Week 2 - Stroke and NDT Flashcards
Common types of post stoke pain:
- Peripheral neuropathic pain
- Nociceptive
- Complex regional pain syndrome
- Central post stoke pain
- Other body pain or pain from previous conditions
What is Type 1 Complex Regional Pain Syndrome (CRPS) commonly associated with?
Hemiplegia
What are some Peripheral and central nervous system changes that might occur with Complex Regional Pain Syndrome - 1 (CRPS)?
PNS
- Hand pain and swelling
- exquisite tenderness or hyperaesthesia
- Immobility
- Trophic skin changes
- instability of the involved UE
CNS
- Disruption of sensory cortical processing
- disinhaibtation of the motor cortex
- disrupted body schema
Treatment for Complex Regional Pain Syndrome (CRPS)?
-Mirror Box Therapy
-ROM Exercises
-Oral Corticosteroids
-Calcitonin
What is Central Post Stroke Pain (CPSP)?
- occurs when a stroke affects the thalamus and parietal lobe where sensory stimulation is processed
- involves a combination of sensory loss, allodynia and spontaneous pain.
How might a patient describe Central Post Stroke Pain (CPSP)
- Burning
- Pins and needles
- sudden stabbing sensation (May be intolerable)
how to manage Central Post Stroke Pain (CPSP)
- combination of drugs and other therapies (aimed to reducing symptoms not fixing)
- relaxation
- Biofeedback
- stimulating procedures of the brain where pain signals are originating.
What is Post Stroke Fatigue (PSF)
- overwhelming tiredness
- abnormal need for sleep
- on predictable feelings of fatigue
Prevalence of Post Stroke Fatigue (PSF)
- 38-73% depending on the study
- Present in both acute and chronic phases
- Not related to size, location or serenity of stoke
Impacts of Post Stroke Fatigue (PSF)
- physical
- cognitive
- Self care
- productivity
- leisure
What is the prevalence of Post Stroke Depression (PSD)?
Greater than 30% of stroke patients experience depression at some point during
their recovery
what are some risk factors of Post Stroke Depression (PSD)?
- previous history
- Functional limitations and/or cognitive impairments
What is the Canadian Stoke Best Practice Recommendations (CSBPR)
All patients with strokes should be considered to be a high risk for PSD
what is the cause of a stoke?
Sudden development of a focal neurological
deficit as a consequence of a local disturbance
in the cerebral circulation
- A sudden injury to part of the brain caused
when arterial blood flow is interrupted- The affected area of the brain is deprived of
oxygen and nutrients. - This damages the neurons and the functions
they control.
- The affected area of the brain is deprived of
What are the signs of a stroke?
F: face is drooping
A: unable to raise arms
S: slurred or jumbled speech
T: time to call 911
What is a Transient Ischemic Attack (TIA)?
Temporary interruption of blood supply to
part of the brain
* Stroke “Warning Sign”
* Angina Equivalent
Symptoms may last a few minutes to an hour
Champlain
What are some similarities and differences between TIA and a stroke?
similarities
- Sudden onset
- Focal neurologic symptoms
difference
TIA
- Caused by transient lack of
blood supply, focal ischemia
* Typically lasts < 1 hour
* No permanent damage to
the brain
Stroke
- Caused by complete
interruption of blood supply
* Lasts > 1 hour
* Permanent damage to brain
What are some modifiable stroke risk factors?
- Hypertension
- Hypercholesterolemia
- Atrial fibrillation
- Diabetes
- Smoking
- Overweight / obesity
- Physical inactivity
- Excessive alcohol consumption
- Stress
How to manage stroke risks factors?
- Medications
- Surgical options
- Lifestyle/Behavioural Modifications
What is the role of a PT in acute strokes?
- Assessment:
- Screen: communication, cognition
- Sensation, tone, motor control
- Functional mobility
- Respiratory system
- Analysis and development of rx plan
- Determine rehab needs
- Interprofessional collaborative approach
What effects does a stroke have on mobility?
- Fatigue
- Sensory changes
- Motor control changes
- Balance
- Posture
- Perceptual changes
- Cognitive changes
What are some factors contributing to shoulder pain
- Loss of scapulo-humeral rhythm
- Loss of outward rotation of the humerus
- Lack of downward movement of the humerus
- Tonal changes-upper limb and trunk
- Handling
- Positioning
- Falls
- Contractures
what is Shoulder Subluxation?
- Common after stroke due to paresis and
muscle imbalances - Tends to improve with return of muscle
tone - Relieved with appropriate positioning
how can music therapy help in stroke rehab?
Music therapy uses music and its components (melody, rhythm, harmony) to address non-musical goals.
What is the goal of Music Therapy in Stroke Rehab
Goals include: Rehabilitation of speech, motor, and cognition - To address areas of psychosocial health
How does music influence the brain?
music can access control processes in the brain related to:
-control of movement
- attention
- speech production
- learning and memory
Music can therefore help to retrain and recover functions lost to injury or disease.
How does music stimulate different parts of the brain?
Music engages various brain functions through different elements:
Pitch Interval – Helps with auditory processing and musical perception.
Pitch Pattern – Recognized by memory and pattern recognition areas.
Harmony – Activates regions involved in emotional response and pleasure.
Timbre – Differentiates sounds and instruments, engaging sensory processing.
Rhythm – Affects movement coordination and timing in the motor cortex.
Pulse/Beat – Engages the brain’s timing mechanisms and motor synchronization.
Emotion – Triggers the limbic system, influencing mood and feelings.
Recognition – Involves memory and association areas of the brain.
