Risk Factors

Nonmodifiable Risk Factors :

Modifiable risk factors :

Age
Race
Sex
Ethnicity
Heredity: Family
history of stroke or
transient ischemic
attacks (TIAs)

Hypertension (the most

important)
Diabetes mellitus
Cardiac disease: congestive
heart failure, coronary artery
disease, valvular heart
disease
Hypercholesterolemia
TIAs
Lifestyle issues: Excessive
alcohol intake, tobacco use,
illicit drug use, physical
inactivity
Obesity
Oral contraceptive
use/postmenopausal hormone
use

Diagnosis
History Taking

Physical Examination

Patient Profile
Chief Complaint
History of the presenting
ilness :

exact nature of the symptom

the onset
how it began ( suddenly,
Gradually)
Previous Occurrences
Provoking factor
Palliative Factor

Past Medical History

Drug history
Smoking
Family History
Social History
Functional history

Vital sign
Sign of trauma
Cardiovascular exam
Skin
Evidence of active bleeding
Level of consciousness (GCS)
Cognition ( Speech,
Comprehension, Naming,
Reading, etc)
Cranial nerve
Motor system ( Inspection,
Strength, Tone, Reflexes,
Coordination
Sensation
Diagnostic Evaluation
CT- Scan, Electrocardiogram,
MRI

Rehabilitation
Goals

Prevent, recognize, and

manage comorbid illnesses.
Prevent, recognize, and
manage complications.
Reduce activity restrictions
(disabilities) that result from
impairments.
Reduce participation
limitations (handicaps) that
limit involvement in life
situations.
Maximize psychosocial
adjustment to disease and
disability for the patient and
the family.
Prevent recurrent stroke.

When
Start rehabilitation in the
acute care hospital after
the patients medical
condition has been
stabilized.
This is often within 24 to
48 hours of the stroke.
Post-acute stroke
rehabilitation is started
when the stroke patient is
medically stable.

How
Basic physical Therapy
Bed positioning, mobility
Antispasticity position,
gradual mobilizaton
Range of motion exercises
(ROM)
Motoric reeducation : PNF
concept, Bobath, Brunstorm,
Rood, Carr & Shepherd, ect
Spasticity inhibition
Sitting/standing balance
control training
Treat dysphagia.
Ambulation Gait
rehabilitation
Prevent and manage
shoulder pain.
Stair climbing
Use of physical modalities
mostly for musculoskeletal
consequences & pain

Occupational Therapy
Focuses on fine motor
development
Developing new
adaptive
technique/devices
Improving
independency of ADL
Training of vocational
skills
Energy expenditures
Sensory reeducation

Speech Therapy
Training of orofacial
motor and stimulation
Concept of language
and vocabularies
Training of phonation
and articulation
Chewing, feeding, and
swallowing training

Orthotic
Shoulder Preventing
shoulder subluxation
Shoulder
sling/Axillary roll
Wrist Extensors
spasticity w/
Functioning fingers
Cock up splint
Legs Flexion
spasticity
HKAFO/KAFO

Prognosis
75% of patients will reach independent
level of self-care or with minimal help
and independent level of ambulation w/
assistive device
Almost all patients will be able to
control bladder and bowel
Only 10-15% of patients fall into severe
disabilities and will be bedriddened