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210 - kcep > lecture 6: stroke > Flashcards

lecture 6: stroke Flashcards

1
Q

true or false: stroke only leads to physical imparement

A

false, also mental

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2
Q

does stroke only affect old people

A

no , young too but more rate

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3
Q

What do you think is your role as a KCEP in the rehab process of your client? (of strokeO

A

incraase functional and fitness levels through exercise training

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4
Q

stroke is a type of injury to what organ

A

brain

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5
Q

what is a stroke

A

An abrupt incident of vascular insufficiency or of bleeding into or immediately adjacent to the brain

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6
Q

a blockage stroke is called

A

ischemic

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7
Q

stroke is the BLANK leading cause of death behind heart diseases and cancer

A

3rd leading cause

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8
Q

how many stroke cases are there in canada per year

A

60k-70k

740 000 canadian adults

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9
Q

what percentage of stroke attacks are first attacks

A

80%

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10
Q

what percentage of strokes are reoccruent attacks

A

20%e

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11
Q

what is the average age of onset of stroke

A

72

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12
Q

since the average age of onset is 72, strokes only happen to older populations

A

false, they can only occur in children and young adults as well

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13
Q

what percentage of stroke causes are under the age of 65

A

1/4

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14
Q

is the incidence of stroke equal in men and woman

A

yes

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15
Q

which gender is more likely to survi ve a stroke

A

women

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16
Q

what percentage of strokes result in death

A

29%

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17
Q

is the percentage if strokes that result in death lower or higher for younger people

A

lower

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18
Q

ischemic strokes account for what percentage

A

80%

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19
Q

what are the 2 causes of ischemic stroke

A

cerebral thrombosis

cerebral embolism

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20
Q

what is cerebral thrombosis

A

Development of a blood clot in a cerebral vessel (occlusion at atherosclerotic plaque)

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21
Q

what is cerebral embolism

A

Displaced clot of bacterial mass that occludes downstream artery
=blood clots can break free from an thrombosis and lead to an occlusion

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22
Q

when does ischemic strokes usually happen

A

periods of decreased acitiy (sleep)

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23
Q

is conciousness preserved during ischemic strokr

A

ues

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24
Q

inntracerebral hemorage acounts for what percent of total strokes

A

20%

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25
Q

what stroke is bleeding into the brain

A

intracerbral hemograge

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26
Q

what is the main cause of intracebreal hemorage

A

arterial rupture

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27
Q

what are the 2 principle causes of stroke i

A

ischemic and intercerbral hemorage

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28
Q

what percentage of strokes are intracerbral hemmorage

A

20%

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29
Q

whatt is arterior reupture associated with

A

Associated with aneurysms and arteriovenous malformations:

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30
Q

when do intracebral hemmorages occur

A

during periods of acvtiyty

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31
Q

what is the LOC for itracebral hemmorage

A

stupor or coma

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32
Q

what are the 5 signs and symptoms of stroke

A 
weakness
trouble speaking
vision problems
headache
dizziness
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33
Q

explain weakness as a sign

A

Sudden loss of strength or sudden numbness in the face, arm or leg, even temporary

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34
Q

explain trouble speaking as a sign and is it assocaited with stroke i nthe left or right hemistpeherw

A

Sudden difficulty speaking or understanding or sudden confusion, even temporary (aphasia)

left

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35
Q

why do people have trouble speaking during a stroke

A

due to a stroke located in the left hemi

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36
Q

explain vision problems as a sign

A

Sudden trouble with vision, even temporary

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37
Q

wexplain headache as a sign

A

sudden sever and unusual headache

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38
Q

explain dizness as a sign

A

Sudden loss of balance, especially with any of the above signs (why?)

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39
Q

why is dizziness not a good sign alone

A

because you can be dizzy to many factors

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40
Q

fast is an aconym for

A

face, arms, speech and time

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41
Q

why does the fast test do

A

allows people to trecognize the signs of sroke

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42
Q

what is the fast test

A

ask person to smile
ask person to speak a simple snetence
ask person to raise both arms

=if they cannot do any of the 3 things get them to a hospital

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43
Q

Following a stroke, sensory and motor impairments are located on which body side?

A

opposite side as brain lesion

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44
Q

what is the most dominant risk factor for stroke

A

age!!

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45
Q

why is the incidence of stroke inreasing as time icnreases

A

because average populationn age is increasing

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46
Q

What is the median age (divides population into 2 groups of equal size) of the Canadian population?

A

40

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47
Q

what are the 3 risk factors we cannot control

A

age
sex
family hisotry

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48
Q

increases age is the dominant risk factor for strokr?

