Skip to main content

Understanding Stroke Recovery and Predicting Outcomes Study Guide

This guide covers the fundamental biological processes underlying stroke recovery, such as neuroplasticity and the impact of diaschisis. It differentiates between true neurological recovery and compensatory strategies, and explains how clinicians use various predictors, including neuroimaging and clinical scores, to forecast patient outcomes and inform discharge planning. Essential for understanding the post-stroke rehabilitation journey.

Save this study guide to your study set

Sign up free

Your learning path

Systems, Assessment, and Intervention of Postural Control

Components and Systems of Postural Control

Postural control involves the control of the body's position in space for stability and orientation through the interaction of individual systems, functional tasks, and environmental constraints.

  • Postural control
  • Steady state control
  • Anticipatory control
  • Reactive control
  • Center of mass
  • Base of support
  • Limits of stability
  • Postural orientation
  • Sensory integration
  • Sensory reweighting
  • Visual inputs
  • Vestibular inputs
  • Somatosensory inputs
  • Motor systems
  • Neural systems
  • Cognitive systems
  • Dual task interference
  • Postural sway
  • Feedforward control
  • Feedback motor activation

Steady State and Postural Control Strategies

This content examines steady state gait patterns, anticipatory postural control, and reactive postural control strategies including fixed support and change in support responses.

  • Steady state gait pattern
  • Center of mass stability
  • Base of support
  • Anticipatory postural control
  • Feedforward and feedback
  • Muscle synergies
  • Reactive postural control
  • Fixed support strategies
  • Ankle strategy
  • Hip strategy
  • Change in support strategy
  • Stepping and reaching strategies
  • Sensorimotor integration

Assessment of Postural Control

Functional assessment of postural control involves evaluating steady state, anticipatory, reactive, sensory interaction, and dual task demands using various outcome measures.

  • Postural alignment and weight distribution
  • Postural sway and limits of stability
  • Steady state postural control
  • Anticipatory postural control
  • Reactive postural control
  • Sensory interaction
  • Dual task postural control
  • Berg Balance Scale
  • Functional Reach Test
  • Trunk Impairment Scale
  • Sensory Organization Test
  • Clinical Test of Sensory Interaction and Balance
  • Activity Specific Balance Confidence Scale
  • Dual Task Timed Up & Go
  • BESTest and MiniBESTest
  • Functional Gait Assessment
  • Function in Sitting Test

Postural Control in Neurologic Dysfunction

This content discusses changes to steady state, anticipatory, and reactive control following neurologic dysfunction using a system framework of individual, task, and environment constraints.

  • Steady state control
  • Anticipatory control
  • Reactive control
  • Neurologic dysfunction
  • Sensory integration
  • Cognitive dysfunction
  • Motor systems
  • Neural systems
  • Individual systems
  • Environment constraints
  • Visual input
  • Vestibular input
  • Somatosensory input
  • Proprioception
  • Afferent pathways
  • Subcortical and cortical integration
  • Motor planning and execution
  • Center of mass (COM)
  • Base of support (BOS)
  • Postural sway

Atypical Postural Control Intervention Strategies

Task oriented approach to intervention involves retraining steady state, anticipatory, and reactive postural control through sensory integration and motor control techniques.

  • Task oriented approach to intervention
  • Steady state control retraining
  • Anticipatory control training
  • Reactive balance training
  • Perturbation based training
  • Sensory reweighting
  • Sensory integration retraining
  • Backward walking training
  • Dual task strategies
  • Center of mass and base of support
  • Motor response optimization

Atypical Postural Control and Dual Task Training

Dual task training improves the ability to allocate attentional resources and reduces fall frequency through balance tasks and cognitive tasks.

  • Dual task training
  • Attentional resources
  • Postural control
  • Fall prevention
  • Balance tasks
  • Cognitive tasks
  • Verbal fluency
  • Walking aids
  • Sensory integration
  • Motor control
  • Outcome measures

Predicting Post Stroke Recovery and Functional Outcomes

Recovery and Outcome Expectations Post Stroke

This material describes mechanisms of recovery, neuroplasticity, and the differentiation between recovery and compensation following ischemic or hemorrhagic stroke.

  • Ischemic stroke
  • Hemorrhagic stroke
  • Diaschisis
  • Interhemispheric excitatory and inhibitory balance
  • Neuroplasticity
  • Neural reorganization
  • Recovery vs compensation
  • Resolution of neural shock
  • Denervation supersensitivity
  • Recruitment of silent synapses
  • Regenerative and reactive sprouting
  • Cortical remapping
  • Learned non-use

Post Stroke Recovery and Discharge Planning

Factors influencing post stroke recovery, functional outcomes, and discharge destination decisions.

