Stroke Flashcards
BE FAST
Balance: LOB or coordination loss
Eyes: vision changes
Face: drooping, asymmetries
Arm: raise both simultaneously and check for differences
Speech: ask person to repeat a statement, check for Dysarthria: slurring
Time: get to ER, 3 hour window after seen “normal” to get tPA to dissolve the clot
Motor Impairments of Stroke
-interference with smooth and purposeful movement
-hypotonia/faccidity
-hypertonia/spasticity
-tonal changes will result in impaired joint alignment
Normal Postural Tone
-tone sufficient to hold us upright against gravity
Pyramid of Postural Reflex Mechanism
-Normal Postural tone
-Primitive movement patterns
-Righting reactions
-Protective Extension Reactions
-Equilibrium Reactions
Primitive Movement Patterns/Reflexes
-provide basis for mocement paptterns that progressively shoow more coordination
Righting Reactions
-provide orientation of the head and alignment of other body parts
-critical for development as upright individuals
ex: inability to lift head in supine, keeping head rotated away from weaker side
Protective Extension Reactions
-1st line of defense against chanfes in our postural balance, CoG over BoS changes
-parachute reactions or protective stepping
ex: client does not extend arm when falling, client doesn’t move impaired leg to prevent falling
Equilibrium Reactions
-extension of protective reaction allows us to maintain balance by adjusting the location of CoG
-cocontracting muscles or making adjustments
ex: clinent doesnt lengthen weight bearing side of trunk when shifting, clien does not increase muscular stability when shifting
Atypical Synergies
-predictable movement patterns occurring during voluntary attempts
-result of loss of selective mmt strategies
-tone changes or neuro disorganization
-impaired timing
UE Flexion Synergy
-Scapular Elevation
-Scapular Retraction*
-Shoulder Abd & ER
-Elbow flexion*
-Forearm Supination
-Wrist flexion*
-Finger Flexion*
UE Extension Synergy
-Scapular Depression*
-Scapular Protraction
-Shoulder extension*
-Shoulder add*
-Shoulder IR*
-Elbow Extension
-Forearm Pronation*
-Wrist Extension
-Finger flexion*
UE Resting Synergy
-Scapular Depression
-Scapular Retraction
-Shoulder extension
-Shoulder add
-Shoulder IR
-Elbow flexion
-Forearm Pronation
-Wrist flexion
-Finger Flexion
LE Flexion Synergy
-Pelvic elevation*
-Pelvic retraction*
-Hip Flexion*
-Hip Abd
-Hip ER
-Knee Flexion
-Ankle DF
-Foot Inversion*
LE Extension Synergy
-Pelvic depression
-Pelvic protraction
-Hip extension
-Hip Add*
-Hip IR*
-Knee Extension*
-Ankle PF*
-Foot Inversion*
LE Resting Synergy
-Pelvic elevation
-Pelvic retraction
-Hip Flexion
-Hip Add
-Hip IR
-Knee Extension
-Ankle PF
-Foot Inversion
Sensory Impairments of Stroke
-disorders of tactile, proprioception, complex sensory systems
-disorders of movement secondary to sensory (lack of feedback and proprioception)
Visual/Perceptual Impairments
-Disorders of body image: neglect, no longer mirror images
-visual disorders
-Disorders of spatial thought (awareness of surroundings)
Cognitive/Communication Impairments of Stroke
-imaired memoory
-disorientation
-Impaired judgement, problem solving
-decreased concentration span
-personality changes
-aphasia
Predictors of Poor Rehab Outcome
-Dementia
-Global Aphasia
-Previous Stroke
-Older age
-incontinence
-severe visuospatial deficits
-Persistent sensory
Goals of Rehabilitation
-maximize functional independence
-Return to most optimal living environment
-Improve Quality of life
Functional Independence
ability to handle one’s needs without assistance
Quality of Life
-one’s ability to pursue pleasureable activites
Neurorehabiliation
-interventions useful for assisting the recovery of pt with neuro lesions
Neurophysiological Approaches
-PNF: proprioception neuromuscular facilitation
-Brunnstrom: Movement therapy for hemiplegia
-NDT: neurodevelopmental techniques
-Neuro-IFRAH: Neuro-integrative Rehab and habilitation
-Rood: sensorimotor retraining
