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Phys Dys > Stroke > Flashcards

Stroke Flashcards

1
Q

What is shaping in the context of contraint-induced therapy?

A

Behavior techniques that approach a desired motor outcome in small successive increments
They are successful in those activities and slowly increase in difficulty

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2
Q

What are four components of task-oriented OT rehab in strokes?

A
  1. Encourage weight-bearing over the involved side
  2. Encourage trunk rotation
  3. Encourage trunk elongation
  4. Encourage scapular protraction
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3
Q

What are the three components of DIM model?

A
  1. Person
  2. Context
  3. occupation
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4
Q

What is the most effective factor factor in all forms of CIT?

A

Instensive practice
Functional use of an affected limb
Across different contexts
Many hours a day for many days

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5
Q

What UE pathologies can limit the success of CIT?

A

Shoulder subluxation
Soft-tissue shortening
Joint contractures/deformities

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6
Q

How many hours of continuous practice a day is good for CIT?

A

six hours

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7
Q

What amount of UE function would you need to see before CIT?

A

Shoulder: 45 degrees flexion and abduction
ARM: 90 degree flexion extension
Wrist: 20 degree extension
MCPs: 10 degree ext of

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8
Q

T/F You can still use CIT with someone who has cognitive impairments

A

False

Cognitive impairments may prevent adequate participation in the strict protocol

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9
Q

What is the difference between an ischemic and hemorrhagic stroke?

A

Ischemic: Insufficient blow flow to brain. May be a result of an embolism to brain
Homorrhagic: Weakened blood vessel ruptures and blood leaks in to the brain

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10
Q

What are 7 modifiable stroke risk factors?

A
  1. Hypertension
  2. Cardiac disease
  3. Diabetes
  4. Smoking cigarettes
  5. Alcohol consumption
  6. Illegal drugs(cocaine, LSD., PCP, weed
  7. Obesity, inactivity, diet, emotional stress
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11
Q

What is the most common brain artery rupture?

A

Middle Cerebral artery

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12
Q

What are the deficits associated wtih middle cerebral artery hemorragic strokes?

A

Contralateral hemiplegia.
Visual field impairmen
Ideational apraxia
Perseveration
Depression
R: anosognosia, visuospatial imapairment, L. unilateral motor apraxia
L: Bilateral motor apraxia Broca’s aphasia

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13
Q

Be able to name 10-15 items scored on teh NIH stroke scale

A

1a: Level of conciousness: lower score=more alert
1b: Level of consciousness: questions: month and age
1c: Level of conciousness Commands: open and close eyes adn then grip and release hand
2: Best gaze: horizontal eye movement
3: Visual: Visual field tested by confrontation
4: Facial palsy: show teeth or raise eyebrow
5: Motor arm (look for drifting)
6. Motor leg: look for drifting
7. Limb ataxia: move finger to nose and heel to shin
8. Sensory: pinprick
9: Best language:describe what is happening in attached image, identify items and read sentenses
10: Dysarthria
11: Extinction and innattention

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14
Q

Name four non-motoric reasons person with stroke have difficulty in performing hemi-adl task

A
  1. Premotor perseveration
  2. Spatial reasoning difficulties
  3. Ideational apraxia
  4. Attention deficit
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15
Q

WHat are five interventions (with a task-oriented approach)?

A

Practice functional tasks
Provide opportunities to practice outside of therapy
Minimize ineffective movement patterns
Help clients adjust to role and task performance limitations by exploring new roles and tasks
Create an environment that includes challenges of everyday life

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16
Q

What are three effects a stroke can have on a person’s trunk?

