Stroke Training and Awareness Resources (STARs)


Six weeks after

The physio and a nurse working with Dave.

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Dave in the acute stroke unit Dave in the general ward
Seizures: Dave has not had any further seizures. Dave has not had any further seizures. Dave has had his baclofen dose slowly increased to treat his high tone. The medical team are still unaware that this can lower seizure threshold. He’s slowly had the dose of his anti-epileptic medications increased also. He can intermittently be drowsy still during therapy sessions, possibly the result of some of these centrally acting drugs.
Pain: Dave no longer complains of pain and only has paracetamol written up ‘as needed’ though he no longer takes any. Dave still has pain down his affected side. He remains on an atypical analgesic and big doses of stronger standard analgesics. His constipation is a bit better but hasn’t fully resolved.
Tone and rehab: Dave has residual tone issues which are now managable with regular positioning and stretching. He has a comfortable resting wrist-hand orthosis which he wears overnight. During the day he doesn’t wear his hand orthosis, instead he tries to practice the exercises he’s been given. He has a comfortable Ankle Foot Orthosis which keeps his foot supported with his heel in contact with the ground as he walks. Dave is being supported to set goals to aim for and the ward staff record his goal setting plan to show when improvements are being made. Dave’s tone remains high. He is making very slow gains with his rehab. Walking is difficult as he cannot get his foot flat on the floor. He has a new Ankle Foot Orthosis but it is no longer a good fit and causes him pain. It has been sent for adaptations. He finds his arm splint very uncomfortable so rarely has it on. The nurses take care to ensure the palm of his hand is cleaned and dried everyday but this is becoming harder as the hand gets tighter.

Page last reviewed: 06 May 2020