A

true

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49
Q

what is the relationsjip between heart disease and age

A

all major forms of heart disease increase with advancing age

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50
Q

as the canaidan population increased, what is expected in terms of stroke

A

number of individauls with heart disease and stroke will increase

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51
Q

true or false, the incidience for women and men are the same for strokr

A

true

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52
Q

what is another important risk factor besides age for strokr

A

family hisoty of early coronary disease

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53
Q

what is an independant risk factor for stroke

A

family histry

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54
Q

facots that contribute to the assocationn of fam hisotry and CAD may include what

A

familial dyslipedimia, lifestule and molecular defects in vascular physiology which render the vessel walls more susceptible to atheroscelorsis

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55
Q

what are 2 examples of modifable risk factors for strokep

A

physicial inactivtiy

high BP

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56
Q

which age groups were very phydscually inactive

A

5-11
12-17
60-79

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57
Q

WHAT CAN REGULAR PA redcude

A

Regular physical activity (PA) can reduce body weight, improve serum lipids and cholesterol, blood pressure and diabetes, and thereby overall stroke risk

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58
Q

national guidelines recomend what in terms of PA

A

recommend 150 min of moderate- to vigorous- intensity aerobic PA per week

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59
Q

High BP is a major risk factor for what

A

both coronary artery disaese and stroke peripheral vascular disease and congestive heart faility

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60
Q

High BP incrased overall cardiovascular risk by what

A

by 2 to 3 fold

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61
Q

which individuals are more liekly to develop high BP

A

indivudals who have excess weight , are physically inactive, use alcohol heavily, excesive salt intake

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62
Q

what type is the best exercuse program for stroke prevention

A

aerobic training

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63
Q

what are the 2 modes of training that are beneficials

A

aerobic training and fucntional training

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64
Q

aerobic rtaining decraes risk of 1st or 2nd stroke

A

2nd

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65
Q

what are the beneficial effects of aerobic rtaining

A

Reduced hypertension
Reduced body fat
Increased ratio HDL/LDL

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66
Q

what dies functinal trainingn icnrase

A

increase ADLS and QoL

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67
Q

what are the beneficial effects of functional trianing

A

Improve muscular strength and endurance

Improve motor functions (walking, balance, coordination)

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68
Q

what are tthe 3 special consideration to exercise for strtoke

A

Reduced motor control (weakness or paralysis) on one side of the body
Sensation may be impaired (implications for stretching)
Intolerance to high intensity exercises (↓VO2 max capacities)

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69
Q

what percentage of men in age 5-11 were meeting guidelines

A

18

70
Q

what percentage of women in age 5-11 were meeting guidelines

A

8

71
Q

what percentage of men in age 12-17 were meeting guidelines

A

8

72
Q

what percentage of women in age 12-17 were meeting guidelines

A

3

73
Q

what percentage of men in age 60-79 were meeting guidelines

A

13

74
Q

what percentage of women in age 60-79were meeting guidelines

A

11

75
Q

The foot drop phenomenon observed after stroke is attributed to the paralysis of _________

a) Gastrocnemius
b) Tibialis Anterior
c) Soleus
d) Rectus Femoris

A

tib ant

76
Q

peopel wil stroke have poor or good fitness level

A

poor

77
Q

why do those with stroke have a decraed VO2

A

1) neural drive
2) blood flow
3) muscle mass

78
Q

the affected limb becomes what type of limb

A

paretic

79
Q

compared to a age matched sedentary person, someone with a stroke has a lower or high VO2 man

A

lower

80
Q

how much lower is someone with a stroke’s VO2 in cormpared to normal

A

50% of whatt it would normally be

81
Q

what is a reason ADL for people with stroke can be compromoed

A

poor cardiovascular fintess

82
Q

BLANK can compromise performance of daily living

A

poor cardio vascular fitness

83
Q

trtue or false: in terms of vo2 max, a age matched sedentary person can easily do ADLs in comparison to strokr

A

yes, because people with stroke cardiovascular VO2 is 50% less they are not able to easily complete the entire ADL range

84
Q

MET indicates metabolic equivalent. One MET is the amount of energy used when _______ (3.5 ml/kg/min)

A

sitting qiueitly

85
Q

what is the peak MET for stroke

A

3.5

86
Q

what are some mild acitvities of daily living that people with stroke can do

A

playing piano
canoeing (leusire)
walking (2mp)

87
Q

what is the mmoderate activtity that those with a stroke can do

A

cycling (leasuirely)

