Stroke Recovery (6/7)

What are the 10 principles of neuroplasticity?

1. use it or lose it

2. use it and improve it

3. specificity

4. repetition matters

5. intensity matters

6. time matters

7. age matters

8. salience matters

9. interference

10. transference

when does most neuroplasticity recover occur post-stroke?

- early in rehab

T/F: contralateral neuronal connections can be altered from unilateral cortical damage?

- true

> activity of contralateral hemisphere was found to enhanced in the acute stage after a stroke

what is the optimal time to start early mobilization

- after 24H of a stroke

- early mobilization (<24H after) is detrimental to functional outcomes

what should the focus of early mobilization post stroke be?

- sitting

- standing

- walking activity

when should subacute stroke patients be considered for inpatient rehab?

- can tolerate 2+ rehabilitation disciplines

- can tolerate 6 days/week with 3 hours of rehab/day

what is defined as chronic stroke patients?

- >6 months post stroke

what treatment should be considered if the patient is chronic poststroke?

- high intensity gait training

what are the 3 goals of interventions post stroke?

- restorative = improve impairments, activity and participation limitations

- preventive = minimize potential complications and indirect impairments

- compensatory = modify the tasks or activities to improve function

what should the PT consider in terms of providing instruction to patients post stroke?

- give clear, simple, and precise verbal instructions

- make sure to not overload the patient with excessive or wordy instructions

what feedback techniques can be helpful for patients post stroke?

- provide knowledge of results so that patient is aware of the achievement of the task

- avoid dependence of the therapist (slowly decrease the amount of assistance)

T/F: balance training should be done in isolation?

- F: balance should be done in the context of the task

T/F: use of mirrors for visual feedback is the same as mirror therapy?

- false

what are some ways to treat pushing syndrome?

- visual mirror feedback

> ask patient to observe their own posture

> emphasize orienting to midline

- PT sit on less involved side and instruct the pt to "lean over me"

why should you not try to push a patient upright if they have pushers syndrome?

- they will just push back harder towards the impaired side

T/F: wearing an AFO hinders muscle activity?

false

T/F: FES can improve muscle activation?

true

T/F: AFOs and FES decreases PF spasticity

false

T/F: AFOs should be considered for faster walkers?

- false

- AFO should be for slower walkers, FES for faster walkers

T/F: AFO use early in rehab enhances participation and leads to a faster recovery process?

true