A
  1. Inability to percieve midline
  2. Multi-directional trunk weakness
  3. Inability to shift weight through pelvis in all three directions
17
Q

List three ADL tasks that promote improved trunk control

A

Oral care: Anterior weight shift to spit
Meal prep: Trunk flexes into gravity controlled fashion to reach into fridge
Transfer: Trunk extends with hip flexion to stand up

18
Q

List 7 components that you can manage in helping a person with a stroke better perform ADL in sitting

A
  1. Establish a neutral yet active starting alignment (think of ergnomic position for a computer)
  2. The client should attempt reaching activites from the above posture
  3. Establish the ability to maintain the trunk in midline using external cues
  4. Maintain trunk ROM
  5. Prescribe dynamic weight-shifting activities
  6. Strengthen the trunk (control trunk against gravity)
  7. Using compensatory strategies and environmental adaptations when trunk control does not improve to a sufficient level and the client is at risk of injury
19
Q

List 5 strategies for improving task performance in standing

A
  1. Establish symmetrical base of support and proper alignment
  2. Establish the ability to bear weight and shift weight through more affected lower extremities
  3. Encourage dynamic reaching activities in multiple environments to develop task-specific weight-shifting abilities
  4. Use the environment to grade task difficulty and provide external support
  5. Training upright control within the context of functional tasks that are graded
20
Q

What are the benefits of sidelying on teh affected side after a stroke?

A
  1. Sensory input
  2. Increasing awareness of this side
  3. Less fearful of putting weight on weak side
  4. Helps prevent painful shoulder
  5. Reduces increased tone in flexion synergies
21
Q

How is the shoulder at risk in sidelying and how can you fix it?

A
  1. Increased risk of subluxation

2. Teach pt. to protract scapula and support position with a pillow

22
Q

T/F It is good to discourage clasped hands overhead ranging of UEs after stroke. Why or why not?

A

True. Risk of increasing pain, impingement or stressing carpal ligaments

23
Q

List 5 contraindications for the use of a bioness FES device

A
  1. Pacemaker
  2. Malignant tumor/skin cancer
  3. Fracture/disslocation
  4. Don’t use simultaneously with high frequency surgical equipment
24
Q

List 5 contraindications for the use of a REO Go therapy device1

A
  1. Clients without supervision
  2. Who can’t be active for 60 m without cardiac or respiratory problems
  3. Fixed contractures in affected limb
  4. Signif. sensation impairment
  5. Sever cognitive/linguistic/percpetual impairments
25
Q

Which electronic neurotherapy tools can be used in conjuntion with CIT tehrapy?

A

Reo-go
Armeo
Bioness H200

26
Q

WHich electronic neurotherapy tools can not be used in conjuction with CIT therapy?

A

Functional Electronic Stimulation

RT300

27
Q

Why is the traditional “funtional C” designed hand splint a poor choice for poeple with hemiplegic hand?

A
  1. Positions long finger flexors in shortened position
  2. Bent up sides cause straps to bridge/gap=fingers can be ulled out of splint
  3. Thumb is too opposed
  4. Tone of involved hand is dynamic and constantly changing
28
Q

Why is a Saebo-Stretch splint considered a better choice than a static splint for a hemiplegic hand?

A
  1. As tone increases saebo allows fingers to move into flexion
  2. Provides a low-load long duration stretch to return fingers to extension
  3. Maintain/improves ROM
  4. Improves positioning by utilizing non-slip material on straps
29
Q

What is the difference between a saebostretch and a saeboflex?

A

Seabostretch: Low-load sustained stretch, static
Saebboflex: Supports peeps with increased tone, dynamic

30
Q

Define CVA

A

Stroke.

31
Q

Define TIA

A

Transient Ischemic attack: Stroke that comes and goes

32
Q

Broca’s aphasia

A

Expression is hard

33
Q

Wernicke’s aphasia

A

Understanding is hard

34
Q

Hemianopsia

A

Loss of half of visual field on each side

35
Q

Cortical blindness

A

Total or partial loss of vision from damage to occiptial cortex

36
Q

Anomia

A

Inability to name objects or recognize the written or spken names of objects

37
Q

DVT

A

Deep vein thrombosis: blood clot from leg can be dislodged and be an embolis

Phys Dys (17 decks)

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