Management
Provide two examples of dual-tasking exercises in stroke rehabilitation.
Walking while carrying a cup of water, walking while counting aloud or reciting words.
Define neuroplasticity
The brain’s ability to reorganise by forming new neural connections in response to experience, learning, or injury.
Which cerebral artery is most commonly affected in stroke?
Middle Cerebral Artery (MCA)
What are the three principles of motor learning?
Feedback, Practice Variability and Problem-Solving / Discovery Learning
What is one primary goal of advanced-stage (late rehab/community transition) stroke rehabilitation?
Promote independence, enable community and home reintegration, and falls education.
What is the purpose of establishing SMART goals with the patient during rehabilitation?
To enhance motivation and engagement by incorporating the patient’s personal hobbies and interests, and to provide clear, measurable objectives for therapy.
Give a clinical example of task specificity in stroke rehabilitation?
If the goal is walking in the community, practice should involve walking in similar environments (stairs, obstacles, different surfaces)
True or False: Brainstem strokes can affect optic nerves, breathing, and blood pressure.
False
What three types of feedback methods are used in motor learning?
Verbal, visual and tactile
Why is determining the type and location of a stroke important before conducting an initial assessment? Provide 1 reason.
It guides clinical reasoning and helps anticipate likely impairments, informing targeted assessment and treatment planning.
List at least four impairments that should be assessed during the initial physiotherapy assessment of a stroke patient.
Motor deficits, sensory deficits, balance issues, tone and reflex abnormalities, coordination problems, cognitive deficits, and visual deficits
List 5 neuroplasticity principles
Describe the typical motor and sensory deficits seen with a Middle Cerebral Artery (MCA) stroke.
Contralateral weakness and sensory loss, affecting the upper limb more than the lower limb
What is the role of feedback in gait and mobility training?
Feedback guides correction of errors and reinforces proper movement. It can be verbal (e.g., “lift your knee higher”), visual (using mirrors or video), or tactile (guiding or cueing movement when necessary).
List three early-stage physiotherapy interventions to improve mobility.
Assisted pivot transfers, Sit-to-stand practice, Seated ball kicks to encourage lower limb movement replicating the swing phase
How does understanding a patient’s home and social environment influence physiotherapy treatment and discharge planning? Provide 2 reasons.
It helps tailor therapy to functional tasks that mirror home activities, informs safe discharge strategies, guides home modifications, and supports reintegration into previous roles.
Explain the principle “Use it or lose it” and give a clinical example.
Neural pathways that are not used become weaker and may be lost over time, potentially leading to functional degradation.
Clinical example: A patient who avoids weight-bearing on their affected leg risks atrophy and loss of motor control.
Which type of stroke is typically associated with impulsiveness, cognitive changes, and bladder incontinence?
Anterior Cerebral Artery (ACA) stroke.
A patient walks well in therapy but struggles at home. Which motor learning principle is missing?
Practice variability
Provide two examples of gait re-education techniques used in mid-stage rehabilitation
Overground walking with parallel bars, rails, or gait aids, Treadmill training with altered speed, incline, or bodyweight support, Theraband assisted dorsiflexion
Give four ways to progress or regress exercises throughout stroke rehabilitation.
Increase intensity (distance, duration, frequency), Increase complexity (part practice → whole task), Reduce support (supported → unsupported), Increase variability (different environments, speeds, dual tasks)
Why does intensity matter in stroke rehabilitation?
Frequent and challenging practice leads to stronger plasticity and better outcomes. Pushing the difficulty appropriately enhances neural gains.
Name at least three signs or symptoms associated with brainstem or cerebellar strokes.
Poor coordination and balance (ataxic gait), vertigo, cranial nerve issues (eye movements, hearing, swallowing), and possible effects on breathing and blood pressure.
How does discovery learning improve functional mobility?
By allowing patients to find solutions themselves, it enhances automaticity, independence, confidence, and cognitive engagement, which translates to safer and more adaptable mobility in daily life.
Give an example of how therapy can become more functional over time.
Making the movement directly transferable to daily tasks. E.g. reaching for an item in a kitchen cupboard, carrying a washing basket