Stroke Rehabilitation Exam Questions And Answers Rated 100% Correct!!

Stroke Rehabilitation Exam Questions And Answers Rated 100% Correct!! stroke rehab is guided by integrated framework of clinical reasoning - Answer- -guide to PT practice -ICF provides enablement language and structure for organizing info -StrokeEDGE task force examination recommendations (recommended outcome measures for stroke population) -synthesized evidence ICF model - Answer- great framework to use in practice when collecting data -helps w/ clinical reasoning and decision making approaches to PT interventions - Answer- 1. restorative 2. preventative 3. compensatory restorative PT interventions - Answer- aimed at improving impairments, activity limitations and participation *helpful for someone to have recovery because taps into neuroplasticity and motor learning start w/ restorative approach to - Answer- improve their impairments like strength and balance ex. strengthen ankle DFs stroke/neuro insult then get more sleep - Answer- better outcomes due to enhanced motor learning preventative PT interventions - Answer- aimed at minimizing potential complications and indirect impairments -prevent loss of ROM post-stroke -prevent foot drop/contractures via resting foot splint in bed compensatory PT interventions - Answer- aimed at modifying the task, activity, or environment to improve function ex. using ankle/foot orthoses (AFO) stroke recovery results from - Answer- -recovery of ischemic penumbra -resolution of cerebral edema -neuroplasticity and rehabilitation penumbra - Answer- viable tissue if given oxygen for increased function *as swelling decreases there is less pressure on other structures so brain is able to function enhance neuroplasticity - Answer- high reps and high intensity *parts of brain taking on new responsibilities better outcomes associated w/ - Answer- -early medical care -smaller strokes -specialized stroke care centers (ex. spaulding charlestown) -early, intensive multidisciplinary rehab approach specialized stroke care centers - Answer- -38% of US hospitals and rehab centers -reduction in mortality rates -1 yr post stroke: lower mortality rates, more functional independence and more likely to be living at home recovery patterns - Answer- variable- depends on part of brain affected and type of stroke (stroke in evolution versus complete stroke) *NIHSS scale scores stroke in evolution - Answer- stroke is stable/complete and symptoms not getting worse *continually decompensated most recovery happens w/in - Answer- first 6 months -can continue w/ measurable gains through chronic stages (6 months post) *aggressive PT to tap into neuroplasticity during first 6 months post stroke poor prognosis for motor recovery if - Answer- no return 4 weeks post-stroke prognosis - Answer- motor and perceptual impairments have greatest impact on functional performance enablement factors - Answer- -high motivation -stable supportive family -financial resources -health literacy -intensive training w/ repetitive practice mortality predictors - Answer- -hx of past CVA -prolonged LOC -dysphagia -aspiration pneumonia -age -ICP -size of lesion 25-75% rely on human assistance for basic ADLs like feeding, self-care and mobility - Answer- 10% full recovery to baseline *mild stroke more likely to have full recovery hope and mental health matters w/ regards to recovery - Answer- depressed mood associated w/ disability but not mortality perceptual impairment like lateral neglect results in - Answer- greater issues w/ functional performance older you are - Answer- increases mortality rate bigger the lesion - Answer- higher the mortality rates 16% in long term care - Answer- 71% are vocationally impaired 7 years post-stroke stroke rehab has an interdisciplinary team approach - Answer- influence on functional outcomes and recovery *value your role and put your voice on the table stroke care team members - Answer- •Patient and family members •Physicians - neurologist, cardiologist, surgeons, etc. •Nurses •Physical therapist •Occupational therapist •Speech and language pathologist •Registered dietician •Social Worker •Neuropsychologist •Respiratory, recreational and vocational therapists PT focus during the acute phase - Answer- -pt and family education -prevention of secondary complications -positioning/splinting -manage impairments (restorative approach) secondary complications include - Answer- -pain -ROM loss -joint contractures -skin breakdown early mobilization is safe and essential - Answer- low intensity w/ close monitoring of status *ramp up intensity once stable to tap into neuroplasticity restorative approach to - Answer- compensatory approach discharge planning - Answer- -average acute care stay is 2-4 days -home w/ or w/out services -acute vs subacute rehab -long term care PT focus during subacute phase - Answer- -pt and family centered goals -maximize functional status and independence -discharge planning w/ team if in rehab: return to home/community equipment - Answer- -DME -orthotics -splints/slings/gloves *restorative approach as much as possible, but potentially compensatory via above equipment community re-entry - Answer- return to work/recreational activities PT focus during the chronic phase - Answer- -outpatient -home care -community and recreational activities HEP - Answer- -exercise workload -health promotion -fall prevention and safety interventions implemented more frequently at chronic phase - Answer- -constraint-induced movement therapy (CIMT) -bilateral training -virtual reality (VR) -electromechanical assisted walking