1
Certified Stroke Rehabilitation
Specialist (CSRS 2025) Questions
and Verified Answers
Action Observation - ANSClient watches another perform, observe mvmt in
non paretic arm, tasks viewed are practiced (use of mirror neurons: frontal
lobe neurons activated by observation of another's activity)
-Action observation has been shown to facilitate motor learning and the
building of a motor memory trace in normal adults as well as in stroke
patients
-During each rehabilitation session, patients are required to observe a
specific object-directed daily action presented through a video clip on a
computer screen, and afterwards to execute what they have observed.
- Only one action is practiced during each rehabilitation session. The
presented action is divided into three to four motor acts.
Adaptive Plasticity - ANSThe brains ability to compensate for loss
functionality due to brain damage as well as in response to interaction with
the environment by reorganizing its structure
-This occurs in response to compensation for the brain injury and in
"adjustment to new experiences"
-Neural changes are "sprouting & rerouting"
-Occurs over the lifespan but is more efficient and effective during
infancy/early childhood
1
, 2
Affected Artery and Corresponding Vison Impairments - ANSMiddle
Cerebral Artery (MCA)
-visual filed impairment (B)
-visuospatial impairment (R)
-contralateral homonymous hemianopsia (B)
-visual perceptual and unilateral neglect (R)
Posterior Cerebral Artery (PCA)
-contralateral homonymous hemianopsia (B)
-visual agnosia (B)
-cortical blindness (R)
-visuospatial impairments (R)
Amplitude: E-STIM - ANSSometime referred to as intensity) refers to the
strength of the stimulation delivered, measured in milliamps (mA)
-This parameter is always adjustable in EMS devices and often appears
like a volume switch.
-Adjustment of this parameter is always available as amplitude may not
always be set to the same level at each treatment session. (adjust to
produce the desired physiological response)
-How "BIG" "INTENSE" the stimulation is compared to baseline
-Measured in amperes (milliamps) or volts (millivolts)
-Inc in amplitude more deeper, and smaller fibers are reached -> stronger
contraction, inc the depth of penetration
PHYSIOLOGICAL RESPONSE is the "KEY", do not focus on the number
of milliamps
-Amplitude: How Much?
2
, 3
-Pulse Duration/Width: Length of time specified amplitude is flowing during
a given pulse stated in msec
Amygdala - ANS-two bean shaped clusters, one located in each
hemisphere of the brain, considered to be part of the brain's limbic system.
This is where emotions are given meaning, remembered, and attached to
associations and responses to them (emotional memories)
-small almond shaped structure on the medial side of the temporal lobe
involved in:
-processing and consolidating memory
-autonomic responses associated with fear
-emotional responses (fight-or flight) anger, sadness and controlling of
agression
Anterior Cerebral Artery (Circle of Willis) - ANSSupplies anterior frontal
lobe
Damage: characterized by weakness and sensory loss in the lower leg and
foot opposite to the lesion and behavioral changes
Aphasia (3 types) - ANSA language disorder that affects a person's ability
to communicate.
-Expressive aphasia - you know what you want to say, but you have trouble
saying or writing what you mean.
-Receptive aphasia - you hear the voice or see the print, but you can't
make sense of the words.
-Global aphasia - you can't speak, understand speech, read, or write
3
, 4
Apraxia
(Lesson 6)
2 types of Apraxia
-Ideational Apraxia
-Ideomotor Apraxia
Damage to the praxis system: The network of structures underlying praxis
is thought to include the frontal and parietal cortex, basal ganglia, and white
matter tracts containing projections between these areas - ANSA
neurological disorder characterized by the inability to perform learned
(familiar) movements on command, even though the command is
understood and there is a willingness to perform the movement. Both the
desire and the capacity to move are present but the person simply cannot
execute the act.
-the inability to carry out learned, skilled motor acts despite preserved
motor and sensory systems, coordination, comprehension, and cooperation
- difficulty in executing learned movements sequences beyond limitations
that could be explained be weakness, lack of coordination, sensory
deficits/loss, comprehension of deficits, memory and/or motivation
Assessment of NEGLECT
THINGS TO CONSIDER - ANS-Make sure that your assessment is
catching multiple domains ( use good assessments)
-Make sure you are insightful if patient has other deficits (e.g global
aphasia "DOES THE PATIENT UNDERSTAND THE TASK)
-Look for poor eye contact, failure to care for one-side of the body and not
the other, does patient drop things on one side
4
Certified Stroke Rehabilitation
Specialist (CSRS 2025) Questions
and Verified Answers
Action Observation - ANSClient watches another perform, observe mvmt in
non paretic arm, tasks viewed are practiced (use of mirror neurons: frontal
lobe neurons activated by observation of another's activity)
-Action observation has been shown to facilitate motor learning and the
building of a motor memory trace in normal adults as well as in stroke
patients
-During each rehabilitation session, patients are required to observe a
specific object-directed daily action presented through a video clip on a
computer screen, and afterwards to execute what they have observed.
