6- Stroke

Question 1

Strokes lead to….

Answer 1

Physical impairment & mental impairment

Question 2

Role as a KCEP in stroke rehab process

Answer 2

Optimize functional capacity & fitness through EXERCISE TRAINING

Question 3

What is a stroke (brain injury)

Answer 3

Abrupt incident of vascular insufficiency or bleeding into or adjacent to the brain

Question 4

What are the two types of strokes

Answer 4

Ischemic and hemorrhagic stroke

Question 5

Which stroke is less severe

Answer 5

Ischemic

Question 6

Strokes are ranked what for death

Answer 6

3

Question 7

How many stroke cases in Canada per year

Answer 7

60 000- 70 000

Question 8

How many strokes are 1st attacks and how many recurrent

Answer 8

80% 1st
20% 2nd stroke

Question 9

Average age of onset for strokes

Answer 9

72 years

Question 10

Incidence of stroke based on gender

Answer 10

Equal

females more likely to survive than males

Question 11

% of strokes that result in death

Answer 11

29%

3/10 strokes are fatal

Question 12

Ischemic strokes account for what % of strokes

Answer 12

80% are Ischemic

Question 13

What are the two subcategories of Ischemic strokes

Answer 13

Cerebral thrombosis
Cerebral embolism

Question 14

What is cerebral thrombosis

Answer 14

blood clot in cerebral vessel

occlusion at artherosclerotic plaque

Question 15

What is a cerebral embolism

Answer 15

displaces clot of bacteria that occludes downstream artery

Question 16

Blood clots can ________ from a thrombus & lead to_________

Answer 16

They can break from a thrombus and lead to artery occlusion

Question 17

When do ischemic strokes usually occur

Answer 17

Periods of decreased activity (sleep)

Question 18

What is an intracerebral hemorrhage

Answer 18

Bleeding into the brain

Question 19

Intracerebral hemorrhage accounts for what % of strokes

Answer 19

20%

Question 20

Two subcategories of intracerebral hemorrhage

Answer 20

Arterial rupture
Aneurysm

Question 21

What is arterial rupture associated with

Answer 21

Aneurysms and arteriovenous malformations

tangled up blood vessels

Question 22

What is an aneurysm

Answer 22

Inflammation of the blood vessel

Question 23

A blood vessel needs to _______ in order for a stroke to happen

Answer 23

RUPTURE

Question 24

When do intracerebral hemorrhagic stroke usually occur

Answer 24

Periods of activity

Consciousness, stupor or coma

Question 25

5 signs and symptoms of a stroke

Answer 25

1. Weakness 2. Trouble speaking 3. Vision problems 4. Headache 5. Dizziness

Question 26

Trouble speaking involves what

Answer 26

Sudden difficulty speaking or understanding Confusion and **aphasia**

Question 27

What is aphasia

Answer 27

Inability to speak write and understand

Question 28

Aphasia is caused by a stroke where

Answer 28

LEFT hemisphere (opposite)

Question 29

What is the FAST test stand for

Answer 29

Face arms speech time

Question 30

What do you ask the person

Answer 30

Smile Speak a simple sentence Raise both arms

Question 31

Following a stroke, where are sensory and motor impairments located

Answer 31

OPPOSITE side of brain lesion

Question 32

Why is the number of stroke victims increasing w time

Answer 32

Due to an increase in average age

Question 33

What is the median age of Canadian population

Answer 33

40

Question 34

NO. 1 risk factor for strokes that can’t be controlled

Answer 34

AGE

Question 35

uncontrolled risk factors of a stroke

Answer 35

Age Sex Family history

Question 36

Main risk factors that CAN be controlled

Answer 36

Physical activity BP

Question 37

What percent of Canadian men meet PA guidelines

Answer 37

5-11: 18% 12-17: 8% 60-79: 13%

Question 38

What percent of women meet PA guidelines

Answer 38

5-11: 8% 12-17: 3% 60-79: 11%

Question 39

What can regular PA do

Answer 39

Reduce body wt Improve lipids and cholesterol Reduce bp and diabetes

Question 40

National guideline for PA

Answer 40

150min of MI- VI per wk

Question 41

NO. 2 risk factor for strokes

Answer 41

High BP

Question 42

What increases risk of high BP

Answer 42

Age Weight Diet PA level

Question 43

Best type of exercise program for stroke prevention

Answer 43

Aerobic training

Question 44

main mode of training PRE stroke

Answer 44

Aerobic training

Question 45

Main mode of exercise post stroke

Answer 45

Functional training

Question 46

What can aerobic training do to reduce stroke

Answer 46

Reduce hypertension Reduce BF increase HDL/LDL ratio

Question 47

How can functional training help stroke victims

Answer 47

Improve muscular strength and endurance Improve motor functions (balance, coordination)

Question 48

What should you remember when working w stroke victim during exercise

Answer 48

- reduced motor control on one side - impaired sensation - intolerance to high intensity

Question 49

Foot drop paralysis involves what muscle

Answer 49

Tibialis anterior

Question 50

Why do stroke victims have a decrease in vo2 max

Answer 50

Decreased: 1. **neural drive** 2. **blood flow** 3. **muscle mass**

Question 51

Paretic limbs are caused by

Answer 51

Decreased neural drive DecreSed blood flow Decreased muscle mass

Question 52

Poor CV fitness can compromise….

