Stroke Impairment & Complications Rehabilitation - #3
Take QuizReview frequent impairment and complications of acute stroke.
Impairments in Stroke:
| Impairment | Acute (%) | Chronic (%) |
|---|---|---|
| Motor weakness | 90 | 50 |
|
45 | 20 |
|
35 | 25 |
|
10 | 5 |
| Sensory deficits | 50 | 25 |
| Dysarthria | 50 | 20 |
| Aphasia | 35 | 20 |
| Cognitive deficits | 35 | 30 |
|
Visuoperceptual deficits |
30 |
30 |
| Depression | 30 | 30 |
|
Bladder incontinence |
30 |
10 |
|
Dysphagia |
30 | 10 |
|
Hemianopsia |
25 |
10 |
Complications in Acute Stroke:
Complication |
Frequency (%) |
|---|---|
Medical |
|
|
Pneumonia, pulmonary aspiration |
40 |
|
Urinary tract infection |
40 |
|
Depression |
30 |
Musculoskeletal pain, RSD, Complex |
|
|
Regional Pain Syndrome |
30 |
|
Falls |
25 |
|
Malnutrition |
16 |
|
Venous thromboembolism |
6 |
|
Pressure ulcer |
3 |
Neurological |
|
|
Spasticity |
232 |
|
Toxic or metabolic encephalopathy |
10 |
|
Stroke progression |
5 |
|
Seizure |
4 |
Recovery: Most motor recovery occurs within the first 3 months, Cognitive function improves mainly in the first 3 months. Language function and visual-spatial function recovers in the first 12 months. Recovery is possible beyond this, and is typically seen in the setting of a motivated patient, focused intervention, and intact support system.3
Functional predictors of outcome: NIHSS (NIH Stroke Scale) at 1 week 4, 1 week post stroke sitting balance, bowel and bladder control, and motor strength.
Negative Predictors of Outcome: Negative predictors include: older age, history of previous stroke, urinary or bowel incontinence, visuospatial deficits, cognitive impairment, speech impairment, depression, coronary artery disease, and absence of a supportive caregiver.
Geriatric Patient Visit.
Implement an effective post-stroke rehabilitation program to reduce morbidity and mortality associated with stroke.
Two thirds of stroke patients are over 65, and stroke is the fourth leading cause of death and the second leading cause of disability in the United States.(1) Eighty percent of stroke patients survive, and there are currently more than six million survivors in the United States, with varying levels of disability.
Science Principles
Define common impairments and complications of stroke.
Identify three functional and/or negative predictors of outcome.
Review of Systems (ROS)
Geriatric Topics
ACGME Compentencies
Science Principles
- Roger VL. Go AS. Lloyd-Jones DM. Benjamin EJ. Berry JD. Borden WB. Bravata DM. Dai S. Ford ES. Fox CS. Fullerton HJ. Gillespie C. Hailpern SM. Heit JA. Howard VJ. Kissela BM. Kittner SJ. Lackland DT. Lichtman JH. Lisabeth LD. Makuc DM. Marcus GM. Marelli A. Matchar DB. Moy CS. Mozaffarian D. Mussolino ME. Nichol G. Paynter NP. Soliman EZ. Sorlie PD. Sotoodehnia N. Turan TN. Virani SS. Wong ND. Woo D. Turner MB. American Heart Association Statistics Committee and Stroke Statistics Subcommittee.(2012) Executive summary: heart disease and stroke statistics--2012 update: a report from the American Heart Association. Circulation. 125(1):188-97.
- McGuire JR. (2011) Stroke. Topics in Stroke Rehabilitation. 18(3).
- Brown AW, Schultz BA. (2010) Recovery and rehabilitation after stroke. Semin Neuro. 30(5): 511-7.
- Johnston SC. (2002) Transient Ischemic Attack. NEJM. v347, 1687-92.
- Jongbloed L.(1986) Prediction of function after stroke: A Critical review. Stroke. 17(4):765-76.
Users are free to download and distribute Geriatric Fast Facts for informational, educational, and research purposes only. Citation: Catherine Tsufis, Steven Denson MD, John McGuire MD, Judith Kosasih MD, Bambi Wessel - Fast Fact #3: Geriatric Stroke Impairment & Complications Rehabilitation. September 2012.
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