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DPT 752 - Neurological Rehab I > Stages of Stroke and Bed Mobility  > Flashcards

Stages of Stroke and Bed Mobility  Flashcards

1
Q

What are the stages of motor recovery following stroke?

A

Stages of motor recovery include…

  • flaccidity
  • spasticity
  • isolated movements
  • coordinated movements
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2
Q

What is synergy in the context of motor recovery?

A

Synergy is a group of muscles that work together to provide patterns of movements, occurring in flexion and extension combinations.

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3
Q

Where does spasticity often initially develop after a stroke?

A

Spasticity often develops in the muscles of the shoulder and pelvic girdle, including shoulder depressors, internal rotators, elbow biceps, wrist, and finger flexors.

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4
Q

What is the importance of positioning after a stroke?

A

Positioning helps…

  • stimulate motor functions
  • improve respiratory function
  • maintain normal ROM
  • minimize MSK deformities
  • prevent pressure ulcers
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5
Q

How should the upper extremity (UE) be positioned when the patient is supine?

A

Small towel under the shoulder, external rotation, abducted 30 degrees, extended with forearm supinated, slightly extended wrist, and finger extension.

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6
Q

What is the Fugl-Meyer Assessment used for?

A

The Fugl-Meyer Assessment is used to assess motor function, balance, ROM, and pain, organized by sequential recovery stages with high reliability.

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7
Q

What are the five domains of the Fugl-Meyer Assessment?

A

Motor function, sensation, balance, joint range of motion, and joint pain.

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8
Q

How long does it take to administer the Fugl-Meyer Assessment?

A

30-40 minutes.

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9
Q

What is the Stroke Impact Scale?

A

A self-reported measure to assess function and quality of life after a stroke, consisting of 59 items in 8 subgroups.

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10
Q

What are the subgroups in the Stroke Impact Scale?

A

Strength, memory, emotions, communication, hand function, participation.

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11
Q

What should a practice schedule include for bed mobility interventions?

A
  • distributed practice, progress to variable practice, high enough intensity, challenging but not discouraging, and task analysis.
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12
Q

What is the FITT principle in the context of bed mobility interventions?

A

Frequency, Intensity, Time, and Type of exercise to ensure effective intervention.

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13
Q

What are the types of motor control skills?

A
  • stability (static postural control)
  • controlled mobility (dynamic postural control)
  • transitional mobility
  • skilled mobility.
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14
Q

What is the progression of treatment for motor control skills?

A

Progress from stability to mobility to skill, elevate COM, narrow BOS, increase cognitive demand, and move towards dynamic and open environments.

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15
Q

.

A
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16
Q

What are the skills involved in bed mobility?

A

Moving in bed (bridging and scooting), rolling from supine to side lying, rolling from sidelying to supine/prone, and transitioning from supine/sidelying to sit.

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17
Q

What are the principles of task analysis in bed mobility?

A

Observe normal movements, ensure adequate mechanical capacity, appropriate neuromuscular function, and effective motor control.

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18
Q

What is hook lying?

A

Supine position with knees and hips flexed to 60 degrees, feet flat on the supporting surface.

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19
Q

What are the benefits of hook lying?

A

Promotes early trunk and hip stability, dynamic postural control, and functional skills like scooting in bed and dressing.

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20
Q

What are common deficits observed in hook lying?

A

Arching/rotating the spine with diminished hamstrings activity, and raising foot with minimal knee flexion indicating lack of core stability.

21
Q

How can you assist a patient in assuming the hook lying position?

A

Patient pushes heel onto mat with knee extended while sliding opposite heel toward buttocks with verbal cues and light resistance.

22
Q

What is bridging in bed mobility?

A

Active transition from hook lying, extending hips and elevating pelvis from the support surface with lumbar spine in neutral position.

23
Q

What are the primary muscles involved in bridging?

A

Lower trunk and hip muscles, gluteus maximus for hip extension, and ankle/foot muscles for stabilization.

24
Q

What are the key points to observe during task analysis of bridging?

A

Pelvis should be in neutral position with movement through bilateral hip extension and symmetrical weight bearing through LE.

25
Q

What is scooting in bed mobility?

A

Active lateral pelvic shift to reposition the whole body, important for positional changes in bed and moving to the edge of the bed before sitting up.

26
Q

What mobility requirements are needed for scooting?

A

Hip abduction/adduction, external/internal rotation, and ability to lengthen/shorten lateral trunk flexors.

27
Q

What is the significance of rolling in bed mobility?

A

Early functional activity, improves bed mobility, leads to LE dressing and independent transfer from supine to sit.

28
Q

How do you assist a patient in rolling to the involved side?

A

Start by turning the head to the side towards which the patient is going to roll, watch the movement, and use rhythmic initiation.

29
Q

How do you assist a patient in rolling to the uninvolved side?

A

Cross one foot over the other to assist in rolling and use the momentum of the UE, especially in SCI.

30
Q

What are the stages of motor recovery?

A

Flaccidity, spasticity, isolated movements, coordinated movements.

31
Q

What are synergy patterns?

A

Groups of muscles working together to provide movement patterns in flexion and extension combinations.

32
Q

What is the importance of positioning after stroke?

A

Stimulates motor function, improves respiratory function, maintains ROM, minimizes deformities, and prevents pressure ulcers.

33
Q

Describe the positioning of the UE in supine.

A

Small towel under shoulder, external rotation, abducted 30 degrees, extended forearm supinated, wrist extended, finger extension.

34
Q

What is the purpose of the Fugl-Meyer Assessment?

A

Assess motor function, balance, ROM, and pain, with high reliability.

35
Q

Name the five domains of the Fugl-Meyer Assessment.

A
  • motor function
  • sensation
  • balance
  • joint ROM
  • joint pain
36
Q

How long does it take to administer the Fugl-Meyer Assessment?

A

30-40 minutes.

37
Q

What does the Stroke Impact Scale assess?

A

Function and quality of life post-stroke with 59 items in 8 subgroups.

38
Q

List the subgroups of the Stroke Impact Scale.

A

Strength, memory, emotions, communication, hand function, participation.

39
Q

What should a practice schedule for bed mobility include?

A

Distributed practice, progression to variable practice, high intensity, and task analysis.

40
Q

Explain the FITT principle.

A

Frequency, Intensity, Time, and Type of exercise for effective intervention.

41
Q

Describe types of motor control skills.

A

Stability, controlled mobility, transitional mobility, skilled mobility.

42
Q

What is the progression of treatment for motor skills?

A

From stability to mobility to skill, elevate COM, narrow BOS, increase cognitive demand.

43
Q

What are the goals of bed mobility techniques?

A

Promote independence, facilitate efficient and pain-free movements, prepare for self-care activities.

44
Q

List the skills involved in bed mobility.

A

Moving in bed, rolling, transitioning from supine/sidelying to sit.

45
Q

What are the principles of task analysis in bed mobility?

A

Observe normal movements, ensure adequate mechanical capacity, neuromuscular function, and motor control.

46
Q

What is hook lying?

A

Supine position with knees/hips flexed to 60 degrees, feet flat on the surface.

47
Q

What are the benefits of hook lying?

A

Promotes trunk and hip stability, dynamic control, and functional skills.

48
Q

What are common deficits in hook lying?

A

Arching spine with diminished hamstrings activity, raising foot with minimal knee flexion.

49
Q

How to assist a patient into hook lying?

A

Push heel on mat with knee extended, slide opposite heel toward buttocks with cues and resistance.

DPT 752 - Neurological Rehab I (22 decks)

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