- Only one action is practiced during each rehabilitation session. The
presented action is divided into three to four motor acts.
Adaptive Plasticity - ANSThe brains ability to compensate for loss
functionality due to brain damage as well as in response to interaction with
the environment by reorganizing its structure
-This occurs in response to compensation for the brain injury and in
"adjustment to new experiences"
-Neural changes are "sprouting & rerouting"
-Occurs over the lifespan but is more efficient and effective during
infancy/early childhood
1
, 2
Affected Artery and Corresponding Vison Impairments - ANSMiddle
Cerebral Artery (MCA)
-visual filed impairment (B)
-visuospatial impairment (R)
-contralateral homonymous hemianopsia (B)
-visual perceptual and unilateral neglect (R)
Posterior Cerebral Artery (PCA)
-contralateral homonymous hemianopsia (B)
-visual agnosia (B)
-cortical blindness (R)
-visuospatial impairments (R)
Amplitude: E-STIM - ANSSometime referred to as intensity) refers to the
strength of the stimulation delivered, measured in milliamps (mA)
-This parameter is always adjustable in EMS devices and often appears
like a volume switch.
-Adjustment of this parameter is always available as amplitude may not
always be set to the same level at each treatment session. (adjust to
produce the desired physiological response)
-How "BIG" "INTENSE" the stimulation is compared to baseline
-Measured in amperes (milliamps) or volts (millivolts)
-Inc in amplitude more deeper, and smaller fibers are reached -> stronger
contraction, inc the depth of penetration
PHYSIOLOGICAL RESPONSE is the "KEY", do not focus on the number
of milliamps
-Amplitude: How Much?
2
, 3
-Pulse Duration/Width: Length of time specified amplitude is flowing during
a given pulse stated in msec
Amygdala - ANS-two bean shaped clusters, one located in each
hemisphere of the brain, considered to be part of the brain's limbic system.
This is where emotions are given meaning, remembered, and attached to
associations and responses to them (emotional memories)
-small almond shaped structure on the medial side of the temporal lobe
involved in:
-processing and consolidating memory
-autonomic responses associated with fear
-emotional responses (fight-or flight) anger, sadness and controlling of
agression
Anterior Cerebral Artery (Circle of Willis) - ANSSupplies anterior frontal
lobe
Damage: characterized by weakness and sensory loss in the lower leg and
foot opposite to the lesion and behavioral changes
Aphasia (3 types) - ANSA language disorder that affects a person's ability
to communicate.
-Expressive aphasia - you know what you want to say, but you have trouble
saying or writing what you mean.
-Receptive aphasia - you hear the voice or see the print, but you can't
make sense of the words.
-Global aphasia - you can't speak, understand speech, read, or write
3
, 4
Apraxia
(Lesson 6)
2 types of Apraxia
-Ideational Apraxia
-Ideomotor Apraxia
Damage to the praxis system: The network of structures underlying praxis
is thought to include the frontal and parietal cortex, basal ganglia, and white
matter tracts containing projections between these areas - ANSA
neurological disorder characterized by the inability to perform learned
(familiar) movements on command, even though the command is
understood and there is a willingness to perform the movement. Both the
desire and the capacity to move are present but the person simply cannot
execute the act.
-the inability to carry out learned, skilled motor acts despite preserved
motor and sensory systems, coordination, comprehension, and cooperation
- difficulty in executing learned movements sequences beyond limitations
that could be explained be weakness, lack of coordination, sensory
deficits/loss, comprehension of deficits, memory and/or motivation
Assessment of NEGLECT
THINGS TO CONSIDER - ANS-Make sure that your assessment is
catching multiple domains ( use good assessments)
-Make sure you are insightful if patient has other deficits (e.g global
aphasia "DOES THE PATIENT UNDERSTAND THE TASK)
-Look for poor eye contact, failure to care for one-side of the body and not
the other, does patient drop things on one side
4
