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.

Test Yourself - Sample Exam Questions

1. During a dual-task intervention, a patient post-stroke is instructed to paint a picture of a house. The patient draws the right side of the house, but not the left side. Which lobe of the brain is most likely affected by the stroke?

a. Right Parietal Lobe
b. Left Parietal Lobe
c. Right Frontal Lobe
d. Left Frontal Lobe

Rationale: Spatial neglect is primarily a disorder of attention where the individual fails to report/respond to stimuli on the contralesional side (1). Neglect is often associated with right hemisphere damage. This individual in this question only draws the right side of the house which further indicates probable right sided hemisphere damage. The right posterior parietal cortex with involvement of the inferior parietal lobe or temporoparietal junction are commonly involved with neglect. (2) The less commonly involved are the superior temporal cortex and frontal lobe. Li K, Malhotra PA. Spatial neglect. Pract Neurol. 2015;15:333-339. / Sarwar A, Emmady PD. Spatial Neglect. StatPearls. 2023. available from: https://www.ncbi.nlm.nih.gov/books/NBK562184/

 2. 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

Rationale: 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. Therefore 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.

3. 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 therapies
c. Provide reminders to look to the right
d. Provide reminders to look to the left

Answer C is the correct answer! Click here for a detailed explanation!

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 10, Part 2: Dr. Bosch & Dr. Kahl - Neurotherapeutic Practice Settings with Clinicians

• Dr. Bosch and Dr. Kahl interviewed clinicians on the most rewarding aspects, most challenging aspects, and general neuro delivery models in the clinic

 Episode 10, Part 1: Dr. Bosch and Dr. Kahl - Neurotherapeutic Practice Settings with Clinicians

• Dr. Bosch and Dr. Kahl interviewed physical therapists on a typical day, typical patient setting, and best preparation they received as a student

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

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 8: Rachelle Studer-Byrnes and Dr. Lynn Johnson: Spasticity during gait

• Rachelle Studer-Byrnes and Dr. Lynn Johnson discuss concepts of spasticity during gait

• Dr. Romney and Ms. Hemmer discuss the evidence-based motivational and attentional factors involved in motor learning using OPTIMAL Theory

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. 

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 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 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 3: Dr. Heather Hayes and DPT Student Jacob Striejewske - Examination Post Stroke - Outcomes Assessment

• Dr. Hayes and Mr. Striejewske continue the discussion about the patient in episode 1.  This discussion focuses on the assessment of outcomes.

• For additional content related to the all the discussion above please visit the  Clinical Practice Guidelines: Core Outcome Measures for Adults with Neurologic Conditions 

Episode 2: Dr. Heather Hayes and DPT Student, Jacob Striejewske - Examination Post Stroke Impairments

• Dr. Hayes and Mr. Striejewske continue the discussion about the patient in episode 1.  This discussion focuses on the assessment of impairments. 

Episode 1: Dr. Heather Hayes and DPT Student, Lynn Johnson - Gait Impairments Post Stroke 

• Dr. Hayes and Ms. Johnson discuss the gait impairments of a woman post-stroke.  Using the Ranchos Los Amigos Gait Analysis format, impairments are identified and a treatment plan is formed. 

  

Expert Responses to Your Questions  

Episode 1: Dr. Heather Hayes - Falls and Fatigue

• Dr. Hayes discusses the fear of falling and post-stroke fatigue  

Episode 2: Dr. Marissa Moran - Outcome Measures 

•  Dr. Moran discusses diagnoses and tests she 'wished she knew' more in her early practice

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 

ASK MORE 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.