn and Yahr?
5
Stage I H&Y?
only one side of body affected
Stage II H&Y?
sx affect both sides of body
Stage III H&Y?
balance and stability become affected
Stage IV H&Y?
sx increase, however still able to stand/walk
Stage V H&Y?
assistance is required for everyday activities
gold standard drug for PD?
Sinemet - attempts to correct essential neurochemical imbalance
risk factors for stroke?
smokng, weight, high cholest., diabetes, genetics, age, sex, etc.
ct scans are better for what in terms of stroke?
quick results, rules out hemorrhage, poor sensitivity for ischemic
MRIs are better for what in terms of stroke?
greater resolution than ct, more sensitive in dx, can pick ishemic up as early as 30min, vascular occlusion within 2-6 hours
what are the two thrombolytic therapies for stroke?
tissue plasminogen activator (tPA) & Tenecteplase (TNP)
what is tissue plasminogen activer (tPA)?
delivered via IV
time dependent benefits
initiate treatment within 60-90min, possibly up to 3hrs
risks include intracranial hemorrhage, neurosurgery, head trauma
what is Tenecteplase (TNP)?
easier to administer, no IV needed after bolus
able to be treated within 4.5 hours
less expensive
recovery from stroke is fastest when?
first few weeks after onset, most measureable aprox. 90% within 3 months
