Stroke - Presentation Flashcards
What are strokes?
A sudden disease affecting the arteries going to or within the brain
- a stroke occurs when these arteries become blocked by a clot or rupture, causing O2 & nutrients to not reach the brain
- leading to long-term disability
What are 5 types/classifications of Stroke?
1.) Hemorrhagic
2.) Ischemic
3.) Tranient Ischemic Attack (TIA)
4.) Cryptogenic
5.) Brain Stem
What is the most common type/classification of stroke?
Ischemic Stroke
What is a Hemmorhagic Stroke & its 2 subtypes?
Stroke caused by the rupture of an artery/vessel
& the 2 subtypes are:
1.) Aneurysm - artery wall widens due to being weakened which then causes the rupture
2.) Arteriovenous Malformations (AVM) - irregular artery-vein connections due to tangles of blood vessels which then causes the rupture
What is an Ischemic Stroke & what % of strokes do they account for?
A stroke causes by a blockage or clot in the artery, typically due to plaque buildup in the artery wall(s)
- account for 87% of strokes
What is a Transient Ischemic Attack (TIA)?
A temporary artery blockage that lasts less than 24hrs & acts as a warning sign
What is a Cryptogenic Stroke?
A stroke where the cause is unknown
What is a Brain Stem Stroke?
Obviously, a stroke occurring in the brain stem, which can cause a “locked in” state where the person cannot speak or move below the neck
When/why would a stroke occur in a child?
Anytime from prenatal to 18 years old & can be hemorrhagic or Ischemic & occur due to malformations or rare diseases
What are some common risk factors for strokes?
- high BP = most common for hemorrhagic
- Heart rhythm disorders
- High cholesterol
- Drug use & unhealthy lifestyle (diet, PA, alc, etc)
- Aging
- pregnancy
What are a few stats of strokes in Canada?
- 3rd leading cause of death
- # 1 leading cause of premature death in women
- 25% of strokes under 65yrs & 75% are over 65
- men & women strokes rates are pretty similar, women slightly higher
Is stroke occurrence/rate higher in men or women?
1st stroke occurrence/likelihood of stroke = higher in men than women
What are some Physical implications/features of someone who has had a stroke?
- paralysis & weakness of body/muscles
- swallowing & eating challenges
- increased muscle tone & nerve damage
- vision & hearing difficulties
- pain
- seizures
How does Nerve Damage influence a stroke survivors daily life?
• Can impact ability to walk, cause pain in different areas in body (clotto), tingly, burning & numbness may occur & typically felt on side the stroke occurred on
What are 4 key categories of Cognitive Implications/Features caused by stroke?
1.) Memory Loss
2.) Spacial Neglect/One-sided Neglect
3.) Lack of attention & Concentration
4.) Vascular Dementia
When discussing Cognitive Implications/Features of stroke, How is Memory impacted?
- Visual memory loss, struggle remembering faces
- Verbal: struggle remembering things you said & phrases
- Informational: difficulty remembering directions or specific instructions
When discussing Cognitive Implications/Features of stroke, What is Spatial or One-sided Neglect?
Unaware of stimuli on one-side of body (eg; stroke in right brain results in one-sided neglect on left side)
- makes moving around challenging
Eg; ignore food on left side of plate if have left-sided neglect
When discussing Cognitive Implications/Features of stroke, How is Attention/Concentration impacted?
Multitasking = extremely challenging
- places with more noise is overstimulating
When discussing Cognitive Implications/Features of stroke, What is Vascular Dementia (VD)?
- occurs when left brain stroke occurs, but VD doesn’t always result
- depends on location & size of stroke
What are 5 Social Implications one may face following a stroke?
1.) reduced interactions & increased isolation
2.) Strain on relationships
3.) Fear of abandonment within social network
4.) Refined social roles & responsibilities
5.) Reduced or loss of employment
How do barriers impact stroke survivors?
