therapeutic consideration for individuals with hemiparesis/ hemiplegia Flashcards

(64 cards)

1
Q

what Can be used to rapidly screen an individual for some common findings associated
with a developing stroke.

A

BE FAST

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2
Q

what does BE FAST stand for

A

B- balance
E- eyes

F- Face
A- arm
S- speech
T- time

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3
Q

what are you looking for in balance for BE FAST

A

look for LOB or coordination loss

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4
Q

what are you checking for in eyes for BE FAST

A

check for vision changes

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5
Q

what are you looking for in face for BE FAST

A

look for asymmetries of the facial muscles by asking the person to smile

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6
Q

what do you ask the person to do for the arm section in BE FAST

A

ask the person o raise both arms simultaneously and see if they respond the same or differently

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7
Q

what is a general slurring and slowing of the speech pattern.

A

dysarthria

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8
Q

if the stroke is being causes by a blood clot then there is a ___ window to administer some tPA to help dissolve the clot

A

3 hour

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9
Q

what is the major sequellae of stroke

A

motor impairments

sensory impairments

visual/perceptual impairments

cognitive/communication impairments

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10
Q

how would you define hypotonia/ flaccidity

A

muscle tone is generally too low for normal function

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11
Q

how would you define hypertonia/ spasticity

A

muscle tone is generally too high for normal function

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12
Q

what will abnormal muscle tone result in

A

impaired joint alignment

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13
Q

muscles to ___ to properly stabilize joints

A

weak

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14
Q

mm to ___ to allow functional movement

A

stiff

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15
Q

what is defined as that amount of tone that is sufficient to hold us upright against gravity, but is not so strong as to inhibit selective movements

A

normal postural tone

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16
Q

These ___ reflexes serve to provide the basis for the movement patterns that progressively show more selective coordination, and less

A

primitive

primitive movement patterns

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17
Q

the righting reaction serve to provide ____ of the head to the vertical pull of gravity and ____ of the body parts to one another

A

orientation
alignment

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18
Q

what represent a critical factor in our development as upright individuals and in the development of trunk rotation.

A

righting reactions

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19
Q

what allow us 1 line of defense against
changes in our postural balance

A

protective extension reactions

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20
Q

what is protective extension reactions termed in UE and LE

A

UE- parachute reactions

LE- protective stepping

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21
Q

what acts As an extension of the protective reactions,
these motor skills allow us to maintain our balance by adjusting the location of the CoG within the BoS either by posturally fixating with strong cocontraction of musculature or by making adjustments of the trunk an

A

equilibrium reactions

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22
Q

Indicate if each statement represents an
impairment of a Righting Reaction (RR), a
Protective Reaction (PR), or an Equilibrium
Reaction (ER)

 _____ Client does not extend and abduct weak arm when falling to that side.
 _____ Client has difficulty lifting head off the surface in supine.
 _____ Client does not move impaired leg forward quickly enough to prevent falling.
 _____ Client does not lengthen weight-bearing side of trunk when shifting over to that
side.
 _____ Client keeps head rotated away from weaker side.
 _____ Client does not increase muscular stability around the proximal joint when
weight is shifted onto one limb.

A

PR
RR
PR
ER
RR
ER

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23
Q

the loss of selective movement patterns so that voluntary attempts at movement result in ___ ____

A

atypical synergies

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24
Q

what is predictable movement patterns occurring during volitional attempts atmovement OR as associated reactions. Thus, movements become “stereotypical” and restrictive of normal activities.

