NCS Stroke Rehabilitation 4

Question 1

A patient 6 weeks post-stroke develops shoulder-hand syndrome (complex regional pain syndrome type 1). Which treatment is MOST evidence-based?

Accepted Answer

Oral corticosteroids combined with active-assisted exercise

Answer

Aggressive passive range of motion twice daily

Answer

Shoulder sling immobilization

Answer

High-frequency ultrasound to the shoulder joint

Question 2

Spasticity post-stroke is BEST defined as:

Accepted Answer

Velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks

Answer

Involuntary, velocity-independent increase in muscle tone

Answer

Sustained tonic contraction causing joint contracture

Answer

Co-contraction of agonist and antagonist muscles during voluntary movement

Question 3

A therapist is positioning a patient with severe flaccid hemiplegia to prevent glenohumeral subluxation. The MOST important positioning strategy is:

Accepted Answer

Supporting the humerus to maintain proper fossa alignment

Answer

Elevated arm board with shoulder at 90° abduction

Answer

Elbow splint in 90° flexion

Answer

Wrist cock-up splint to prevent contracture

Question 4

Post-stroke dysphagia is MOST commonly associated with damage to which neural structures?

Accepted Answer

Bilateral cortical lesions or unilateral brainstem lesion

Answer

Unilateral parietal lobe only

Answer

Cerebellar peduncles

Answer

Anterior cingulate cortex

Question 5

Which fall risk factor is MOST specific to the post-stroke population compared to the general older adult population?

Accepted Answer

Unilateral spatial neglect

Answer

Polypharmacy

Answer

Orthostatic hypotension

Answer

Urinary incontinence

Question 6

A patient demonstrates increased spasticity and decreased function in their affected lower extremity. Botulinum toxin injection is most appropriately targeted to which muscle group to improve gait?

Accepted Answer

Gastrocnemius-soleus complex

Answer

Tibialis anterior

Answer

Quadriceps femoris

Answer

Iliopsoas

Question 7

Central post-stroke pain (CPSP) is characterized by which feature that distinguishes it from musculoskeletal pain?

Accepted Answer

Allodynia and dysesthesia in the distribution of the stroke-affected body region

Answer

Pain localized to the shoulder joint and reproduced by palpation

Answer

Pain relieved by NSAIDs and rest

Answer

Pain onset during the acute phase only