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Questions and Answers
What is a characteristic of Level 5 in the Functional Test of Hemiparetic Upper Extremity?
What is a characteristic of Level 5 in the Functional Test of Hemiparetic Upper Extremity?
Which tasks are associated with Level 6 of the Functional Test of Hemiparetic Upper Extremity?
Which tasks are associated with Level 6 of the Functional Test of Hemiparetic Upper Extremity?
What is a key distinction of Level 6 compared to Level 5 in terms of motion?
What is a key distinction of Level 6 compared to Level 5 in terms of motion?
At Level 5, which ability is indicated alongside the ability to box with blocks?
At Level 5, which ability is indicated alongside the ability to box with blocks?
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Which statement accurately reflects the movement capabilities at Level 5?
Which statement accurately reflects the movement capabilities at Level 5?
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What aspect of stroke rehabilitation does the Bobath Concept primarily focus on?
What aspect of stroke rehabilitation does the Bobath Concept primarily focus on?
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Which of the following is most relevant in the context of poststroke spasticity management?
Which of the following is most relevant in the context of poststroke spasticity management?
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According to common background concepts in stroke rehabilitation, what is considered a primary focus?
According to common background concepts in stroke rehabilitation, what is considered a primary focus?
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What term is used to describe the adjustment of treatment strategies based on individual patient needs in stroke rehabilitation?
What term is used to describe the adjustment of treatment strategies based on individual patient needs in stroke rehabilitation?
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Which therapy focuses on the translation of research into practical applications within motor control?
Which therapy focuses on the translation of research into practical applications within motor control?
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What condition results from decreased voluntary motor unit recruitment after a stroke?
What condition results from decreased voluntary motor unit recruitment after a stroke?
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Which medication is NOT typically used for post-stroke spasticity?
Which medication is NOT typically used for post-stroke spasticity?
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What can profound hemiparesis lead to that severely impairs mobility?
What can profound hemiparesis lead to that severely impairs mobility?
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What is a common consequence of weight-bearing asymmetry in patients with hemiparesis?
What is a common consequence of weight-bearing asymmetry in patients with hemiparesis?
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Which term describes the coordinated muscle movements resulting in smooth actions?
Which term describes the coordinated muscle movements resulting in smooth actions?
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Which muscle pattern may inhibit movements and daily activities like self-care in post-stroke patients?
Which muscle pattern may inhibit movements and daily activities like self-care in post-stroke patients?
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What primary activity is affected by hemiparesis due to the inability to recruit motor units?
What primary activity is affected by hemiparesis due to the inability to recruit motor units?
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What type of exercises are utilized to mitigate secondary musculoskeletal impairments from decreased joint range of motion?
What type of exercises are utilized to mitigate secondary musculoskeletal impairments from decreased joint range of motion?
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What is the primary goal of extended arm weight bearing with upper-trunk-initiated movement?
What is the primary goal of extended arm weight bearing with upper-trunk-initiated movement?
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Which position is recommended for the hemiplegic upper limb during daily activities?
Which position is recommended for the hemiplegic upper limb during daily activities?
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Which technique involves helping the affected hand move the skateboard?
Which technique involves helping the affected hand move the skateboard?
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What does 'Body on Arm' movement primarily reinforce?
What does 'Body on Arm' movement primarily reinforce?
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What is a key objective of Level II remedial activities?
What is a key objective of Level II remedial activities?
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In what scenario should the OB help arm be utilized?
In what scenario should the OB help arm be utilized?
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What does bilateral cleansing of the table require?
What does bilateral cleansing of the table require?
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Which of the following movements should be prevented during upper-trunk-initiated activities?
Which of the following movements should be prevented during upper-trunk-initiated activities?
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What is the primary cause of death from stroke in Hong Kong as of 2022?
What is the primary cause of death from stroke in Hong Kong as of 2022?
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How often does someone die from a stroke worldwide?
How often does someone die from a stroke worldwide?
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What was the crude death rate for stroke per 100,000 population in Hong Kong in 2022?
What was the crude death rate for stroke per 100,000 population in Hong Kong in 2022?
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What is the mortality rate in the first year after experiencing a stroke?
What is the mortality rate in the first year after experiencing a stroke?
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Which of the following is an immediate treatment for an ischemic stroke?
Which of the following is an immediate treatment for an ischemic stroke?