88
Q

true or false: if you have a storke , you cant cycle

A

false, you can, just leisurely

89
Q

true or false: those with stroke can do vigourouse activtiyies and why

A

false, they cannot because it requries a VO2 max higher than what they have

90
Q

what are some examples of ADLS that those with a stroke cannot usually do

A

swimming, walking (4) tennis and jogging

91
Q

what does hemiparetic mean

A

weakness/inbiability to move 1 side of the body

92
Q

in the case study, stroke leads to what type of disrorders

A

motor functiton and motor perfornace

93
Q

explain how stroke can cna lead to motor function disorders

A

Restriction of mvts or paralysis on the affected side
Weakness of the affected side
Problems of coordination of the affected side

94
Q

explain how stroke leads to motor performance disorders

A

Decrease in balance
Decrease in walking capacities
Decrease in mobility

95
Q

decrase in blaance, walking or mobility is an example of a motor performance or motor function disorder

A

motor performance

96
Q

restrinction or fmovement, weakenss and problems of coordination are examples of motor function or motor performatnce disorders

A

motor function

97
Q

Are all individuals with stroke eligible to the exercise program?

A

no

some participants are too good (no serious complications) and some are too affected (cannot stand and do exercisdes)

98
Q

what is the best type of participant for tthe exercise program

A

those who are affected by can still take an acitve part in the training/rehab

99
Q

in the case study, what is the major contradiction to exercise

A

Aerobic or resistance training at high intensity could potentially lead to major medical complications (2nd stroke, heart attack, etc.)

100
Q

Aerobic or resistance training at high intensity could potentially lead to wha

A

major medical complications (2nd stroke, heart attack, etc.)

101
Q

true or false: Aerobic or resistance training at low intensity could potentially lead to major medical complications (2nd stroke, heart attack, etc.)

A

false, only at high intensityes

102
Q

what is the rational behind the exercise program for people witth stroke/case study

A

In people with chronic stroke (1 year post-stroke), these disorders (motor perfomance and function) are increased by the absence of regular physical activity

103
Q

what is chronic strokr

A

1 year post stroke

104
Q

the motor function and motor performance disorders are increased or decreaed by absense of PA

A

increased

105
Q

true or false: you cannot make signifc ant gains (in 5 movements) 6 months post strokr

A

true

106
Q

what is the experimental questions for the case study exercise program

A

Can people with chronic stroke improve their physical condition (i.e. functional level) through the participation in a 8-week group exercise program?

107
Q

what are the 4 main bullet points for making an exercise program

A

1) desciptibion of participants condition
2) prepartion of a questionnaire
3) elaboraion of the exricse program
4) evalutaion

108
Q

in the prepareation of the questionaire, what type of information is collection

A

medical hisotry (ex: high BP)
meds
PA status (ex: level of fitness, balance, walk capacity, balance)
-goals of participant

109
Q

why are the goals of the participant necessary for the progam

A

MOTIVATION

more likely to see results and comeback if they are motivated and actvitely participating

110
Q

what did the exerceise prgram focussed on

A

strengthening the affected extremities and practicing functional tasks involving the upper and lower limbs.

111
Q

explaon some examples of execruse for upper limbs

A

push ups in standing
strtecth band in sitting position
ROM with wooden stick

112
Q

explain who push up in standing postition is good

A

to imporve elbow extensions and easier to icnrease or decrease diffucilty

113
Q

for upper limb exercises, they acnn do normal push ups?

A

falsse, standing push ups

114
Q

w=what position are stretch band exercises dont

A

in sitting position

115
Q

whey are stretch band exrecises done in sitting positions

A

to impove shoulder flexors, extensors and abductors

116
Q

why use ROM with wooden stick

A

unaffected limb can lead to other)

117
Q

what are some examples of lower limb exercises

A

step exericses
sit to stand
standing on 1 leg
standing in tandem

118
Q

explain the step exrcised for lower limb

A

forward, backward, side steps) to improve lower limb ROM and strengthen the weak side

119
Q

what is the function of step exrcises

A

to improve lower limb ROM and strengthen the weak side

120
Q

explain the stit to stand exercise for loweer limb (what does it improve)

A

Sit-to-stand from a chair with forward and backward steps for improving functional mobility

121
Q

why is the sit to stand exercise effective

A

for improving functional mobility

122
Q

what is the function of standing on one leg as execier

A

imporoving balance

123
Q

whta is the function of tandem stance

A

improve balance

124
Q

which muscle is uxed for elbow extension

A

triceps (but ofeten will try to cheat with shoulder and torso)

125
Q

how many particpantts are in the exrceise session groups

A

8

126
Q

what is the frequency of exercise session

A

2/week

127
Q

what is the duration of exercise session

A

60 min/session

128
Q

what is the intenisty of the exreicse sessions

A

RPE (rating of perceived exertion) method (0 to 10 point scale)

