Non-Motor Impairment

Question 1

List 5 most common primary non-motor impairments in stroke.

Answer 1

Vision, Proprioception, Sensation, Speech & Language, Perceptual & Cognitive function

Question 2

Define dysarthria

Answer 2

Reduced ability to produce clear speech due to impaired function of the speech muscles.

Question 3

Define dysphagia

Answer 3

Reduced ability to understand or express spoken or written language. (Broca’s - expressive, Wernicke’s - receptive)

Question 4

Define dyspraxia

Answer 4

reduced ability to organise, plan, process and/or execute skilled speech. (e.g. sequencing of words & pronunciation)

Question 5

define neglect and state the most commonly affected side.

Answer 5

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)

Question 6

Define agnosia

Answer 6

inability to recognise sounds, smells, objects or body parts despite intact sensory systems. Disabling and potentially dangerous condition –> unable to recognise danger.

Question 7

List 3 types of Agnosia

Answer 7

Astereognosia, autotopagnosia, anosognosia.

Question 8

define Astereognosia

Answer 8

inability to recognise symbols or objects by touch.

Question 9

define autotopagnosia

Answer 9

disturbed perception of own body parts, inability to distinguish right from left side of body.

Question 10

define anosognosia

Answer 10

inability to recognise presence or severity of paralysis due to underlying neurological condition. (cannot detect change in their body)

Question 11

List 2 types of dyspraxia and describe the impairment.

Answer 11

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)

Question 12

Describe Pusher Syndrome

Answer 12

patients actively push away from non-hemiparetic side, leading to loss of balance.

Question 13

State the characteristics of pusher syndrome

Answer 13

Leaning towards hemiparetic side, extension & abduction on stronger side, resistance to passive correction of posture.

Question 14

List some of the assessments for Perceptual-cognitive functions

Answer 14

Montreal-Cognitive Assessent (MoCA), Mini-mental state exam (MMSE), Abbreviated Mental Test (AMT).

Question 15

List some of the assessments for Neglect

Answer 15

NIHSS (item 11), general observation, line bisection tests, cancellation tests, copying and drawing tests, Catherine Bergego Scale (CBS)

Question 16

CBS score = 26, what category of neglect do you classify patient under?

Answer 16

Severe (21-30).

Question 17

List some possible treatments for Visual impairment.

Answer 17

Visual scanning, eye patch for double vision, eye drops for dry eyes, gaze stabilization exercises.

Question 18

List treatments for sensation & proprioception.

Answer 18

Sensory re-training (restorative approach), sensory stimulation (without active attention or discrimination)
Stimulation intervention includes, compression, electrical, thermal, sensory integrative, magnetic.

Question 19

Treatments for perceptual-cognitive impairment.

Answer 19

Increasing attention to affected side, Visual scanning, mirrior therapy, prism adaptation, mental practice, eye patch/ half-field patching.

Question 20

For a mild neglect, how will yout treat?

Answer 20

visual scanning, prism adaptation.

Question 21

For severe neglect, how will you treat?

Answer 21

might need to stand on intact side and physically direct patient’s attention to you.

Question 22

Treatment for Pusher Syndrome (4 steps)

Answer 22

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.

Question 23

Strategies for Speech and language deficits.

Answer 23

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.

Question 24

What is N.U.R.S.E

Answer 24

Naming, understanding, respecting, supporting, exploring.

Question 25

Strategies for Fatigue patients?

Answer 25

1. Explain the type of fatigue (Exertional/pathological)
2. Discuss strategies to reduce fatigue.
3. check sleeping pattern, exercise pattern, mood.
4. recommend good sleeping habits (e.g. no caffeine after 6pm, wind down from a specific time, sleeping environment)
5. spending time with family.