Stages of Stroke and Bed Mobility Flashcards
What are the stages of motor recovery following stroke?
Stages of motor recovery include…
- flaccidity
- spasticity
- isolated movements
- coordinated movements
What is synergy in the context of motor recovery?
Synergy is a group of muscles that work together to provide patterns of movements, occurring in flexion and extension combinations.
Where does spasticity often initially develop after a stroke?
Spasticity often develops in the muscles of the shoulder and pelvic girdle, including shoulder depressors, internal rotators, elbow biceps, wrist, and finger flexors.
What is the importance of positioning after a stroke?
Positioning helps…
- stimulate motor functions
- improve respiratory function
- maintain normal ROM
- minimize MSK deformities
- prevent pressure ulcers
How should the upper extremity (UE) be positioned when the patient is supine?
Small towel under the shoulder, external rotation, abducted 30 degrees, extended with forearm supinated, slightly extended wrist, and finger extension.
What is the Fugl-Meyer Assessment used for?
The Fugl-Meyer Assessment is used to assess motor function, balance, ROM, and pain, organized by sequential recovery stages with high reliability.
What are the five domains of the Fugl-Meyer Assessment?
Motor function, sensation, balance, joint range of motion, and joint pain.
How long does it take to administer the Fugl-Meyer Assessment?
30-40 minutes.
What is the Stroke Impact Scale?
A self-reported measure to assess function and quality of life after a stroke, consisting of 59 items in 8 subgroups.
What are the subgroups in the Stroke Impact Scale?
Strength, memory, emotions, communication, hand function, participation.
What should a practice schedule include for bed mobility interventions?
- distributed practice, progress to variable practice, high enough intensity, challenging but not discouraging, and task analysis.
What is the FITT principle in the context of bed mobility interventions?
Frequency, Intensity, Time, and Type of exercise to ensure effective intervention.
What are the types of motor control skills?
- stability (static postural control)
- controlled mobility (dynamic postural control)
- transitional mobility
- skilled mobility.
What is the progression of treatment for motor control skills?
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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What are the skills involved in bed mobility?
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.
What are the principles of task analysis in bed mobility?
Observe normal movements, ensure adequate mechanical capacity, appropriate neuromuscular function, and effective motor control.
What is hook lying?
Supine position with knees and hips flexed to 60 degrees, feet flat on the supporting surface.
What are the benefits of hook lying?
Promotes early trunk and hip stability, dynamic postural control, and functional skills like scooting in bed and dressing.
What are common deficits observed in hook lying?
Arching/rotating the spine with diminished hamstrings activity, and raising foot with minimal knee flexion indicating lack of core stability.
How can you assist a patient in assuming the hook lying position?
Patient pushes heel onto mat with knee extended while sliding opposite heel toward buttocks with verbal cues and light resistance.
What is bridging in bed mobility?
Active transition from hook lying, extending hips and elevating pelvis from the support surface with lumbar spine in neutral position.
What are the primary muscles involved in bridging?
Lower trunk and hip muscles, gluteus maximus for hip extension, and ankle/foot muscles for stabilization.
What are the key points to observe during task analysis of bridging?
Pelvis should be in neutral position with movement through bilateral hip extension and symmetrical weight bearing through LE.
What is scooting in bed mobility?
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.
What mobility requirements are needed for scooting?
Hip abduction/adduction, external/internal rotation, and ability to lengthen/shorten lateral trunk flexors.
What is the significance of rolling in bed mobility?
Early functional activity, improves bed mobility, leads to LE dressing and independent transfer from supine to sit.
How do you assist a patient in rolling to the involved side?
Start by turning the head to the side towards which the patient is going to roll, watch the movement, and use rhythmic initiation.
How do you assist a patient in rolling to the uninvolved side?
Cross one foot over the other to assist in rolling and use the momentum of the UE, especially in SCI.
What are the stages of motor recovery?
Flaccidity, spasticity, isolated movements, coordinated movements.
What are synergy patterns?
Groups of muscles working together to provide movement patterns in flexion and extension combinations.
What is the importance of positioning after stroke?
Stimulates motor function, improves respiratory function, maintains ROM, minimizes deformities, and prevents pressure ulcers.
Describe the positioning of the UE in supine.
Small towel under shoulder, external rotation, abducted 30 degrees, extended forearm supinated, wrist extended, finger extension.
What is the purpose of the Fugl-Meyer Assessment?
Assess motor function, balance, ROM, and pain, with high reliability.
Name the five domains of the Fugl-Meyer Assessment.
- motor function
- sensation
- balance
- joint ROM
- joint pain
How long does it take to administer the Fugl-Meyer Assessment?
30-40 minutes.
What does the Stroke Impact Scale assess?
Function and quality of life post-stroke with 59 items in 8 subgroups.
List the subgroups of the Stroke Impact Scale.
Strength, memory, emotions, communication, hand function, participation.
What should a practice schedule for bed mobility include?
Distributed practice, progression to variable practice, high intensity, and task analysis.
Explain the FITT principle.
Frequency, Intensity, Time, and Type of exercise for effective intervention.
Describe types of motor control skills.
Stability, controlled mobility, transitional mobility, skilled mobility.
What is the progression of treatment for motor skills?
From stability to mobility to skill, elevate COM, narrow BOS, increase cognitive demand.
What are the goals of bed mobility techniques?
Promote independence, facilitate efficient and pain-free movements, prepare for self-care activities.
List the skills involved in bed mobility.
Moving in bed, rolling, transitioning from supine/sidelying to sit.
What are the principles of task analysis in bed mobility?
Observe normal movements, ensure adequate mechanical capacity, neuromuscular function, and motor control.
What is hook lying?
Supine position with knees/hips flexed to 60 degrees, feet flat on the surface.
What are the benefits of hook lying?
Promotes trunk and hip stability, dynamic control, and functional skills.
What are common deficits in hook lying?
Arching spine with diminished hamstrings activity, raising foot with minimal knee flexion.
How to assist a patient into hook lying?
Push heel on mat with knee extended, slide opposite heel toward buttocks with cues and resistance.