Barriers for one person may be facilitators for anther, or not even considered, that is because they’re individualized & highly dependent on;
- severity, type, structures affected, age, values, & recovery
What are some Intrapersonal Barriers that may be faced by someone following a Stroke?
1.) Self-doubt, shame, embarrassment, & isolation (inability to participate & facing failure)
2.) Post-Stroke Depression (energy trade-off)
3.) Burden/Inconvenience (heavily rely on others)
4.) Fear, reduced confidence, & frustration (falling, memory loss & cognitive impairments)
5.) Loss of control (their life is no longer in their control)
What are some Interpersonal Barriers that may be faced by someone following a Stroke?
1.) Communication Impairments
2.) Spouse/Caregiver Support
3.) Practitioners Predictions
4.) Lack of knowledge
When discussing Interpersonal Barriers of communication impairments, what is Aphasia vs Apraxia vs Dysarthria?
Aphasia = impairment in the ability to use or comprehend words
Apraxia = difficulty executing voluntary movement patterns necessary to produce speech when there is no paralysis or weakness of speech muscles
Dysarthria = affects pronunciation, loudness, & ability to speak at a normal rate
What are some Structural Barriers that may be faced by someone following a Stroke?
1.) Financial Stress - less income & treatment cost
2.) Finding Programming - uncomfortable, age groups, or not interested
3.) Transportation - really on others & public transportation location
4.) Navigating familiar places - barriers not considered
What are some Sociocultural Barriers that may be faced by someone following a Stroke?
1.) Work Limitations or refusal - worried about recurrence
2.) Inability to return to their “social role”
3.) Loss of societal value
4.) Lack of knowledge
What are 3 types of therapy’s that are used as management strategies for stroke patient’s?
Physical, Speech, & Occupational
How is Physical Therapy used as a Management Strategy for stroke patients?
Therapy assists with motor skills, mobility, & ROM and also utilizes constraint-induced therapy
How is Speech Therapy used as a Management Strategy for stroke patients?
Can be done one-on-one of in group sessions
- computers & mobile apps can be used as outside resources to help with speech barriers
How is Occupational Therapy used as a Management Strategy for stroke patients?
- Impatient/outpatient services
- assists with residential care, returning to driving, & work
How is Acupuncture used as a Management Strategy for stroke patients?
Shown to help improve areas such as speech & communication & helps with wide range of muscle spasms & pain
How is Stress Reduction used as a Management Strategy for stroke patients?
Massages = increase blood flow, reduces pain, & improves gait
Yoga/Meditation = improves memory & state of anxiety
How is Weight Management used as a Management Strategy for stroke patients?
- lower body weight if overweight/obese
- decrease cholesterol, blood pressure, etc
- maintain a healthy weight
How is Nutrition used as a Management Strategy for stroke patients?
- maintain proper hydration
- more whole foods & high in essential nutrients
What are the primary goals of the management strategies & interventions?
- regain ability to perform ADL’s & improve QoL
- foster community participation, inclusivity, & awareness
- meet specific needs of each individual
- foster resiliency & perseverance
- improve all functional aspects & capabilities
Using the STEP Framework, how could you adapt/adjust the Space for stroke patients?
- smooth & slip resistant surface
- limit # of obstacles & distractions
- ensure accessible for those with mobility aids
- provide rest areas with seating
Using the STEP Framework, how could you adapt/adjust the Task for stroke patients?
- interval activities to increase rest opportunities
- modify locomotor requirements
- adjust success criteria & simplify tasks
- adjust pace of activity & encourage self-pace
Using the STEP Framework, how could you adapt/adjust the Equipment for stroke patients?
- slower moving & larger sized targets
- provide lighter equipment & modify grips
- adjust height of equipment
Using the STEP Framework, how could you adapt/adjust the People for stroke patients?
- smaller groups
- pair with friends or people comfortable with
- focus on process over performance
