Exam 3- stroke part 2 Flashcards
After a stroke, pt revert a
synergistic pattern
synergistic pattern (details)
~Good bc there is a contraction (not flaccid)
~does not mean that they are very functional
~Important bc if there is a synergy be there is some form of a contraction (not flaccid)
~They can appear fast; can use it if you know it is there/ avoid it
UE flexor synergy
~Scapular/ retraction/ elevation or hyperextension ~Shoulder abduction, ER ~Elbow flexion ~Forearm supination ~Wrist and finger flexion
UE extensor synergy
~Scapular protraction ~Shoulder adduction, IR ~Elbow extension ~Forearm pronation ~Wrist and finger flexion
LE flexor synergy
~Hip flexion, abduction, ER
~Knee flexion
~Ankle DF, inversion
~Toe DF
LE extensor synergy
~Hip extension, adduction, IR
~Knee extension
~Ankle PF, inversion
~Toe PF
Combined for UE
~Shoulder IR/adduction
~Elbow flexion
~pronation
weight bearing for LE
~knee extension
~hip adduction
~inversion
synergistic pattern- UE
~Flexion is the stronger
~test extension first
synergistic pattern- LE
~extension is stronger
~Flexor not seen that often- test this first
~triggered by weight bearing
Can classify the level of motor ability post stroke on the ____ scale
Bronnstrom Scale
Bronnstrom Scale- lvl 1
~1 is your lowest ~no movement of the limbs ~flaccid ~no associated reactions ~"Recovery from hemiplegia occurs in a stereotyped sequence of events that begins with a period of flaccidity immediately following the acute episode. No movement of the limbs can be elicited"
Bronnstrom Scale- lvl 2
~minimal voluntary movements, small synergistic movement can be made
~not all components are there
~spasticity can begin to develop
~associated reaction can be invoked
~”As recovery begin, the basic limb synergies or some of their components may appear as associated reactions, or minimal voluntary movement responses may be present. At this time, spasticity begins to develop”
Bronnstrom Scale- lvl 3
~voluntary movement of the synergistic movement- we don’t have to do anything to cox the movement
~full extent of spasticity
~”The pt gains voluntary control of the movement synergies, although full range of all synergy components does not necessarily develop. Spasticity has further increased and may become severe”
Bronnstrom Scale- lvl 4
~combinations that do not follow the path of either synergy pattern
~can do either ext or flexor contraction or a movement that is a combination of both
~can begin to do the other movement (if you can do flex, can begin to do ext)
~”Some movements combinations that do not follow the paths of either synergy are mastered, first with difficulty, then with more ease, and spasticity begins to decline”
Bronnstrom Scale- lvl 5
~can move even more out of the synergistic pattern
~”If progress continues, more difficult movement combinations are learned s the basic limb synergies lose their dominance over motor acts.”
Bronnstrom Scale- lvl 6
~can do complex tasks outside of the synergistic patterns
~”With the disappearance of spasticity, individual jt movements become possible and coordination approaches normal. From here on, as the last recovery step, normal motor function is restored, but this last stage is not achieved by all, for the recovery process can plateau at any stage.”
Bronnstrom Scale- lvl 7***
~some books have this- completely normal
