CVA Interventions

Question 1

List the core standarized tasks that should be included in a task analysis

Answer 1

1. Sitting
2. Standing
3. STS
4. Walking
5. Step Up/Down
6. Reach, Grasp, Manipulation

Question 2

List the indications for immediate cessation of exercise program for CVA pts

Answer 2

1. Lightheadedness
2. Dizziness
3. Chest heaviness, pain or tightness; angina
4. Heart palpitations or irregular heart beat
5. Sudden SOB not due to increased activity
6. Volitional fatigue and exhaustion

Question 3

List 4 required lead up skills necessary for most ADLs

Answer 3

1. Trunk postural stability
2. Shoulder stability and mobility
3. Elbow stability and mobility
4. Wrist stability and mobility

Question 4

T/F: we can improve tone abnormalities through PT?

Answer 4

FALSE

we can monitor and manage

Question 5

What did the AVERT study determine with regards to exercise post stroke?

Answer 5

early mobilization not found to have additional AE compared to standard care group

EOB/upright activities, including standing and walking, at frequent intervals within 24-hrs stroke onset improves functional outcomes and is safe

Question 6

List the endurance recommendations for the Acute Care setting

Answer 6

1. Goal → prevent deconditioning, OH, depression
2. <11-12 RPE (3-4 mRPE)
3. Resting HR +10-20bpm
4. Duration and frequency as tolerated
   
   • interval approach
5. Mode → walking, ADLs, standing activities

Question 7

List the endurance recommendations for IP Rehab and OP

Answer 7

1. Goal:
   
   • increased walking speed and efficiency
   • improve exercise tolerance
   • increased indpendence w/ADLs
   • reduce motor impairments
   • improve cognition
   • improve vascular health
2. RPE 11-14 (mRPE 3-5/6)
3. 40-70% VO2 reserve or HR reserve
4. 55-80% HRmax
5. 20-60 min/session, 3-5x/week
   
   • +adequate warm-up and cool down
6. Mode → large-muscle activities

Question 8

List various ways we can manage a hemiplegic subluxed shoulder

Answer 8

1. Strengthening
2. Kinesio-tape
3. NMES
4. Slings
5. Positioning

Question 9

List commonly used shoulder slings for hemiplegic subluxed shoulders

Answer 9

1. Neoprene sling
2. AliMed sling
3. GivMohr sling
4. Shoulder saddle sling

Question 10

List various somatosensory intervention techniques

Answer 10

1. Sensory retraining programs
   
   • mirror therapy
   • repetitive sensory discrimination
   • bilateral simultaneous movements
   • repetitive task practice
2. Sensory stimulation approaches
   
   • compression techniques
   • mobilizations
   • E-stim
   • thermal stimulation
   • magnetic stimulation

Question 11

Long-term goals are typically based on expected length of PT service. List off the various CVA typical time frames per setting

Answer 11

1. Acute care → 1-2 weeks
2. IP acute rehab → 3-4 weeks
3. IP subacute rehab → 4+ weeks
4. OP → highly variable, usually <6-12 months