Stroke Lab II: Task Analysis

Question 1

You are performing sit-to-stand with a stroke patient. What can you do to make the task easier?

Answer 1

• increase BoS
• raise height of surface
• anterior horizontal shift
• help with hands
• foot position further back

Question 2

when strengthening/training stroke patients to stand from sitting, what kind of things does the lab manual suggest for interventions?

Answer 2

• breaking task into components
• isometric holds at certain positions along action, then controlled descent. For higher level, can put band around legs and incorporate hip abduction isometrics.
• ensuring proper anterior pelvic tilt and trunk elongation by practicing leaning forward with hands on a table or ball
• forcing weight onto hemi side with foot position
• avoiding use of momentum to raise up

Question 3

For a stroke patient stuck in synergies, what position does the lab manual recommend to practice volitional knee flexion in a flexion synergy?

Answer 3

side-lying affected side up, with the affected leg on a large sliding board and pillow.

Question 4

what ideas does the manual include for improving gait in stroke patients?

Answer 4

• knee flexion and extension in sidelying on a sliding board
• sit-to-stand reps/training
• stepping up and down onto stool
• walking over and around obstacles
• using ramps and treadmills

Question 5

How can stair training be made easier for stroke patients?

Answer 5

• smaller steps
• less stairs or only working at bottom of stairs
• breaking movement down into parts

Question 6

Which leg do you want leading with stair training to encourage forced weight bearing on the hemi side and increased concentric force?

Answer 6

• hemi leg leading

Question 7

To encourage more substantial hip and leg flexion of the hemi side, which leg should lead with stair training?

Answer 7

• unaffected leg leading

Question 8

Match these:

(1) eccentric control esp quads, strong WB component
(2) fwd CoM mvt, hip abd strength to prevent scissoring

(a) descending stairs with good foot first
(b) descending stairs with hemi foor first

Answer 8

(1) a

(2) b

Question 9

what requires the greatest amount of anti-gravity strength?

(a) level walking
(b) descending stairs
(c) ascending stairs
(d) none of the above - all exhibit the same patterns thus require the same amount of anti-gravity strength

Answer 9

(b) descending stairs - there is a longer stance phase with stairs, and demands are higher for going down rather than going up.

Question 10

When handling patients during gait training, the _____ is often a key point of control

Answer 10

pelvis - can manage wt shift, speed, balance…

Question 11

which phase of gait is usually focused on first?

Answer 11

stance

Question 12

therapist handling can be used to:

(a) stabilize
(b) facilitate
(c) inhibit
(d) all or none of the above

Answer 12

(d) all of the above