Stroke SIG Student Corner
We look forward to sharing content with you and working with you during your student career. Please review the objectives of the group below, as well as watching this short video regarding our group's purpose.
The objectives of this group are the following:
- Provide resources and materials about rehabilitation management of individuals post-stroke for student learners.
- Provide a platform for student learners to develop clinical skills related to rehabilitation management of individuals post-stroke.
- Provide a platform for student learners to ask questions and seek feedback about rehabilitation management of individuals post-stroke.
How To Engage
Please use the online form below to send questions you would like answered to the Stroke SIG. The goal of this platform is to provide a resource for students to ask questions they may have about Stroke Rehabilitation. Questions will be screened, answered by the Stroke clinical experts via posts to this webpage, and used to guide future postings. We will keep your name anonymous on the webpage posting; however, we request that you complete the following information when submitting the “question(s) of interest”. This is requested in case we need to contact you to clarify a question.
New Exam Question Results and Rationale!
A patient presents with right arm numbness, blurred vision, and speech deficits. Neurological examination findings included mild fluent aphasia with some word substitutions, difficulty seeing fingers on the right side, mild right pronator drift and absent graphesthesia/stereognosis of the right hand. Where is the most likely location of the lesion?
a. Left-sided injury to: postcentral gyrus, primary somatosensory cortex, and parietal cortex
b. Right-sided injury to: frontal lobe, primary somatosensory and primary motor cortex
c. Right-sided injury to: lateral and caudal pons
d. Left-sided injury to: medulla and medial pons
This patient presents with deficits on the right side of the body consistent with a stroke in the left cerebral hemisphere, so we can conclude that the stroke occurred in the left side of the brain. For that reason, answers b. and c. can be eliminated as they indicate a lesion on the right hemisphere. The answer d. is also incorrect, as the medulla regulates heart rate, respiration, vasoconstriction and vasodilation within the autonomic nervous system, and the pons is also involved in regulating respiration, not cortical signs as described in the case.
Answer A is correct! This patient presents with the following:
- Right arm numbness, which would indicate a lesion in the left primary motor area.
- The patient’s speech is reported as fluent, which would also indicate that the left Broca’s area is not affected, but this patient does occasionally have incorrect word substitution, which would be indicative of a lesion to Wernicke’s area in the left posterior superior temporal gyrus (temporoparietal junction).
- The patient exhibits sensory deficits, including visual field deficits of the right visual field, indicating a lesion of the left occipital lobe, right pronator drift indicating a deficit in proprioception on the right side of the body, indicating a lesion of the postcentral gyrus of the parietal lobe, which contains the primary somatosensory cortex, and absent graphesthesia and stereognosis, which are cortical sensory deficits indicative of a lesion of the parietal secondary somatosensory cortex as well.
Reference: Lundy-Ekman, L. Neuroscience: Fundamentals for rehabilitation. 5 th edition. Elsevier; 2018.
Exam question and rationale completed by Stroke SIG Student Resource Co-Directors: Pamela Bosch, PT, DPT, PhD & Dana Kahl, PT, DPT, EdD
Student Educational Resource Videos
EXPERTS GUIDING YOU THROUGH STROKE MANAGEMENT
*The content in the videos is intended for professional educational purposes only.
Thank you to our video editor, Cicely Fabiano!
Episode 1: Dr. Heather Hayes and DPT Student, Lynn Johnson - Gait Impairments Post Stroke
Episode 2: Dr. Heather Hayes and DPT Student, Jacob Striejewske - Examination Post Stroke Impairments
Episode 3: Dr. Heather Hayes and DPT Student Jacob Striejewske - Examination Post Stroke - Outcomes Assessment
Episode 4: Dr. Heather Hayes and DPT student, Kylie Roberts - AFO Clinical Practice Guidelines Post-Stroke
- Dr. Hayes and Ms. Roberts discuss how to use the AFO CPG post-stroke in clinical practice given a patient case study example
Episode 5 - Case 1: Dr. Arco Paul and DPT student Kristen Hammack - High Intensity Gait Training (HIGT)
- Dr. Paul and Ms. Hammack discuss how to use the HIGT CPG post-stroke in clinical practice given a patient case study example
Episode 5 - Case 2: Dr. Arco Paul and DPT student Kristen Hammack - High Intensity Gait Training (HIGT)
- Dr. Paul and Ms. Hammack discuss how to use the HIGT CPG post-stroke in clinical practice given a second patient case study example
Episode 6 - Part 1: Dr. Rachelle Studer-Byrnes and Dr. Lynn Johnson - Defining Spasticity and Treatment Concepts for Patients Post-Stroke
- Dr. Studer-Byrnes and Dr. Johnson discuss foundational concepts and clinical features of tone and spasticity.
- Dr. Romney and Ms. Hemmer discuss the evidence-based motivational and attentional factors involved in motor learning using OPTIMAL Theory
Episode 7 Pt 2: Dr. Wendy Romney and DPT student Mary Claire Hemmer: OPTIMAL Theory in Practice
- Dr. Wendy Romney and DPT student Mary Claire Hemmer discuss a case-example of applying OPTIMAL theory in clinical practice for an individual post-stroke
Episode 8: Rachelle Studer-Byrnes and Dr. Lynn Johnson: Spasticity during gait
- Rachelle Studer-Byrnes and Dr. Lynn Johnson discuss concepts of spasticity during gait
Episode 9, Part 1: Dr. Bosch, Dr. Hayes, and Dr. Kahl - Hemiwalkers Acutely Post-Stroke
- Dr. Bosch, Dr. Hayes, and Dr. Kahl discuss the evidence around the use of the hemiwalkers for gait training after stroke
Episode 9, Part 2: Dr. Bosch, Dr. Hayes, and Dr. Kahl - Hemiwalkers Acutely Post-Stroke Case Conclusion
- Dr. Bosch, Dr. Hayes, and Dr. Kahl conclude their case discussion, centering around the use of a hemiwalker for gait training after stroke
EXPERT RESPONSES TO YOUR QUESTIONS
Episode 1: Dr. Heather Hayes - Falls and Fatigue
Episode 2: Dr. Marissa Moran - Outcome Measures
Episode 3: Dr. Rachel Prusynski and Dr. Kiersten McCartney - DPT to PhD
- PhD Candidates Dr. Prusynski and Dr. McCartney discuss their respective paths into PhD programs
Episode 4: Student Corner Question: Aphasia
- Dr. Marissa Moran answers a student question about how best to communicate with patients with aphasia
Episode 5: Rhythmic Auditory Stimulation
- Dr. Heather Hayes answers a student question about the use of rhythmic auditory simulation for individuals post-stroke
Sample Test Questions
1. A patient post-stroke with right hemiparesis demonstrates profound homonymous hemianopsia. Which of the following initial training strategies is BEST to assist in compensating for this deficit?
A. Encourage decreased eye movements
B. Encourage mirror therapy activities
C. Provide guidance and reminders to look toward the right
D. Provide guidance and reminders to look toward the left
Click here for a detailed explanation of the answer!
ASK YOUR QUESTIONS HERE!
This is for informational and educational purposes only. It should not be used as a substitute for clinical decision making. The Academy of Neurologic Physical Therapy and its collaborators disclaim any liability to any party for any loss or damage by errors or omissions in this publication. The views or opinions expressed are those of the individual creators and do not necessarily represent the position of the Academy of Neurologic Physical Therapy.