Brunnstrom

Question 1

What are associated reactions

Answer 1

involuntary movts or reflexive increases in tone

auto responses of affected limb from movt that occurs from movt on unaffected side

Question 2

when are associated reactions mostly present

Answer 2

w/ spasticity

Question 3

when are associated reactions less common

Answer 3

when there is normal mm tone

Question 4

Where do associated reactions produce movt

Answer 4

same direction in UE

opposite direction in LE

Question 5

What are the 2 types of associated reactions

Answer 5

bimanualsynkinesis (mirror movt)

homolateralsynkinesis

Question 6

What is bimanualsynkinesis

Answer 6

brain tells 1 side to do something, other side does it

Question 7

what is homolatersynkinesis

Answer 7

produces movt on the same side

Question 8

What are limb synergies

Answer 8

stereotypical movt patterns

Question 9

what are the 2 types of synergies

Answer 9

flexor

extensor

Question 10

components of flexor synergy

Answer 10

scapular elevation
retraction
shoulder ab and er 
elbow flexion
forearm supination 
wrist and finger flexion

Question 11

What is the strongest component of flexor synergy

Answer 11

elbow flexion

Question 12

components of extensor synergy

Answer 12

scapular protraction
horizontal ad
IR
elbow ext
forearm pronation
wrist and finger flexion

Question 13

what is the strongest component of extensor synergy

Answer 13

adduction and pronation

Question 14

What to assess

Answer 14

synergy
sensory
adls
balance and transfers
vision and cognition

Question 15

How to assess

Answer 15

through ops, formal assessments, Fugl-Meyer

Question 16

What are the stages of recovery

Answer 16

1. Flaccidity
2. Spasticity develops
3. spasticity increases(begin voluntary movt, associated reactions)
4. Decreased spasticity- (some movt occurs)
5. Synergies diminish-(more voluntary movt)
6. isolated movts.- (movt freely occurs, very close to normal movt)

Question 17

What does not follow the brunnstrum stages

Answer 17

hand recovery

Question 18

What is flaccidity

Answer 18

no movt

Question 19

what happens during spasticity

Answer 19

synergys may occurs. flexion b/f extension

Question 20

What are the 3 steps stage 4 (decreased spasticity) is broken into

Answer 20

IR
Arm to forward horizontal
pronation/supination w/ elbow flexed

Question 21

What is the goal of brunnstrom

Answer 21

to progress through all stages

Question 22

What does brunnstrom use

Answer 22

reflexes, associated reactions, cutaneous and prop simulation (focus on stages 1-3)

Question 23

What to develop in brunnstrom

Answer 23

voluntary control

Question 24

Order voluntary control develops

Answer 24

isometric, eccentric, concentric

reverse movts.

Question 25

Interventions to facilitate trunk control

Answer 25

balance response
forward flexion
trunk rotation
(reach for something over counter)

Question 26

Interventions to facilitate upper extremity control

Answer 26

Rowing
weight bear
shoulder elevation (ab,er, supination)

Question 27

Interventions to develop hand function

Answer 27

mass grasp and release (involuntary)
wrist stabilization
voluntary release
active grasp ad release (voluntary) 
e.g. holding papers, book, using key, dressing tasks, dealing cards, holding pencils

Question 28

What are strengths of brunnstrom

Answer 28

research has shown it is just as affective as other approaches

Question 29

what are limitations of this approach

Answer 29

limited research

Question 30

what do most therapists believe

Answer 30

don’t believe that reflexive patterns or associated mov patterns should be facilitated during recovery

Question 31

Assumptions of brunnstrom

Answer 31

• primitive reflexes and movt patterns promote movt.
• prop input and cutaneous stimulation facilitate movt
• once primitive movt. patterns become voluntary, facilitation using reflexes is discouraged
• correct, new movt patterns need to be practiced
• voluntary movt is enhanced by incorporating daily functional tasks