Stroke Rehab Study Set Questions And Answers

What is the leading cause of long-term disability in the US? correct answer: Strokes Impacts ALL areas of function and roles What are some of the types of neural recovery? correct answer: Collateral sprouting to re-innervate cells Unmask alternative neural pathways and synapses How is Neuroplasticity facilitated? correct answer: Skilled tasks Effortful activities Trial repetition Evidence for stroke rehab correct answer: Earlier and intense rehab leads to better outcomes What effects are typically seen with strokes? correct answer: Motor and sensory deficits Memory impairment Executive function impairment Impulsivity Lability Visual field changes Depression What deficits will you see if you are left dominant hemisphere? correct answer: Right hemiplegia (paralysis) Aphasia Apraxia (can not perform the task they are given) What will you see in the Right/non dominant hemisphere? correct answer: Left hemiplegia Perceptual impairments If stroke occurs in the Anterior Cerebral Artery, what might you see? correct answer: Hemiplegia more pronounced in LE Behavioral changes Incontinence Confused-distractible Perseveration (repeat over and over) or slowness of speech Whispering What is the most common area for an ischemic stroke? correct answer: Middle Cerebral Artery What stroke occurs in Middle cerebral artery? correct answer: Hemiplegia seen more in UE Aphasia Apraxia Perceptual impairment: unilateral inattention and visual perceptual Depression and lability Is there a Visual deficit with a stroke in the MCA? correct answer: NO! It is PERCEPTUAL Pt will only eat 1/2 of plate bc that is all the see- move plate over and they will eat Posterior Cerebral Artery sxs correct answer: Movement impairments such as ataxia or intention tremors Memory impairments Perceptual problems such as asterognosis(can't identify common objects), topographic (get lost-can't find room) disorientation, visual object agnosia or color anomia Where is the problem? R. hemiplegia Flaccid Right UE Aphasia correct answer: MCA Where is the problem? L. Hemiplegia Substantial memory impairments and perceptual dysfunctions including visual object agnosia correct answer: Posterior Right Cerebral Artery What occurs in rehab process? correct answer: Referred to OT, PT and SLP (speech language pathology) Evaluate and develop a plan Establish goals with pt and fam based on severity of stroke and length of stay Undergo therapy What is the average length of stay? correct answer: 17 days What is the overall goal of stroke rehab? correct answer: To maximize FUNCTION, reduce burden of care to allow for highest level of discharge possible Rehab is approached as a team consisting of who? correct answer: OT, PT, SLP, PA, NP, MD, Pharmacist, Dietician and others Complex and MULTIDISCIPLINARY process What are the two types of therapeutic approaches? correct answer: Remediation and Compensation Both approaches can be used simultaneously What type of approach? Wear a pull over shirt to avoid having to button? correct answer: Compensation What type of approach? Practice fine motor tasks to support function? correct answer: Remediation What are some types of physical management? correct answer: Motor function-synergy patterns Management of tone-(muscles can be flaccid, hypertonicity or spasticity) Pain management Visual field deficits Difficulty swallowing Management of tone involves what? correct answer: Flaccid- needs to be protected Spasticity-Need to learn how to bear weight- you don't want to keep limb immobile (don't use sling) Need to worry about hemiplegic UE why? correct answer: There could be pain-perhaps from compression of nerves if subluxation occurs Subluxation of shoulder can occur from changes in tone Don't use sling- don't want arms to be immobile Dysphagia puts stroke pts at risk for? correct answer: Aspiration and swallowing impairment- SLP and OT can work with them Can show compensatory strategies or modified food choices What are types of aphasia? correct answer: Broca's (expressive) Wernicke's (receptive) Global What is Dysarthria? correct answer: May be difficult to control of use muscles around mouth after a stroke Who can help with communication issues? correct answer: SLP -can help to reduce verbal requirements and allow for increased processing time What are some examples of cognitive and perception issues? correct answer: Cognition: memory, problem solving, judgement Perception: motor perception, body scheme, spatial and visual perception NEED TO THINK ABOUT SAFETY OF PT and HOW IT IMPACTS THEIR ABILITY TO FUNCTION What are some examples of functional mobility? correct answer: Bed mobility, transfers, wheelchairs, gait OTs help with? correct answer: ADL Upper Extremity Management Activity tolerance When a stroke pt is discharged, what are a few things you should think ok? correct answer: What level of care they might need Home accessibility Any equipment needs? Caregiver instructions/training Role of PA in stroke rehab? correct answer: Advocate for EARLY and INTENSE rehab Later care of pt: look for changes in function manage health