CONSTANCE FORD

Question 1

Biopsychosocial Model (Cormack et al., 2022)

Answer 1

• BPSM only partially implemented in healthcare
• Humanistic ( Patient centred care) and Causation (multi-factorial contributions to illness) interpretations
• George Engel’s model
• Human experience of illness and disease
• Increase rigour for Pt’s Hx
• Heuristic framework for clinical medicine

Question 2

Shared Decision Making (Grenfell et al., 2022)

Answer 2

• Trust, communication, decision ability, decision preferences
• 2 way communication, power control, collaborative relationship, know risks and options

Question 3

Value-Based Care (Cook et al., 2021)

Answer 3

• patient-centredness
• guideline-orientated strategies
• measurement of Pt outcomes and experiences
• cost-effectiveness

Question 4

3 treatments for Stroke Rehab (NICE 2013., Thomas et al., 2016, Morreale et al. 2016, Hordacre. 2021, Gamble. 2016)

Answer 4

1. RTT (NICE Stroke Rehab Guidelines, 2013; Thomas et al, 2016)
2. Early Mobilisation & Intervention (Morreale, 2016; Hordacre, 2021)
3. Core Strengthening (Gamble et al, 2021)

Question 5

NICE., 2013 (Stroke Rx Recommendations)

Answer 5

• Offer Pt’s UL RTT (grasping, reaching, pointing)
  Offer Pt’s LL weakness (sit to stand, walking, using stairs)
• Recommend meaningful strength training inclusion for Pt

Question 6

Thomas et al., 2016 (SR, RTT)

Answer 6

• Pt’s who receive RTT improve function UL and LL compared to usual care, benefits maintained > 6 months after Rx

Question 7

Gamble et al., 2016 (SR, Core training)

Answer 7

• addition of core stability improves trunk control and balance, should be incorporated into rehab planning

Question 8

Morreale et al., 2016 (RCT, Early mobilisation)

Answer 8

• Early mobilisation produced greater improvements in ambulation and general function at 12 months post-stroke

Question 9

Maier et al., 2019 (Spaced Repetition)

Answer 9

• Spaced repetition is more effective than massed repetition for promoting neuronal activity and cell survival

Question 10

Hordacre et al., 2021 (SR, Early Mobilisation)

Answer 10

• Post-stroke window of enhanced neuroplasticity at 2-4 weeks post-stroke. The brain is more receptive and adaptive to rehab programmes

Question 11

Neuroplasticity (Emmady et al., 2022)

Answer 11

• ability of nervous system to change activity in response to intrinsic or extrinsic stimuli by reorganizing its structure, function or connections after injuries like stroke
• accomplished via neuronal regeneration or reorganization (3 phases: 48 hours, following weeks, weeks to months after injury)

Question 12

Partial Anterior Circulatory Infarction

Answer 12

• Ischaemic stroke (87%) when the blood supply to an area of brain tissue is reduced
• The anterior cerebral arteries supply the anteromedial area of the cerebrum
• Two of the following need to be present for a diagnosis of a PACS:

Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)

Question 13

NICE., 2013 (Stroke Screening Assessment)

Answer 13

• comprehensive assessment should take into account a person’s previous functional abilities, impairment of psych and body functioning, including pain and environmental factors