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.
