Stroke

Question 1

Transient Ischaemic Attack (TIA)

Answer 1

Rapidly developing clinical signs of focal or global disturbance of cerebral fx lasting <1h, with no apparent non-vascular cause.

Factors than ↑ risk of subsequent stroke:

• DM
• Age >60
• Symptom duration >10’
• Motor or speech impairments
• High BP (>140/90 mmHg)

Question 2

Stroke: definition

Answer 2

Rapidly developing clinical symptoms and/or signs of focal and at times global loss of cerebral fx, with symptoms lasting >24h with no apparent cause other than that of vascular origin.

Question 3

Recovery after stroke

Answer 3

> Respiratory function:

• Regular and frequent turning.
• Sitting out of bed in a supportive chair and mobilization as possible.
• Mechanical suction, postural drainage, manual hyperinflation if unconscious and continuous positive airway pressure (CPAP) once conscious.

> Musculoskeletal integrity

• ROM exercises
• Positioning: to prevent muscle shortening and increased stiffness
• Active exercises: ASAP, not wait until pt regains full consciousness.

Question 4

Sensorimotor impairments and secondary adaptive changes

Answer 4

> ↓ muscle activation and difficulty sustaining muscle activity.

> ↓ muscle force generation and poor timing of peak forces leading to slowness of mvmt.

> Poor control of synergistic muscle activity.

> Lack of skill (dexterity) due to loss of fine motor control/impaired coordination.

Question 5

Physiotherapy Rehabilitation

Answer 5

A typical PT session includes:
> Balancing activities in sitting and standing: reaching beyond arm's length
> Standing up and sitting down.
> Walking.
> Manipulation.