4.16 Post-Stroke 2 Flashcards
What is the Brunnstrom scale for?
stage someone’s recovery after a stroke
How many stages in the Brunnstrom scale?
6
Brunnstrom stage 1
- completely flaccid
- no movement of the limb can be elicited
If flaccidity is caused by a neuro injury, what is the implication?
- cannot strengthen
- must have SOME motor response to strengthen
If we can even elicit SOME motor, what is happening?
the brain is sending some kind of signal to the muscle
Brunnstrom stage 2
- some basic limb synergies or some of their components may appear as associated reactions
- the smallest amount of movement, trace muscle contraction
What are associated rxns?
UE and LE reactions are yoked
Brunnstrom stage 3
- patient has some voluntary control to create a movement
- don’t have full innervation of the synergy
- stronger spasticity
Brunnstrom stage 3: If we ask them to flex their elbow, what will they do?
they’ll start pulling up into the synergistic pattern
Brunnstrom stage 4
- patient can now do some movements that don’t follow the synergistic pattern
- starting to gain voluntary functional control
Brunnstrom stage 5
- more difficult movement patterns (brush teeth, feedings, etc.)
- multiple movements that are no longer controlled by synergy
Brunnstrom stage 6
more coordinated, movement appears to be almost normal
Brunnstrom stage 6: “normal:
- some people, you’d never know they had a stroke
- some people say that if you stress them enough, they may have some issues come back up
Why is the Brunnstrom scale important for us?
- allows us to scale, helps us give a prognosis, could potentially use for goals
- use the body’s actions after a stroke to their advantage
- The sooner we see progress, typically will have a better recovery
How would we use the body’s normal actions after stroke to their advantage for recovery?
strengthen the synergy » hopefully progress them to the next stage
What is the school of thought that says you shouldn’t encourage any abn movements?
NDT
Which synergy must be tested first?
weaker
Why must the weaker synergy be tested first?
if you test the stronger one, it will override the weaker
synergies: what do the fingers do?
go into flexion (fingernails can grow into the hand)
How do pts go through the Brunnstrom stages?
progress through each one, even though you may not see it
