Neuroplasticity + Theories/Models
Complete regaining of identical functions that were lost or impaired after brain damage is known as this
What is spontaneous recovery?
This is what BEFAST stands for
What is: balance, eyes, face, arm, speech, and time?
If a pt has expressive aphasia, contralateral homonymous hemianopsia, and contralateral hemiplegia w/ UE more involved, blood supply to this artery is impaired
What is middle cerebral (MCA)?
A pt may be given an orthotic that promotes DF in order to encourage ______ of the knee
What is flexion?
Clonus, hyperreflexia, and hypertonia are associated w/ ______ motor neuron lesions
What is upper?
**LMN lesions associated w/ atrophy, hyporeflexia, and hypotonia
Reduced function of a region of the brain due to a lesion as a remote site which normally supplies background excitation is known as this
What is diaschisis?
___________ in the UE and ___________ in the LE are the two last movements out of synergy to return in Stage 6 of recovery
What is finger extension and eversion?
For the NIHSS, the _______ (larger/smaller) the score, the worse the severity of stroke
What is larger?
**scale is 0-42
These are reasons why bed mobility/positioning is important (I listed 6)
What are:
-increase comfort
-prevent skin breakdown
-prevent injury/trauma
-prevent or minimize contractures
-promote natural alignment
-promote functional movement
With a central CN VII injury, you would see weakness on the _________ side and it affects the ________ portion of the face
What is contralateral and lower?
**Peripheral VII shows weakness on the ipsilateral side and affects both the upper and lower face
This traditional model focused on inhibition of reflexes and assumed higher centers of the brain would resume control
What is the hierarchical model?
This is the more important forecaster of stroke
What is a TIA?
**risk of stroke within 90 days is >10%
Neurological recovery is generally complete within _________ post stroke
What is 3 months?
**but we may see continued functional improvements for years
A ground reaction force AFO (GRAFO) would be good for this pattern of gait
What is crouch gait?
If you ask a pt to protude their tongue and it deviates to one side, this is their _______ (weak/strong) side
What is weak?
This type of collateral sprouting leads to dysfunction as nerve fibers start sprouting fast, the fibers grow short, and they are not chemically specific
What is heterotypic collateral sprouting?
These are the three domains that the AM-PAC measures
What are: basic mobility, daily activity, and applied cognitive?
At this stage of recovery we start to see some movement out of synergy
What is Stage 4?
*for UE: hand behind sacrum, shoulder flexion w/ elbow extension, and pro/sup w/ elbow flexed to 90
*for LE: sitting w/ knee flexion beyond 90, DF of ankle w/ heel on the floor, and initiation of bridging motion in hooklying
These are interventions for Pusher Syndrome (I listed 4)
What are:
-visual vertical
-practice leaning towards non-paretic side and WB through forearm
-position pt w/ wall next to non-paretic side and ask them to keep their body there
-practice reaching towards non-paretic side
A problem w/ oral-motor mechanism due to CN involvement is called this
What is dysarthria?
This principle states that infants will have fewer deficits compared to adults w/ same injury
What is the Kennard principle?
These are the two main initial management strategies for ICH
What are BP control (SBP <180 or <140) and reversal of anticoagulation?
These two imaging scans will help us look at the size of the infarct vs the size of the penumbra with an ischemic stroke
What are CT perfusion head or MRI brain w/ perfusion?
These are indications for rhythmic initiation (I listed 6)
What are:
-difficulty relaxing
-hypertonicity
-motor learning deficits
-apraxia
-aphasia
-to learn the pattern for the first time
These are three advantages of the Fugl-Meyer over Brunnstrom
What are:
1. More detailed exam of wrist function2. Inclusion of time coordinated items
3. Standardized ways to test for different grips and grasps