Answer 52

Performance in ADLs

Question 53

Peak fitness level after stroke (met)

Answer 53

3.5 METS

Question 54

1 MET=

Answer 54

3.5mL/kg/min

Question 55

What is the maximal exertion a stroke victim can do

Answer 55

Walking at 3.0mph

Question 56

What activities can a stroke victim do

Answer 56

Light hardening General cleaning Dishes Putting groceries away Walking 2-3 mph

Question 57

The case study is an exercise program for who

Answer 57

Hemiparetic participants

Question 58

What year was the study started

Answer 58

2000

Question 59

What does motor FUNCTION disorders include for the study eligibility

Answer 59

Restriction of movement or paralysis Weakness and coordination issues

Question 60

What does motor performance disorders include for eligibility

Answer 60

Decrease balance Decreasing walking capacity Decrease mobility

Question 61

Exercise at high intensity could….

Answer 61

Lead to 2nd stroke or heart attack

Question 62

Rationale for the case study

Answer 62

People with chronic stroke are increased by the absence of regular PA

Question 63

What is a chronic stroke

Answer 63

1 year post stroke

Question 64

Experimental question of case study

Answer 64

Can people w chronic stroke improve physical condition (functional level) in an **8 week group exercise** program ?

Question 65

What kind of questions are on the preparation questionnaire

Answer 65

High bp, medication PA status Walking ability **GOALS**

Question 66

Whah are goals of a participant important

Answer 66

MOTIVATION

Question 67

What did the exercise program focus on

Answer 67

**strengthening the affected extremities** Practicing **functional tasks of all limbs**

Question 68

Example of upper limb exercises

Answer 68

Standing pushups Stretch band exercises to improve shoulder strength ROM w a wooden stick

Question 69

Examples of lower limb exercises

Answer 69

Step exercises Sit to stand Standing on one leg/ tandem

Question 70

What does step exercises improve

Answer 70

Lower limb ROM and strengthen weak side

Question 71

How often did the exercise in the study

Answer 71

8 people 2x/wk 60mins/ session Used an RPE 0-10 scale

Question 72

How can intensity me modified

Answer 72

Number of reps Ankle weights Use of parallel bars Exercise difficulty

Question 73

How did they evaluate the participants

Answer 73

Timed up & go (3m) 6 min walk test Stroke impairment assessment set Berg balance scale

Question 74

Independent people in balance mobility score________on timed up and go

Answer 74

<10s

Question 75

Dependent individuals in ADL and balance score what on timed up and go

Answer 75

>30s

Question 76

What is the Berg balance scale scored on

Answer 76

56

Question 77

Goal of berg balance scale

Answer 77

Provide a comprehensive balance assessment

Question 78

A score of _____ of BERG indicates what

Answer 78

**45 or less**= Risk fall

Question 79

How many items in Berg

Answer 79

14 items

Question 80

Goal of 6 min walk tes r

Answer 80

Evaluate CRE

Question 81

Goal of stroke impairment assessment set (SIAS)

Answer 81

Assess motor function and coordination for upper and lower extremities

Question 82

The SIAS is hard to easy to do

Answer 82

Easy to administer but hard to score due to lack of detail

Question 83

Exercise study precautions

Answer 83

Medical clearance Med list BP check HR before each session

Question 84

Instructions given to participants

Answer 84

Exercise at own pace Start each session slow Stop exercise if having symptoms

Question 85

Group adapted exercise program included who

Answer 85

1 certified KCEP 1-2 interns 1 volungeer

Question 86

SIAS motor score went from _____ to ______/25

Answer 86

13.8—-> 16.2 Difference of 2.4

Question 87

BERG balance scale score went from _____ to ______/56

Answer 87

45.4—> 49.6 Difference of 4.2 **no more risk fall**

Question 88

Timed up and go score time went from _____ to ______

Answer 88

26.3—> 21.7s Difference of 4.6s **dependent (>26s) to independent (<26s)**

Question 89

6 min walk test went from _____ to ______

Answer 89

170—>188.8m Difference 18m **endurance improved more than speed!**