stroke recovery and treatment Flashcards
what is neuroplasticity?
-the adaptive capacity of the CNS - the ability to modify its own structural organisation and functioning
how does neuroplasticity happen?
-developmental proteins that are not normally expressed in an adult re emerge in the brain in the hrs and days post brain injury
-they exert their effects for a no of weeks or months - growth, apoptosis, angiogenesis
what does the process of recovery of the brain involve post stroke?
-cell death
-secondary damage (functional inhibition)
-early spontaneous recovery (body own healing) - oedema reduces, collateral circulation (back up circulation)
what is axonal sprouting?
undamaged axons grow new nerve endings to reconnect to neurons whose links were damaged
what is unmasking?
-activation of normally inhibited pathways
what is the vicaration theory?
-that brain areas w/ diff function could sometimes assume or take over the functions of injured areas
what are examples of factors influencing neuroplasticity?
-age
-gender
-size and site of lesion
-environment enriched
-drugs
-intensity of practice - better recovery
-social support - family is v important
why is the learned non use theory?
-the stroke pt learns to become more efficient by using the intact upper limb, while ‘learning’ not to use the affected upper limb because of the loss of activity, frustration and increased effort
what type of function is very important for learning for stroke patients in rehab?
-cognitive function is vital
eg remembering what physio said, instructions for safe movement, sit to stand etc
what is a ‘good recovery’ for a stroke pt?
the the pt is able to resume normal life even through there may be some minor impairments
what are examples of factors that influence recovery?
-severity
-side of stroke
-sensory deficits
-incontinence
-poor cognitive status
-age
-co-existing disease
-motivation
-depression
what are the different stages of rehabilitation in stroke pts?
-acute
-intermediate
-long term
what are the factors that influence rehab?
-complications / pain
-psychological
-cognitive - tolerance, concentration, attention
-other medial probs, co-morbidities
what is the bobath neurodevelopment treatment?
an older approach that focuses on facilitating normal movement patterns, normalising tone and sensory input, balance etc
what is the motor relearning programme?
-a programme used in neuro rehab that focuses on function and not impairment
-involves strength training, biomechanics, motor learning and problem solving
what are examples of aids and appliances that can be used in stroke pts?
-splints
-orthotics
-footwear
-walking stick
-frames
what is a tilt table?
- a table where the pt is positioned and it is gradually raised to the upright position
-important to check for dizziness
what is the stroke treatment table?
-table that has a concave area so can be easily positioned infant of the patient and can be used for UL rehab treatments / positioning of UL
why do you use a wide treatment plinth for neuro pts?
-provides a more supportive surface, for practicing bed mobility, bridging etc
what can foam arm elevators be used for?
they can be helpful if the hemiplegic hand is very swollen , the elevated position can reduce swelling
what is the purpose of the ankle foot orthosis in neuro pts?
-can provide some stability to the ankle
what are the guidelines on therapy session times for stroke pts?
3 hours a day
what is the redundancy theory?
-duplicate or back up areas that can mediate a function after brain damage eg homologous region on the opposite side of brain
