Rehabilitation and management of apraxia after stroke

2001 ◽  
Vol 11 (2) ◽  
pp. 177-184 ◽  
Author(s):  
Caroline M van Heugten
Keyword(s):  
Stroke Patient ◽  
Neuropsychological Deficits ◽  
Sensory Loss

IntroductionA stroke patient puts on his shoes and then tries to put on his socks over his shoes. Entering the kitchen, this patient puts milk in the teapot, places the sugar bowl in the oven, and tries to drink from the milk jug. This patient is most probably apractic. Apraxia is one of the four classical neuropsychological deficits – such as agnosia, amnesia and aphasia – causing restrictions in the ability to carry out purposeful and learned activities. One of the first definitions of apraxia was given by Geschwind: ‘Disorders of the execution of learned movements which cannot be accounted for by either weakness, inco-ordination, or sensory loss, nor by incomprehension of, or inattention to commands.’

The Management and Rehabilitation of the Stroke Patient

1980 ◽  
Vol 25 (4) ◽  
pp. S41-S43
Author(s):  
J. Marshall
Keyword(s):  
Stroke Patient ◽  
Functional Disability ◽  
Neurological Deficits ◽  
Sensory Loss ◽  
Clinical Context ◽  
Neurological Defect

The residual neurological deficits after stroke are discussed in this article. The main problems are weakness, spasticity and rigidity. Weakness may be amenable to help with a variety of physical aids and mobility maintained with a wheelchair. Spasticity is defined in terms of the neurological defect and its consequences examined in the clinical context of the stroke patient. The place of antispastic drugs and their method of use is described. The importance of sensory loss in the production of functional disability is also discussed.

Questions and Answers

2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Spinal Nerve ◽  
Sensory Loss ◽  
Residual Symptoms ◽  
Additional Information ◽  
Questions And Answers ◽  
Motor Nerves ◽  
Symptoms And Signs ◽  
Limited Motion

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.

Evaluating Shoulder Impairment

1998 ◽  
Vol 3 (5) ◽  
pp. 1-3
Author(s):  
Richard T. Katz ◽  
Sankar Perraraju
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Sensory Loss ◽  
Motor Deficits ◽  
Nerve Lesion ◽  
Fourth Edition ◽  
Specific Patient ◽  
Industrial Medicine ◽  
Shoulder Motion ◽  
Upper Extremity Impairment

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fourth Edition, offers several categories to describe impairment in the shoulder, including shoulder amputation, abnormal shoulder motion, peripheral nerve disorders, subluxation/dislocation, and joint arthroplasty. This article clarifies appropriate methods for rating shoulder impairment in a specific patient, particularly with reference to the AMA Guides, Section 3.1j, Shoulder, Section 3.1k, Impairment of the Upper Extremity Due to Peripheral Nerve Disorders, and Section 3.1m, Impairment Due to Other Disorders of the Upper Extremity. A table shows shoulder motions and associated degrees of motion and can be used in assessing abnormal range of motion. Assessments of shoulder impairment due to peripheral nerve lesion also requires assessment of sensory loss (or presence of nerve pain) or motor deficits, and these may be categorized to the level of the spinal nerves (C5 to T1). Table 23 is useful regarding impairment from persistent joint subluxation or dislocation, and Table 27 can be helpful in assessing impairment of the upper extremity after arthroplasty of specific bones of joints. Although inter-rater reliability has been reasonably good, the validity of the upper extremity impairment rating has been questioned, and further research in industrial medicine and physical disability is required.

