Brunnstrom Flashcards
brunnstrom technique is aka
movement therapy
what makes brunsstrom technique different from bobath
use of motor patterns at any point
better to move than none
synergies and reflexes are considered normal parts of recovery
UE flexor synergy
elbow flexion - strongest
shoulder retraction, elevation, ER and abd 90°
forearm supination
UE extensor synergy
forearm pronation, shoulder add and IR - strongest component
elbow extension
LE flexor synergy
hip flexion - strongest
hip ER and abd
ankle DF and inversion
toes DF
LE extensor synergy
knee ext - most common
hip ext, IR and add
ankle PF and inversion
toes PF
what are the tonic neck and labyrinthine reflexes
STNR
ATNR
TLR
tonic neck and labyrinthine reflexes are aka
magnus’s or de kleijin’s reflexes
discuss STNR
neck flexion: UE flexion and LE ext
neck extension: UE extension and LE flexion
discuss TLR
tonic labyrinthine
SEX: supine inc ext tone
prone inc flexor tone
discuss ATNR
bow and arrow head or fencer
turn head: face side UE and LE ext while occ side UE and LE flex
discuss tonic lumbar reflex
trunk rot: face side inc ext tone while occ inc flexor tone
discuss mirror synkinesis
resisted flexion of normal UE = flexion of affected UE
resisted flexion of normal LE = extension of affected LE
discuss homolateral synkinesis
done on affected side
R LE resisted flexion = R UE flexion
discuss raimiste’s phenomenon
Le only
abd phenomenon and adduction phenomenon
like mirror synkenisis
discuss soque’s phenomenon
UE only
passive shoulder flexion = extension of fingers
discuss marie-foix phenomenon
aka betcherev’s reflex
passive PF of toe and ankle: mass flexor response on LE
hip and knee flexion and ankle DF
brunnstrom stages of recovery
stage 1: flaccidity
stage 2: spasticity begins to develop
stage 3: spasticity peaks
stage 4: spasticity begins to decline
stage 5: spasticity continues to decline
stage 6: spasticity disappears
stage 1: flaccidity
no movement either reflex or voluntary
no activation
stage 2: spasticity begins to develop
basic limb synergies or some of their components
minimal voluntary movement
stage 3: spasticity peaks
semi voluntary
able to initiate but unable to control
naka synergies na
stage 4: spasticity begins to decline
some normal movements that do not follow the synergies are mastered
mga easy muna
stage 5: spasticity continues to decline
more difficult normal movements are mastered
synergies lose their dominance
stage 6: spasticity disappears
normal and coordinated na lahat
stage 1 shoulder and elbow
flaccid
stage 2 shoulder and elbow
basic limb synergies start
elbow flexion spasticity
stage 3 shoulder and elbow
sure limb synergies
obvious elbow flexion synergy
stage 4 shoulder and elbow
hand behind shoulder
shoulder flexion to 90°
able to pronate supinate FA c elbow at 90° flexion at side
open doors
stage 5 shoulder and elbow
arm abd, forward and overhead
pronate supinate c ext elbow
for reaching overhead
stage 6 shoulder and elbow
normal na
stage 1 hand
flaccidity
stage 2 hand
little or no active finger flexion
stage 3 hand
mass and hook grasp d/t spasticity
reflex finger ext via soque’s
stage 4 hand
lateral prehension
release via thumb movement
semi voluntary small range finger ext
stage 5 hand
palmar prehension of thumb
cylindrical and spherical grip
voluntary mass extension of digits
stage 6 hand
all are normal
stage 1 trunk and lower limb
flaccid
stage 2 trunk and lower limb
minimal voluntary movements
stage 3 trunk and lower limb
hip-ankle-knee flexion in sittng
stage 4 trunk and lower limb
knee flex > 90° and voluntary ankle DF
foot sliding on floor while sitting
stage 5 trunk and lower limb
swing and initial contact
stage 6 trunk and lower limb
all normal
hip abd, ER and IR
ankle inv and eversion
