Stroke Rehabilitation Exam Questions and Answers 2024

Stroke Rehabilitation Exam Questions and Answers 2024 What does stroke recovery result from? - Answer-Recovery of the ischemic penumbra (restoring blood flow) Resolution of cerebellar edema Neuroplasticity and rehabilitation What are better outcomes of stroke recovery associated with? - Answer-Early medical care Smaller strokes (more focal) Specialized stroke care centers Early intensive multidisciplinary rehab (mobility ASAP) Is stroke recovery the same for all patients? - Answer-NO - highly variable Ex. Hemorrhagic pts tend to not recovery as quickly due to edema then seem to make major gains at once. Whereas ischemic pts have rapid, steady rate of gains in first 6 months then plateau T/F: Most stroke recovery happens in first 6 months and progress stops once the stroke is considered chronic - Answer-True that most stroke recovery occurs in first 6 months however progress can still be made in chronic stages What is the prognosis for motor recovery if motor does not return after 4 weeks post stroke? - Answer-Poor What are mortality predictors of stroke? - Answer-History of past CVA, prolonged LOC, dysphagia, aspiration, pneumonia, age, increased ICP, and size of lesion What percent of stroke patients will need some level of assistance long term? - Answer- 66% (1/3) Is there a genetic effect on prognosis following a stroke? - Answer-Yes - there are genetic polymorphisms related to stroke recovery (BDNF production) Goals of stroke care units? - Answer-Rapid medical attention Limit neurologic damage Optimize medical status Initiate early rehab/functional mobilization Multidisciplinary inpatient units - reduction in mortality rates but only 38% of US hospitals and rehab centers have these units Who is on the stroke care team? - Answer-Patient and family Physicians (neurologist, cardiologist, surgeon, etc.) Nurses PT/OT SLP Dietician Social worker Neuropsychologists Respiratory, recreation and vocational therapists ICU/Acute care goals of post-stroke PT - Answer-Pt and family education Prevention of secondary complications Positioning, splinting Manage impairments EARLY MOBILIZATION: low intensity, monitor status closely Discharge planning (avg acute care stay is 5 days) Rehab goals of post-stroke PT - Answer-Same as acute care setting but patient will be more stable Focus on pt and family centered goals Maximize functional status and independence Discharge planning with the team - to home, community, work, recreational activities Equipment needs (DME, orthotics, splints, slings, gloves) Chronic phase post-stroke PT goals - Answer-Chronic (6 months and beyond) - home care - community rehab - outpatient - home exercise program Goals are focused on maintaining/continuing to improve ROM, strength, endurance, balance, functional mobility, independent participation in recreational and vocational activities What is the traditional neurorehab approach for post-stroke rehab? - Answer-NDT - based on neuromaturational and hierarchical theories of motor control. Commonly used in practice but limited evidence to show effectiveness. What is the contemporary approach in neurorehab? - Answer-Evidence-based concepts of motor control, motor learning and neuroplasticity. Different names, same approach: - Task Oriented Retraining - Motor Relearning Program - Functional Movement Re-education - Neuromuscular re-education Task Oriented Training steps - Answer-Task analysis Part-task practice Whole-task practice Transfer of training Task Analysis - Answer-Observing pts natural movements (safely