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NMR II > Exam 3: Stroke Examination > Flashcards

Exam 3: Stroke Examination Flashcards

1
Q

Is it necessary to test reflexes when examining a stroke patient?

A

No because we already know that they have a central pathology

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2
Q

What are the three prognostic indicators for shoulder pain?

A
  1. Low stage of motor recovery
  2. Scapular malalignment
  3. Loss of shoulder movement
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3
Q

What shoulder motions are likely limited following stroke?

A

Flexion less than 90
Abduction less than 90
ER less than 60

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4
Q

What are the two precautions to protect shoulder joint integrity in stroke patients?

A
  1. Do not force ROM
  2. No ABD or flexion above 90 if the patient has limited scapular mobility or lack of ER
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5
Q

If you move a pt’s shoulder above 90 degrees of flexion or abduction, what else must you do to ensure the patient’s safety?

A

Passively assist with scapular mobility

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6
Q

Should you assess for motor control or strength first?

A

Motor control assessment should always precede a strength assessment

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7
Q

How do you assess voluntary movements in stroke patients?

A

Assess synergy dominance, Fugl-Meyer, Chedoke-McMaster, or isolated active movement against gravity

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8
Q

Should MMT be used as the standard to assess strength in stroke patients? Why or why not?

A

No, MMT is not valid due to strong spasticity, reflex, and synergy dominance

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9
Q

How should you assess strength in patients in the early stages of stroke recovery?

A

Functional strength testing

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10
Q

How should you assess strength in patients in the late stages of stroke recovery?

A

MMT or handheld dynamometer

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11
Q

How should you assess the trunk of a stroke patient?

A

Anterior pelvic tilt paired with lumbar extension, posterior pelvic tilt paired with lumbar flexion, bilateral lumbar lateral flexion

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12
Q

What would you expect to find when examining trunk function in a patient in the early stages of stroke recovery?

A

Impaired motor recruitment

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13
Q

What would you expect to find when examining trunk function in a patient in the late stages of stroke recovery?

A

Impaired motor recruitment and ROM restrictions

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14
Q

What is the NIH Stroke Scale?

A

A systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit

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15
Q

Why is the NIH Stroke Scale used?

A

As an early prognostic assessment, to evaluation acuity, determine appropriate treatments, predict outcome

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16
Q

What does the NIH Stroke Scale assess?

A

LOC, language, neglect, visual field loss, eye movement, motor strength, ataxia, dysarthria, sensory loss

17
Q

What is the score range for the NIH Stroke Scale?

A

1 is mild and 42 is very severe

18
Q

If a pt scored between 1-5 on the NIH Stroke Scale, what severity are they classified as?

A

Mild

19
Q

If a pt scored between 5-14 on the NIH Stroke Scale, what severity are they classified as?

A

Moderate

20
Q

If a pt scored between 15-24 on the NIH Stroke Scale, what severity are they classified as?

A

Severe

21
Q

If a pt scored between 25-42 on the NIH Stroke Scale, what severity are they classified as?

A

Very severe

22
Q

If a pt scores between 1-5 on the NIH Stroke Scale, what rehab setting is recommended?

A

Pt will likely be able to be discharged

23
Q

If a pt scores between 6-13 on the NIH Stroke Scale, what rehab setting is recommended?

A

Inpatient rehab

24
Q

If a pt scores a 14 or higher on the NIH Stroke Scale, what rehab setting is recommended?

A

Acute, subacute, or long-term care

25
Q

What is the purpose of the Fugl-Meyer Assessment?

A

Evaluate recovery in post-stroke hemiplegic patients

26
Q

What is the gold standard assessment for stroke rehabilitation?

A

Fugl-Meyer Assessment

27
Q

What are the five domains assessed by the Fugl-Meyer Assessment?

A
  1. Motor function of UE and LE
  2. Sensory function
  3. Balance
  4. Joint range and motion
  5. Joint pain
28
Q

What are the core measures to assess gait, balance, and transfers according to the APTA?

A

6 Minute Walk Test
10 Meter Walk Test
Berg Balance Scale
Functional Gait Assessment
Activities-Specific Balance Confidence Scale
5 Time Sit to Stand Test

NMR II (27 decks)

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