A

atypical synergies

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25
what is the **UE flexion** synergy that is associated with hemiparestic synergies scapular shoulder elbow forearm wrist
-scapular elevation and retraction* - shoulder abduction and ER - elbow flexion* -forearm supination - wrist and finger flexion *
26
what is the **UE extension** synergy that is associated with **hemiparestic synergies** (9) scapular 2 shoulder 3 elbow forearm wrist finger
*scapular depression* - scapular protraction - shoulder extension * - shoulder adduction * - shoulder IR* -elbow extension -forearm pronation* - writs extension -finer flexion*
27
where is the strongest motion components for synergies associated with **hemiparetic synergies**
UE
28
what is UE resting synergy
combination of the strongest components from both movement synergies
29
what are the **most common UE** synergies for these Scapula: Shoulder: Elbow: Forearm: ] Wrist/Hand:
Scapula: Scapular depression & retraction Shoulder: Extension, adduction, & internal rotation Elbow: Flexion Forearm: Pronation Wrist/Hand: Wrist & finger flexion
30
what are the LE flexion synergy associated with **hemiparetic syngeries** (6) pelvic hip 3 knee ankle
-pelvic elevation and retraction* - hip flexion * - hip abduction - hip ER -knee flexion -ankle DR with foot inversion*
31
what are the LE **extension** synergy associated with **hemiparetic syngeries** pelvic hip 3 knee ankle
-pelvic depression and protraction - hip extension -hip adduction* - hip IR * - knee extension * -ankle PF won’t foot inversion*
32
what is the **LE resting synergy** associated with hemiparetic synergies pelvis: Hip: knee: ankle/foot:
pelvis: elevation and retraction Hip: flexion , adduction , IR knee: extension ankle/foot: PF with inversion
33
what is dysphasia
eating/swallowing activity limitation
34
disorders of tactile function can be what 3 things
hypo , hyper or dysesthesia
35
what is disorders of proprioception and knesthesia
lacks awareness of limb position/movement
36
interactions of what 3 things will be disturbed for disorders of **complex multimodal sensory** mechanisms
vestibular , visual and proprioception for balance
37
lack of somatosenation anf proprioception can causes ultimate breakdown in ___ _____ since motor planning becomes more chaotic
movement patterns
38
although pre-programmed movements can be initiated without sensory stimulus, what is required for motor learned or refinement
feedback
39
what are disorders of body imagine
R and L sides of the body are no longer mirror images of each other
40
disorders of body imagine makes what hard for the pateitns to do
pre plan movements bc actions are no longer bilateral symmetrical
41
what is the main visual disorder
homonymous hemianopsia
42
the double letter cancellation test is. a ___ test
times
43
what is the fugl meyer test assessing
UE and LE sensorimotor function
44
what is the line bisection test
bisect the middle of the line
45
what is the modified ashworth scale for
muscle tone (spasticity )
46
what scale determines the severity of the stroke
national institutes of health stroke scale
47
what score is used for the prognosis of the stroke
orpington prognostic score
48
which scale test gait , stance , sitting and speech
scale for the assessment and rating of ataxia (SARA)
49
what does the stroke rehabilitation assessment of movement (STREAM) measure
impairments and activity levels
50
what scores can you use for the stroke rehabilitation assessment of movement
total score , voluntary movement limb score and/or basic mobility score
51
what position is the angle of muscle reaction measured at
52
what does R1 mean for the angle of muscle reaction
PROM till catch point (where it catches during ROM)
53
what does R2 mean for the angle of muscle reaction
full PROM (the ROM the PT can go after the catch happens)
54
what scale is used for spasticity
tardieu scale
55
 Action Reach Arm Test  Functional Independence Measure/Functional Assessment Measure (FIM/FAM)  Postural Assessment Scale Stroke (PASS)  STREAM (also impairment based)  Stroke Impact Scale (SIS) these are all examples of what
outcome measures
56
what are the 3 things that the **action reach arm test** assesses
grip grasp pinch
57
Functional Independence Measure/Functional Assessment Measure (FIM/FAM) is used for what
rehabilitation
58
what outcome measrue test for posture in sitting and standing
postural assessment scale for stroke patients (PASS)
59
what kind of questions does the stroke impact scale ask
about physical problems
60
 Dementia  Global aphasia  Previous stroke  Older age  Prolonged urinary and bowel incontinence  Severe visuospatial deficits  Persistent sensory deficits these are all examples of what
predictors of poor rehab outcome in stroke
61
what is functional independence define as
ability to handle ones needs without the assistance of a caregiver
62
what are the general goals of rehabilitation
maximize functional independence return to the most optimal living environment improve quality of life
63
what are some identifiable “neurophysiolgical approaches”
 PNF = Proprioception Neuromuscular Facilitation  Brunnstrom = Movement Therapy in Hemiplegia  NDT = Neurodevelopmental Techniques (Bobath)  Neuro-IFRAH = Neuro-Integrative Rehabilitation and Habilitation  Rood = Sensorimotor Retraining
64
what are some identifiable “neurophysiolgical approaches”
 PNF = Proprioception Neuromuscular Facilitation  Brunnstrom = Movement Therapy in Hemiplegia  NDT = Neurodevelopmental Techniques (Bobath)  Neuro-IFRAH = Neuro-Integrative Rehabilitation and Habilitation  Rood = Sensorimotor Retraining