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In stroke assessment, which symptom indicates potential midbrain function loss?
In stroke assessment, which symptom indicates potential midbrain function loss?
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What is the main factor considered when determining the need for an open skull operation during a stroke?
What is the main factor considered when determining the need for an open skull operation during a stroke?
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What is the leading cause of disability related to stroke in Hong Kong?
What is the leading cause of disability related to stroke in Hong Kong?
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Study Notes
Stroke in Hong Kong
- In 2022, Stroke was the 5th leading cause of death and the 1st leading cause of disability in Hong Kong.
- In 2022, there were approximately 25,000 stroke admissions in Hong Kong.
- The age-specific mortality rate is 4230 per 100,000 population for patients aged 65.
Stroke Statistics 2020
- On average, someone dies from a stroke every 6 seconds globally.
- The mortality rate in the first year after stroke is 20-25%.
- Stroke is the 4th leading cause of death in Hong Kong
- Stroke kills around 3,000 people annually in Hong Kong.
Stroke Care and Treatment
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Immediate Treatment:
- tPA (Tissue plasminogen activator)
- Operation: 導管吸⾛ leision (for ischemic cases by increasing blood flow and reducing lesion size)
- Open Skull Surgery
- When to perform: Pupillary dilation, midbrain dysfunction, and time constraint (<3-4 hours).
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Post-stroke Spasticity
- Medications: baclofen, tizanidine, dantrolene, and benzodiazepines are routinely used.
Stroke Motor Impairment
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Hemiparesis and Hemiplegia: This refers to decreased voluntary motor unit recruitment, which results in difficulty generating movement or torque. This arises from damage to the motor control areas of the nervous system and brain.
- Impact: Weaknesses can range from complete loss of motor activity (Paralysis) to partial loss (Paresis).
- Consequences: Decreased active and passive range of motion, joint contractures, impaired mobility, pressure ulcers.
- Impact on Activities of Daily Living: Weight-bearing asymmetry, postural sway, and balance issues.
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Synergy Movement: Represents multiple muscle contractions that trigger at once. This can occur with Flexion synergy, which is a sign of recovery but can inhibit movement and activities such as reaching and self-care.
- Examples: During shoulder movement, the elbow and wrist might contract simultaneously.
Rehabilitation of the Upper Limb
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Functional Test of Hemiparetic Upper Extremity (FTHUE)
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Level 5:
- Motion: Beginning ability to combine components of strong mass flexion and strong mass extension patterns; greater than 5 pounds of grasp; greater than 3 pounds of lateral pinch.
- Tasks: Eat with a spoon, Box and Blocks
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Level 6:
- Motion: Isolated control in the shoulder, elbow, and wrist against gravity; Full extension of the shoulder, elbow, wrist, and fingers; Greater than 5 pounds of grasp; Greater than 3 pounds of lateral pinch; Controlled and coordinated movements may be poor and sluggish.
- Tasks: Box on Shelf, Drink from Glass.
- **Hand onto lap when sitting, Bilateral cleansing of table, Position hemiplegic upper limb with extended arm bearing if possible beside hip during daily activities (Level 6), Incorporate weight shifting with weight bear on extended arm (Level 6), Skateboard, Flat sanding, Stacking cones (Level II).
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Extended arm weight bearing with upper-trunk-initiated movement:
- Position: Extended arm in shoulder extension and external rotation.
- Movement: Anterior and Lateral weight shift.
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Level 5:
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Level III treatment activities:
- Training Activities: Weight bear on extended arm and incorporate remedial activities.
- Functional Activities: Clearance of the arm for dressing.
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Remedial Activities:
- Use OB help arm for forearm support.
- Perform sanding on the table with shoulder and elbow flexion/extension.
- Under the assistance of the affected hand, move the skateboard with horizontal shoulder abduction and adduction; as well as elbow flexion and extension.
- Reinforce "Body on Arm" movement with weight bearing on the extended arm with shoulder in slight extended and externally rotated position.
- Re-educate movement components: Reciprocal movements at a single segment including grasp and release action.
- Prevent the development of undesirable compensatory movement.
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Description
This quiz covers critical information about stroke statistics, causes, and treatments specific to Hong Kong. Learn about the impact of stroke on mortality and disability, as well as immediate care options available. Test your knowledge on stroke management and prevention strategies.