Abstract #809: Spontaneous Pituitary Apoplexy in the Second Trimester Associated with Sensory Loss

2015 ◽  
Vol 21 ◽  
pp. 152
Author(s):  
Rtika Abraham ◽  
Rachel Pollitzer ◽  
Murat Gokden ◽  
Peter Goulden
Keyword(s):  
Pituitary Apoplexy ◽  
Sensory Loss ◽  
Second Trimester

Physical Therapy for the Stroke Patient

2012 ◽  
Author(s):  
Jan Mehrholz ◽  
Claudia Flaemig ◽  
Janet Carr
Keyword(s):  
Physical Therapy ◽  
Stroke Patient

Improvement of somatopsychic and cognitive abilities in a post-stroke patient treated with neurotrophic factors

Psihiatru ro ◽  
2020 ◽  
Vol 4 (63) ◽  
pp. 30
Author(s):  
Gabriela Marian ◽  
Brânduşa Ecaterina Focşeneanu ◽  
George Stercu ◽  
Andrei-Cristian Bondar ◽  
Claudiu Pavel ◽  
...  
Keyword(s):  
Stroke Patient ◽  
Neurotrophic Factors ◽  
Cognitive Abilities ◽  
Post Stroke

Feasibility of an iPhone-based application for knee joint goniometry during gait in a stroke patient (Preprint)

2018 ◽  
Author(s):  
Claudia Nava ◽  
Patrizio Sale ◽  
Vittorio Leggero ◽  
Simona Ferrante ◽  
Cira Fundaro' ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Stroke Patient ◽  
Reference Method ◽  
Flexion Angle ◽  
Good Reliability ◽  
Rater Reliability ◽  
Maximum Extension ◽  
Angle Measurements ◽  
Hemiparetic Gait ◽  
Flexion Extension

BACKGROUND In recent years, different smartphone apps have been validated for joint goniometry, but none for goniometric assessment of gait after stroke. OBJECTIVE The aims of our work were to assess:1) to assess intra-rater reliability of an image-based goniometric app – DrGoniometer- in the measurement of the extension, flexion angles and range of motion of the knee during the hemiparetic gait of a stroke patient; (2) its validity comparing to the reference method (electrogoniometer) for flexion-extension excursion measurements; and the intra-rater agreement in the choice of the video frames. METHODS An left-hemiparetic inpatient following haemorrhagic stroke was filmed using the app while walking on a linear path. An electrogoniometer was fixed on the medial face of the affected knee in order to record the dynamic goniometry during gait. Twenty-one raters, blinded to measurements, were recruited to rate knee angle measurements from video acquired with DrGoniometer. Each rater repeated the same procedure twice, the second one at least one day after the first measure. RESULTS Results showed that flexion angle measurements are reliable (ICC95%=0.66, 0.34;0.85; SEM=4°), and adequately precise (CV=14%). Extension angles measurements demonstrated moderate reliability and higher degree of variation (ICC=0.51, 0.09;0.77; SEM 4°; CV=53%). ROM values were: ICC=0.23 (-0.21;0.60); CV=20%. Accuracy of DrGoniometer compared to the electrogoniometer was 7.3±4.7°. The selection of maximum extension frame revealed an accordance of 58% and 72% within a range of ±5 or ±10 frames, respectively; while the best flexion frame reported 86% of agreement for both range of 5 and 10 frames. CONCLUSIONS The results demonstrated moderate to good reliability concerning the maximum extension and flexion angles, while assessing ROM DrGoniometer showed poor intra-rater reliability. Flexion angle measurements seemed to be reliable according to ICC and SEM values and more precise with a limited dispersion of results DrGoniometer revealed a good accuracy in the measurement of range of motion. The agreement of the maximal extension frame was anyway adequate within 5 frames (59%) and noticeably increased within 10 frames (72%). In conclusion, DrGoniometer was found to be a valid and reliable method for assessing knee angles during hemiparetic gait. Further studies are necessary to investigate inter-rater reliability and confirm our results.

scholarly journals Multi‐modal combination therapy rescued a frequent ischemic stroke patient due to giant cell arteritis

2019 ◽  
Vol 7 (3) ◽  
pp. 132-135
Author(s):  
Yoshiaki Takahashi ◽  
Kota Sato ◽  
Namiko Matsumoto ◽  
Yuko Kawahara ◽  
Taijun Yunoki ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Combination Therapy ◽  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Stroke Patient ◽  
Ischemic Stroke Patient
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