Exam #2: Brunstrom

Question 1

Brunstrom

Answer 1

• one of the traditional neurophysiological approaches

- focus is on REFLEXES (primitive)

Question 2

Associated reactions

Answer 2

-mirror movements on weak side as patient moves on strong side (look to see if hemiplegic arm moves in the same way)

Question 3

Synergy patterns

Answer 3

• associated reactions that occur reflexively, or when voluntary motion is attempted, in the presence of spasticity
• movement at one joint leads to automatic movement at other joints

Question 4

UE Flexion synergy

Answer 4

• scapula = elevation and retraction
• shoulder = external rotation and aBduction
• elbow = flexion (*strongest part)
• forearm = supination
• wrist and digit = flexed

Question 5

UE Extension synergy

Answer 5

• scapula = protracted
• humerus = internal rotation and horizontal adduction
• elbow = extension
• forearm = pronated
• wrist = neutral
• fingers= flexed

Question 6

UE Flexion synergy pattern is _____

Answer 6

• more prominent

- tends to be stronger

Question 7

When two synergy patterns occur together the posture is a ______

Answer 7

-typical CVA UE posture

Question 8

Combo of postures

Answer 8

• scapula = retraction
• shoulder = adduction (down by side)
• elbow = flexion
• humerus = internal rotation and pronation
• wrist and digit = flexion

*They try to do one movement and the rest comes along with it

Question 9

LE Flexion synergy

Answer 9

• hip = flexion*, aBduction, external rotation
• knee = flexion
• ankle = inversion, dorsiflexion
• toe = dorsiflexion

Question 10

LE Extension synergy

Answer 10

• hip = extension, adduction*, internal rotation
• knee = extension*
• ankle = plantar flexion* and inversion
• toes = plantar flexion

Question 11

In standing posture ______ is most prominent

Answer 11

• LE Extension synergy

- ambulation implications

Question 12

Brunstrom levels of recovery: I

Answer 12

-flaccid

Question 13

Brunstrom levels of recovery: II

Answer 13

• spasticity develops; synergies elicited reflexively

- can kick in extension/flexion synergy patterns

Question 14

Brunstrom levels of recovery: III

Answer 14

• volitional motion occurs; synergies occur with this movement
• some active muscle control, synergy kicks in

Question 15

Brunstrom levels of recovery: IV

Answer 15

• volitional motion out of synergy patterns possible

- able to move intentionally not in a synergy pattern

Question 16

Brunstrom levels of recovery: V

Answer 16

• further volitional motion independent of synergy

- synergy pattern starts to go away

Question 17

Brunstrom levels of recovery: VI

Answer 17

-isolated individuals joint AROM with coordination

Question 18

Brumstrom levels of recovery: VII

Answer 18

-normal speed and coordination of motor function

Question 19

Hand levels of recovery: I

Answer 19

-flaccid

Question 20

Hand levels of recovery: II

Answer 20

-minimal active finger flexion (or tone without AROM)

Question 21

Hand levels of recovery: III

Answer 21

-mass grasp/hook grasp (intrinsic minus); no extension

Question 22

Hand levels of recovery: IV

Answer 22

-lateral key pinch possible with active thumb extension; some active digit extension

Question 23

Hand levels of recovery: V

Answer 23

-palmer prehension (tip, three point pinch)

Question 24

Hand levels of recovery: VI

Answer 24

-skilled, coordinated digit flexion, extension, aBduction