129
Q

why is it good to use RPE for intensity

A

because HR and BP will usually fluctutaet because of meds

130
Q

what are the ways to modify the intensity

A

↑ the number of repetitions
↑ ankle weights
↓ the use of parallel bar
↑ exercise difficulty

131
Q

decreasing the use of the parallel bar increases or decreased intensity

A

icnreases

132
Q

evaluation is done only before a exercis prgram

A

false, before and after

133
Q

what are 4 tests for evaulution in the case strudy

A

time up and go
berg balance test
6 min walk test
stroke impairement asessment set

134
Q

what is the goal of time up and go

A

to detect balance and mobility problems in the elderly

135
Q

what is the instructions for time up anf go

A

Subjects stand up from a chair, walk 3m, turn around and return to sit back down

136
Q

what is the scoring for time up and go

A

Neurologically intact adults who are independent in balance and mobility skills < 10s. If > 30s = dependent in most ADLs and balance and mobility skills

137
Q

which test main goal is to detect balance and mobility

A

timed upo and go

138
Q

how long should the timed up and go take for neurogloically intact adults

A

less than 10 secs

139
Q

if you take greater than 30 secondns for the timed up and go, what does that mean

A

person is usually dependent in most ADLs and balance and mobility skills

140
Q

what is the goal of the berg balance test

A

to provide a comprehensive balance assessment

141
Q

which test main ghoal is to provide a comprehensive balance assessment

A

berg balance

142
Q

the assessment form for berg balance has how many items

A

14

143
Q

where is the berg balance test mainly used

A

widcely used in clinical research field

144
Q

the berg test is very BLANK and easy/hard to admisiter

A

very edtailed and easier to administer

145
Q

the berg balance allows allows a better stcreening of what

A

balance imporants

146
Q

what is the goal of the 6 minute walk test

A

to evaluate cardiorespiratory (submaximal) endurance in individual with cardiovascular conditions

147
Q

which test has the goal of to evaluate cardiorespiratory (submaximal) endurance in individual with cardiovascular conditions

A

6 minute walk test

148
Q

what are the instructions for 6 minute test

A

The participants are instructed to walk from end to end, covering as much ground as they could during the allotted time.

149
Q

what does SIAS stand for

A

stroke imporaiment assessment set

150
Q

what is the goal of SIAS

A

to assess motor function and coordination for upper and lower extremities in individuals with stroke

151
Q

which test has the goal of to assess motor function and coordination for upper and lower extremities in individuals with stroke

A

SIAS

152
Q

is the SIAS easy to adminster

A

yes

153
Q

is teh berg balance easy to adminster

A

yes

154
Q

is scoring easy or diffult for SIAS and why

A

scoring is often difficult because not detailed enough.

155
Q

true or false: beofre completeing exrcise, those with a stroke need medical clearance

A

yes from a physician

156
Q

true or false: you need a list of meds for a stroke patient

A

true

157
Q

whatt measruent is needed to check befgore starting the program

A

BP

158
Q

what measurent is always taken before each session

A

heart beat

159
Q

what are the 3 main instructions giving to partticipatn

A

Exercise at your own pace
Try to start each session slowly before increasing the pace
Stop exercising if you have one of these symptoms: severe fatigue, feeling faint, feeling of dizziness etc…

160
Q

true or false: the participants need to follow the exrise program pace

A

false, they can exercise at their own pace

161
Q

they should start the execrise session quicly;

A

false, start each session slowly before increasing the pace

162
Q

what are some symptoms that mean the patient should stop exerciseing

A

severe fatigue, feeling faint, feeling of dizziness etc…

163
Q

for a group adapted exersice program, what is the supervision needed

A

1 certified KCEP
1 or 2 KCEP interms
1 vlunteer from the center

164
Q

which tests had significant chagnes between pre and post exrcise

A

SIAS motor scole
berg balance scale
timed u opand go

165
Q

what is the score out of for the brg balance

A

/56

166
Q

if you score a 45 or less for berg balance, you are at risk of what

A

falling

167
Q

the SIAS motor score is out of what

A

/25

168
Q

what is the 2nd strogner risk factor for strike

A

high BP

169
Q

what is atriovenous malformations and what can they cause

A

they are when the blood vessels get all tangled and can cause arterial rupture

170
Q

what are some typical arm stances for those with stroke

A

flaccid arm or tripple flexed

171
Q

which test did not show any significant changes between pre and post exrecise

A

6 min walk

210 - kcep (14 decks)

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