Enabling 3 Stroke Rehab Upper Extremity

Front 1

what leads to pain, soft tissue shortening, ineffective/inefficient movement patterns, and contractures?

Back 1

-inefficient or ineffective skeletal muscle recruitment: increased activity at rest or inability to recruit activity, imbalanced activity

-static positioning or guarding muscles

Front 2

what is typical head posture post stroke?

Back 2

-flexed to involved side, rotation away from involved side

Front 3

what is typical scapula posture post stroke?

Back 3

depression and retraction

Front 4

what is typical upper arm/shoulder posture post stroke?

Back 4

adduction and internal rotation

Front 5

what is typical elbow//lower arm position post stroke?

Back 5

flexion and pronation

Front 6

what is typical wrist position post stroke?

Back 6

flexion and ulnar deviation

Front 7

what is typical finger position post stroke?

Back 7

flexion

Front 8

what is typical trunk position post stroke?

Back 8

posterior tilt, possible rotation, and lateral flexion to involved side

Front 9

what is typical lower extremity pattern: flexion or extension?

Back 9

flexor synergy pattern

Front 10

what is typical pelvis position post stroke?

Back 10

elevation and retraction (facing backwards)

Front 11

what is typical position post stroke at the hip?

Back 11

internal rotation, adduction, and extension

Front 12

what is typical leg position at the knee post stroke?

Back 12

extension

Front 13

what is typical foot position post stroke?

Back 13

plantar flexion, supination, and inversion

-toe flexion

Front 14

what effect does lateral trunk flexion have on scapula movement patterns?

Back 14

scapula on flexed side is adducted (retracted)

scapula on extended side is abducted (protracted)

Front 15

what effect does side flexion of trunk have on scapular alignment and subluxation and arm function?

Back 15

-scapula downward rotates/retracts in relation to the rest of the body when it follows the trunk on the flexed side

-this tips the glenoid fossa downwards

-supraspinatus (sitting on top of scapula, starts abduction) loses line of mechanical advantage, has difficulty abducting arm and may overstretch

Front 16

what effect does lack of thoracic spine extension (to one side) and scapular adduction have on arm movements (when trying to straighten spine)

Back 16

humerus abducts to support spinal extension

Front 17

when should you use a sling?

Back 17

-protection of arm during mobility (ie transfers)

-to improve balance during transfers and gait

-if pain or swelling increases when UE is down during gait

-if the client and or caregiver is able to don/doff it safely

Front 18

when should you not use a sling?/ what are the disadvantages?

Back 18

-it hinders function of the arm (during times that it would be good to use)

-can cause significant pressure on the neck

-risks of contractures when arm is immobilized

-promotes disregard and sensory deprivation of affected limb

Front 19

what are muscles with high tone typically in the shoulder (to target with botox?)

Back 19

-subscapularis (internal rotation of humerus)

-rhomboids (retracts scapula)

-lattissimus dorsi (adducts and internally rotates humerus)

-pectoralis major/minor (internal rotation, adduction of humerus)

Front 20

what are muscles with high tone typically in the arm/ forearm/hands (ie to target with botox)?

Back 20

-biceps

-brachialis (flexes arm in pronation)

-brachioradialis (flexes arm and rotates into midprone)

-wrist/finger flexors

Front 21

when is kinesiotape useful?

Back 21

-helps support limbs during movement to prevent future damage

-useful when muscles or joints are affected

Front 22

when is kinesiotape not useful?

Back 22

-people with skin vulnerabilities

-people whose muscles and joints are not affected (because there is no point)

-people with diabetes (skin damage may lead to amputations, esp with neuropathies)

-check with a nurse before using it (for skin vulnerabilities, diabetes, etc)

Front 23

when is a splint that supports the lower arm (in a position where it is not elevated) useful? what are its advantages?

Back 23

-a person with good scapular control but distal weakness

-allows the forearm and scapula to be in a more natural position

-can help with balance while walking

-less likely to lead to contractures when compared to holding arm at 90

Front 24

where should you put the bigger pocket of the sling and why?

Back 24

-the larger pocket should go over the hand

-this is to prevent edema

Front 25

when the torso is laterally flexed to the right side, what shoulder is more likely to have subluxation?

Back 25

the right shoulder (same side as the lateral flexion)

Front 26

what major muscle is involved in protracting and stabilizing the scapula?

Back 26

serratus anterior

Front 27

what are common pelvic positions in a stroke?

Back 27

-lateral tilt to side of weakness (causing scoliosis)

-posterior pelvic tilt with kyphosis

-trunk and pelvic rotation to one side when lying down

Front 28

what are some consequences of pelvic rotations?

Back 28

-pressure ulcers

-affects alignment of the rest of the body, leading to pain and movement difficulties

Front 29

what is a common leg misalignment pattern in stroke after sitting?

Back 29

hips move towards extended/unaffected side

-hip adduction with knees together

-"windswept" hips: unaffected side abducted and externally rotated, affected side adducted and internally rotated

-feet not equally bearing weight, foot in front of knee