Non-Motor Impairment Flashcards
List 5 most common primary non-motor impairments in stroke.
Vision, Proprioception, Sensation, Speech & Language, Perceptual & Cognitive function
Define dysarthria
Reduced ability to produce clear speech due to impaired function of the speech muscles.
Define dysphagia
Reduced ability to understand or express spoken or written language. (Broca’s - expressive, Wernicke’s - receptive)
Define dyspraxia
reduced ability to organise, plan, process and/or execute skilled speech. (e.g. sequencing of words & pronunciation)
define neglect and state the most commonly affected side.
failure to report, respond, or orient to stimuli when presented to opposite side of brain. Most commonly seen left neglect. (Right hemisphere affects spatial awareness)
Define agnosia
inability to recognise sounds, smells, objects or body parts despite intact sensory systems. Disabling and potentially dangerous condition –> unable to recognise danger.
List 3 types of Agnosia
Astereognosia, autotopagnosia, anosognosia.
define Astereognosia
inability to recognise symbols or objects by touch.
define autotopagnosia
disturbed perception of own body parts, inability to distinguish right from left side of body.
define anosognosia
inability to recognise presence or severity of paralysis due to underlying neurological condition. (cannot detect change in their body)
List 2 types of dyspraxia and describe the impairment.
Ideational dyspraxia - absent-mindedness and lack of purpose in performing actions (forgot how to use items). Ideomotor dyspraxia - inability to select, sequence and use ojects (just cannot do the task)
Describe Pusher Syndrome
patients actively push away from non-hemiparetic side, leading to loss of balance.
State the characteristics of pusher syndrome
Leaning towards hemiparetic side, extension & abduction on stronger side, resistance to passive correction of posture.
List some of the assessments for Perceptual-cognitive functions
Montreal-Cognitive Assessent (MoCA), Mini-mental state exam (MMSE), Abbreviated Mental Test (AMT).
List some of the assessments for Neglect
NIHSS (item 11), general observation, line bisection tests, cancellation tests, copying and drawing tests, Catherine Bergego Scale (CBS)
CBS score = 26, what category of neglect do you classify patient under?
Severe (21-30).
List some possible treatments for Visual impairment.
Visual scanning, eye patch for double vision, eye drops for dry eyes, gaze stabilization exercises.
List treatments for sensation & proprioception.
Sensory re-training (restorative approach), sensory stimulation (without active attention or discrimination)
Stimulation intervention includes, compression, electrical, thermal, sensory integrative, magnetic.
Treatments for perceptual-cognitive impairment.
Increasing attention to affected side, Visual scanning, mirrior therapy, prism adaptation, mental practice, eye patch/ half-field patching.
For a mild neglect, how will yout treat?
visual scanning, prism adaptation.
For severe neglect, how will you treat?
might need to stand on intact side and physically direct patient’s attention to you.
Treatment for Pusher Syndrome (4 steps)
Help patient realise disturbed perception of body position (reinforce visual info), locate vertical structure (orientate patient to correct vertical position), move into vertical position (voluntarily), maintain vertical position while performing activities.
Strategies for Speech and language deficits.
Refer to speech therapists.
- give patient time to respond, or use picture cards or non-verbal communication.
- Use short instructions or demo
- train whole task for patient with dyspraxia.
What is N.U.R.S.E
Naming, understanding, respecting, supporting, exploring.
Strategies for Fatigue patients?
- Explain the type of fatigue (Exertional/pathological)
- Discuss strategies to reduce fatigue.
- check sleeping pattern, exercise pattern, mood.
- recommend good sleeping habits (e.g. no caffeine after 6pm, wind down from a specific time, sleeping environment)
- spending time with family.
