Stroke problem list

Question 1

Left Upper Limb Weakness and Poor Function

Answer 1

*Evidence: Inability to use left arm for daily tasks; relies on wife for dressing/washing; flexed posture with shoulder subluxation.
*Cause: Damage to right motor cortex (supplied by MCA), leading to upper motor neuron weakness.
*Impact: Severe loss of independence in self-care; increased caregiver burden; risk of secondary complications (e.g. joint contractures).

Question 2

Spasticity and Increased Tone in Left Wrist and Fingers

Answer 2

*Evidence: Tightness in left wrist/fingers; flexed posture of hand.
*Cause: Loss of inhibitory motor control from UMN lesion post-stroke.
*Impact: Limits hand function and fine motor control; contributes to pain, deformity, and reduced hygiene.

Question 3

Shoulder Subluxation and Pain Risk

Answer 3

*Evidence: Left shoulder appears depressed; arm supported with pillow.
*Cause: Weakness of shoulder stabilising muscles post-stroke; gravity and improper positioning.
*Impact: Risk of shoulder pain (hemiplegic shoulder), limits rehab potential.

Question 4

Left Lower Limb Weakness and Foot Drop

Answer 4

*Evidence: Left foot catching during walking; marked hip circumduction.
*Cause: Damage to motor pathways in right hemisphere (MCA territory).
*Impact: Increased fall risk, unsafe gait pattern, reduced community mobility.

Question 5

Impaired Balance and Functional Mobility

Answer 5

*Evidence: Relies on stick and furniture to walk; trips frequently; heavily weight-bearing on right side.
*Cause: Asymmetrical weight distribution and hemiparesis; poor postural control.
*Impact: Increased risk of falls and injury; limits ability to move independently.

Question 6

Fatigue and Reduced Endurance

Answer 6

*Evidence: Transfers become unstable when tired; needs more help when fatigued.
*Cause: Neurological fatigue common post-stroke; increased effort needed for simple tasks.
*Impact: Reduces participation in rehab and daily activities.