Week 2 - Stroke and NDT Flashcards
Common types of post stoke pain:
- Peripheral neuropathic pain
- Nociceptive
- Complex regional pain syndrome
- Central post stoke pain
- Other body pain or pain from previous conditions
What is Type 1 Complex Regional Pain Syndrome (CRPS) commonly associated with?
Hemiplegia
What are some Peripheral and central nervous system changes that might occur with Complex Regional Pain Syndrome - 1 (CRPS)?
PNS
- Hand pain and swelling
- exquisite tenderness or hyperaesthesia
- Immobility
- Trophic skin changes
- instability of the involved UE
CNS
- Disruption of sensory cortical processing
- disinhaibtation of the motor cortex
- disrupted body schema
Treatment for Complex Regional Pain Syndrome (CRPS)?
-Mirror Box Therapy
-ROM Exercises
-Oral Corticosteroids
-Calcitonin
What is Central Post Stroke Pain (CPSP)?
- occurs when a stroke affects the thalamus and parietal lobe where sensory stimulation is processed
- involves a combination of sensory loss, allodynia and spontaneous pain.
How might a patient describe Central Post Stroke Pain (CPSP)
- Burning
- Pins and needles
- sudden stabbing sensation (May be intolerable)
how to manage Central Post Stroke Pain (CPSP)
- combination of drugs and other therapies (aimed to reducing symptoms not fixing)
- relaxation
- Biofeedback
- stimulating procedures of the brain where pain signals are originating.
What is Post Stroke Fatigue (PSF)
- overwhelming tiredness
- abnormal need for sleep
- on predictable feelings of fatigue
Prevalence of Post Stroke Fatigue (PSF)
- 38-73% depending on the study
- Present in both acute and chronic phases
- Not related to size, location or serenity of stoke
Impacts of Post Stroke Fatigue (PSF)
- physical
- cognitive
- Self care
- productivity
- leisure
What is the prevalence of Post Stroke Depression (PSD)?
Greater than 30% of stroke patients experience depression at some point during
their recovery
what are some risk factors of Post Stroke Depression (PSD)?
- previous history
- Functional limitations and/or cognitive impairments
What is the Canadian Stoke Best Practice Recommendations (CSBPR)
All patients with strokes should be considered to be a high risk for PSD
what is the cause of a stoke?
Sudden development of a focal neurological
deficit as a consequence of a local disturbance
in the cerebral circulation
- A sudden injury to part of the brain caused
when arterial blood flow is interrupted- The affected area of the brain is deprived of
oxygen and nutrients. - This damages the neurons and the functions
they control.
- The affected area of the brain is deprived of
What are the signs of a stroke?
F: face is drooping
A: unable to raise arms
S: slurred or jumbled speech
T: time to call 911
What is a Transient Ischemic Attack (TIA)?
Temporary interruption of blood supply to
part of the brain
* Stroke “Warning Sign”
* Angina Equivalent
Symptoms may last a few minutes to an hour
Champlain
What are some similarities and differences between TIA and a stroke?
similarities
- Sudden onset
- Focal neurologic symptoms
difference
TIA
- Caused by transient lack of
blood supply, focal ischemia
* Typically lasts < 1 hour
* No permanent damage to
the brain
Stroke
- Caused by complete
interruption of blood supply
* Lasts > 1 hour
* Permanent damage to brain
What are some modifiable stroke risk factors?
- Hypertension
- Hypercholesterolemia
- Atrial fibrillation
- Diabetes
- Smoking
- Overweight / obesity
- Physical inactivity
- Excessive alcohol consumption
- Stress
How to manage stroke risks factors?
- Medications
- Surgical options
- Lifestyle/Behavioural Modifications
What is the role of a PT in acute strokes?
- Assessment:
- Screen: communication, cognition
- Sensation, tone, motor control
- Functional mobility
- Respiratory system
- Analysis and development of rx plan
- Determine rehab needs
- Interprofessional collaborative approach
What effects does a stroke have on mobility?
- Fatigue
- Sensory changes
- Motor control changes
- Balance
- Posture
- Perceptual changes
- Cognitive changes
What are some factors contributing to shoulder pain
- Loss of scapulo-humeral rhythm
- Loss of outward rotation of the humerus
- Lack of downward movement of the humerus
- Tonal changes-upper limb and trunk
- Handling
- Positioning
- Falls
- Contractures
what is Shoulder Subluxation?
- Common after stroke due to paresis and
muscle imbalances - Tends to improve with return of muscle
tone - Relieved with appropriate positioning
how can music therapy help in stroke rehab?
Music therapy uses music and its components (melody, rhythm, harmony) to address non-musical goals.
