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Age
Race
Sex
Ethnicity
Heredity: Family
history of stroke or
transient ischemic
attacks (TIAs)
Diagnosis
History Taking
Physical Examination
Patient Profile
Chief Complaint
History of the presenting
ilness :
Vital sign
Sign of trauma
Cardiovascular exam
Skin
Evidence of active bleeding
Level of consciousness (GCS)
Cognition ( Speech,
Comprehension, Naming,
Reading, etc)
Cranial nerve
Motor system ( Inspection,
Strength, Tone, Reflexes,
Coordination
Sensation
Diagnostic Evaluation
CT- Scan, Electrocardiogram,
MRI
Rehabilitation
Goals
When
Start rehabilitation in the
acute care hospital after
the patients medical
condition has been
stabilized.
This is often within 24 to
48 hours of the stroke.
Post-acute stroke
rehabilitation is started
when the stroke patient is
medically stable.
How
Basic physical Therapy
Bed positioning, mobility
Antispasticity position,
gradual mobilizaton
Range of motion exercises
(ROM)
Motoric reeducation : PNF
concept, Bobath, Brunstorm,
Rood, Carr & Shepherd, ect
Spasticity inhibition
Sitting/standing balance
control training
Treat dysphagia.
Ambulation Gait
rehabilitation
Prevent and manage
shoulder pain.
Stair climbing
Use of physical modalities
mostly for musculoskeletal
consequences & pain
Occupational Therapy
Focuses on fine motor
development
Developing new
adaptive
technique/devices
Improving
independency of ADL
Training of vocational
skills
Energy expenditures
Sensory reeducation
Speech Therapy
Training of orofacial
motor and stimulation
Concept of language
and vocabularies
Training of phonation
and articulation
Chewing, feeding, and
swallowing training
Orthotic
Shoulder Preventing
shoulder subluxation
Shoulder
sling/Axillary roll
Wrist Extensors
spasticity w/
Functioning fingers
Cock up splint
Legs Flexion
spasticity
HKAFO/KAFO
Prognosis
75% of patients will reach independent
level of self-care or with minimal help
and independent level of ambulation w/
assistive device
Almost all patients will be able to
control bladder and bowel
Only 10-15% of patients fall into severe
disabilities and will be bedriddened