ASC Stroke Rehabilitation & Recovery 2 — Questions and Answers
Question 1: Which standardized tool is most commonly used to assess functional independence in stroke rehabilitation?
- Barthel Index (Correct answer)
- Glasgow Coma Scale
- NIH Stroke Scale
- Rankin Scale
Correct answer: Barthel Index
The Barthel Index measures functional independence in activities of daily living and is widely used in stroke rehabilitation settings.
Question 2: A stroke survivor has left-sided hemispatial neglect. Which rehabilitation strategy is most evidence-based for this condition?
- Prism adaptation therapy (Correct answer)
- Constraint-induced movement therapy
- Mirror therapy
- Neuromuscular electrical stimulation
Correct answer: Prism adaptation therapy
Prism adaptation therapy uses wedge prisms to shift visual field and has strong evidence for improving hemispatial neglect.
Question 3: Post-stroke spasticity is best characterized as:
- Velocity-dependent increase in tonic stretch reflexes (Correct answer)
- Flaccid paralysis with loss of reflexes
- Ataxia with loss of coordination
- Rigidity with cogwheel resistance
Correct answer: Velocity-dependent increase in tonic stretch reflexes
Spasticity is defined as a velocity-dependent increase in tonic stretch reflexes resulting from upper motor neuron lesions.
Question 4: Which of the following is the FIRST-LINE pharmacological treatment for post-stroke spasticity?
- Baclofen (Correct answer)
- Diazepam
- Dantrolene
- Tizanidine
Correct answer: Baclofen
Baclofen is the preferred first-line oral agent for post-stroke spasticity due to its GABA-B agonist mechanism and favorable profile.
Question 5: In the Brunnstrom stages of motor recovery, Stage 3 is characterized by:
- Spasticity peaks and synergy patterns are at maximum (Correct answer)
- Flaccidity with no voluntary movement
- Some voluntary movement out of synergy
- Near-normal movement with minimal synergy
Correct answer: Spasticity peaks and synergy patterns are at maximum
Brunnstrom Stage 3 is marked by peak spasticity with voluntary control only within limb synergy patterns.
Question 6: A 68-year-old post-stroke patient develops central post-stroke pain. Which medication class has the best evidence for this condition?
- Tricyclic antidepressants (e.g., amitriptyline) (Correct answer)
- NSAIDs
- Opioids
- Calcium channel blockers
Correct answer: Tricyclic antidepressants (e.g., amitriptyline)
Tricyclic antidepressants, particularly amitriptyline, have the strongest evidence for treating central post-stroke pain.
Question 7: What is the recommended minimum intensity of rehabilitation therapy for stroke survivors in the acute inpatient setting per AHA/ASA guidelines?
- At least 3 hours of active therapy per day (Correct answer)
- At least 1 hour of active therapy per day
- At least 6 hours of active therapy per day
- Therapy on an as-tolerated basis with no minimum
Correct answer: At least 3 hours of active therapy per day
AHA/ASA guidelines recommend at least 3 hours of combined occupational, physical, and speech therapy per day in the acute inpatient rehabilitation setting.
ASC Stroke Rehabilitation & Recovery 2
Which standardized tool is most commonly used to assess functional independence in stroke rehabilitation?