Stroke Continuing Education

Course Objectives

Upon successful completion of this course the participant will be able to:

• Identify the key areas that need to be tested to establish a baseline of measures.
• Identify red flags and priorities for Stroke treatment.
• Identify the appropriate cognitive and functional evidence-based assessment tools to utilize when establishing baselines and progressions of care to reach targeted goals.
• Discuss the benefits to utilizing progressive developmental sequencing to optimize coordinated functional movement.
• Utilize evidence-based tools to evaluate deficits in mobility and/or stability in the complex geriatric patient.
• Develop strategies for reducing re-hospitalization rates.
• Prioritize impairments when developing comprehensive treatment programs for the geriatric patients with neurological and/or orthopedic problems.
• Analyze abnormalities in the components involved with functional movements and prioritize a treatment approach to improve an individual’s functional patterns of movement.
• Perform PNF techniques to improve functional mobility.
• Describe the initiation of movement (stability to mobility and coordination) when utilizing developments sequencing to enhance functional motion.
• Identify techniques to incorporate into the program for fall intervention and prevention.
• Incorporate specific exercises with and without equipment into a comprehensive program to improve functional mobility.
• Discuss how to develop a comprehensive rehab program for a variety of diagnoses in the home care environment.

Learn From the Expert - Suzanne White, PT

Suzanne White, PT, has over 30 years of experience as a physical therapist. She graduated from California State University Northridge. Her credentials include extensive experience in acute rehabilitation, inpatient rehabilitation, outpatient orthopedics, outpatient Neurorehabilitation and home health PT. She has been internationally recognized as a PNF advanced instructor. Suzanne has taught short term and long term courses in the United States as well as internationally in South Korea and Germany. Suzanne was on staff at Kaiser Foundation Rehabilitation Hospital from 1987-2000, where she was an advanced international instructor in the PNF residency program. She has completed numerous long-term manual therapy courses including the Folsom yearlong manual therapy course utilizing Maitland and Kaltenborn approach. She has been working in her own private Home Health practice for over 16 years.  Working primarily with the complex geriatric patient, getting them back to living a more functional life and integrating the patient’s hobbies into her treatment plan.

Establish a Baseline

• Systematically review of all of your Geriatric Patients systems
  • How is their cardiovascular system?
  • Do they have congestive heart failure?
  • Do they have chronic obstructive pulmonary disease?
  • Are they on blood thinners?
  • Are they on beta blockers?
  • Skin integrity
  • Metabolic-Diabetic?
  • Dehydration/malnutrition
  • Eye/ear checks?
  • Psychiatric Medication usage
  • Bowel and bladder
  • Urgent bladder
  • Neurological issues
  • Chemotherapy
• How fast did they move/walk prior to needing to see a therapist
• Know your patient’s strengths along with their limitations

Functional Objective Measurement and Assessment

• Timed Get up and Go
• Activities-Specific Balance Confidence Scale-ABC
• Test of Reaction Time
• Functional Mobility Test
• five time sit to stand
• Cognitive Screening Tool
• Balance and falls

Building a Treatment Philosophy

• PNF Proprioception Neuromuscular Facilitation:
  • Dr. Kabat and Maggie Knott PT and the basic philosophy of treatment
  • Learn to treat the patient as a whole mind, body, spirit and emotion
  • Reinforcing what the patient can do well
  • People did not move in straight planes
• Treatments are functional
• Using the developmental sequence
• Creating stability, mobility & coordination.
• Usimg Repetition to promote, retain motor learning, to develop strength and endurance.

Case Study Post CVA-Ambulatory

Patient with a diagnosis of CVA

• Patients physical presentation
• Patients physical presentation and balance deficits
• Discussion of functional measurement tools
• Precautions for this type of patient
• Learn to create priorities of treatment
• Treatment for back pain
• The treatment approach for the patients back pain
• Treatment for balance dysfunction

• Treatment exercises
  • Quadruped for muscle elongation and back pain
  • Address frozen shoulder
  • Treatment in prone
  • High level training
• Review of treatment and progression into a home exercise program
• Building the best treatment program for CVA
• Discharge evaluation and plan

Case Study The Post CVA-Non-Ambulatory

• Learn to evaluate patient history and level of function
• Functional objective measurement tests
• Precautions and treatment priorities
• Determining baseline measures
• Treatment Techniques to initiate rolling:
  • Sidelying, PNF pelvic patterns, dynamic reversals
  • Sidelying, PNF pelvic patterns, anterior elevation and posterior depression
  • Sidelying, PNF pelvic patterns posterior depression of the pelvis
  • From supine: PNF patterns-flexion
  • From supine and back: PNF patterns-extension
  • From supine and back: PNF patterns-approximation
• Treatment to initiate coming up on the elbow
  • From side-lying: irradiation
  • From side-lying:manual cues
  • To hand from side-lying:functional movements, mobility exercises
• Learn treatments to initiate coming from side-lying to sitting
• Treatments to initiate coming from side-lying to sitting
• Enhance sitting stability
• Understand vitals relative to patients position
• Techniques to move patient from sit to stand
• Review protocol for an eight week period

Exercises to Progress Functional Movement

• Develop a comprehensive floor exercise program
  • In supine with therapy ball
  • In supine with resistive band and prone on elbows
  • In quadruped over ball
  • To improve shoulder range of motion
  • To progress from quadruped to kneeling and activities in kneeling
  • Exercises in half kneeling
• Seated Exercises with resistance band and physioball
• Standing exercises working on balance activities

Course Test - Evaluate your knowledge

• Use the Healthclick proprietary online education system which provides the online student with:
• Worldwide access to high definition video, anatomical animations and images, and written information
• The highest quality film in the industry, you can see the difference!
• Stop and resume within a course, the Healthclick system will optimize your course based on your device, connection and remembers where you left off.
• Real-time course updates. We are always adding to each courses, updating content, adding animations, these are not static courses!
• Evaluate your knowledge with the course test on any device.
• Print your state course certificate for CE credit.
• Take the online test as many times as need in order to achieve a 70 % or greater score.