  • Discharge destination
  • Post stroke recovery
  • Functional outcomes
  • Inpatient rehabilitation facility
  • Skilled nursing facility
  • Long-term acute care hospital
  • Admission NIHSS Score
  • Physiologic reserve
  • Primary stroke diagnosis
  • Length of stay
  • Prognosis
  • Hand function
  • Gait function
  • ADL domains

Neuroimaging and Upper Limb Recovery Prediction

Use of neuroimaging and the PREP 2 algorithm to predict functional outcomes and upper limb recovery potential post stroke.

  • CT Perfusion
  • Diffusion weighted imaging (DWI)
  • Diffuse tensor imaging
  • Functional MRI
  • Upper limb dysfunction
  • PREP 2 Algorithm
  • MRC MMT grades
  • NeuroRehabilitation

Mobility Prognosis and Recovery Post Stroke

Assessment of mobility prognosis and recovery post stroke using transcranial magnetic stimulation, trunk control tests, and postural assessment scales to predict walking independence.

  • Transcranial Magnetic Stimulation
  • Motor evoked potentials
  • Corticospinal pathways
  • Mobility prognosis
  • Sitting Balance Scale
  • Trunk Impairment Scale
  • Trunk Control Test
  • Postural Assessment for Stroke Scale
  • Walking independence
  • Time to Walking Independently after Stroke (TWIST) Algorithm
  • Postural control

Fundamentals and Strategies of Motor Learning

Fundamentals of Motor Learning and Control

Concepts of motor learning include motor control, skill acquisition, and mechanisms such as sensorimotor adaptation, use-dependent learning, instructive learning, and reinforcement learning.

  • Motor control
  • Motor learning
  • Motor performance
  • Skill acquisition
  • Degrees of freedom
  • Fits and Posner's Stages of Motor Learning
  • Cognitive stage
  • Associative stage
  • Autonomous stage
  • Sensorimotor adaptation
  • Use-dependent learning
  • Instructive learning
  • Reinforcement learning
  • OPTIMAL theory of motor learning
  • Task specificity
  • Learner autonomy
  • External focus of attention

Motivation and Enhanced Expectations in Motor Learning

Motor skill learning is enhanced when performance expectations are enhanced through strategies like positive feedback, social-comparative feedback, and promoting autonomy.

  • motor learning
  • performance expectations
  • response expectancy theory
  • self-efficacy
  • positive feedback
  • social-comparative feedback
  • self modeling
  • perceived task difficulty
  • conceptions of ability
  • growth mindset
  • positive affect
  • autonomy
  • learner control

Autonomy Support and External Focus of Attention

This content explores autonomy support versus controlled support in clinical settings and the effectiveness of external focus of attention on skill acquisition and retention.

  • Autonomy Support
  • Controlled Support
  • Self-regulation strategies
  • Self-efficacy
  • Dopaminergic response
  • External focus of attention
  • Internal focus of attention
  • Skill acquisition and retention
  • Instructional language
  • Task and environmental monitoring

Mechanisms and Variables of External Focus

External focus of attention increases automaticity, improves goal/action coupling, and utilizes intrinsic and extrinsic feedback variables.

  • External focus of attention
  • Automaticity
  • Goal/action coupling
  • Use-dependent learning
  • Instructive feedback
  • Reinforcement feedback
  • Sensorimotor adaptation
  • Intrinsic feedback
  • Extrinsic feedback
  • Knowledge of Results
  • Knowledge of Performance
  • Feedback frequency
  • Feedback timing
  • Feedback mode

Motor Learning Practice Structures and Schedules

This content explores various practice structures including part versus whole training, massed versus distributed practice, and constant versus variable practice to enhance motor learning.

  • Part Training
  • Whole Training
  • Massed Practice
  • Distributed Practice
  • Constant Practice
  • Variable Practice
  • Blocked Practice
  • Random Practice
  • Contextual Interference
  • Dose and Intensity

Motor Learning and Facilitation Strategies

Strategies to facilitate motor learning and practice parameters including use-dependent learning, instructive learning, sensorimotor adaptation, reinforcement learning, and motor priming.

  • Use-dependent learning
  • Instructive learning
  • Sensorimotor adaptation
  • Reinforcement learning
  • Intrinsic feedback
  • Extrinsic feedback
  • Learner autonomy
  • External focus of attention
  • Task specificity
  • Dose and intensity
  • Motor priming
  • Stimulation-based priming
  • Motor imagery
  • Action observation
  • Movement based priming

Make it your own.

Keep these readings and topics in a new study set, or add them to one you already use.

Get started freeLog in