Midterm Flashcards
Brunnstrom stage 1
No voluntary movement
Flaccid UE & LE & hand
Brunnstrom stage 2
Beginning movement in synergy
UE: Resist opp side flex/ext (same side response)
LE: resist opp side ext/flex (opp side response)
Brunnstrom stage 3
Movement in synergy
UE: reach down from behind ear to opp knee (shoulder add, IR, elbow ext, pronation)
Scratch behind ear (shoulder abd, elbow flex, ER, supination)
LE: hip abd & flex, knee and ankle flexion in supine
Push down, back and in (sidelying)
Hand: fisted
Brunnstrom stage 4
Movement deviating from synergy
UE:
Pronation/supination w/ elbows at 90*
Shoulder flexion to 90*
Reach behind back to sacrum
LE:
Hip flexion beyond 90*
Flex knee in sitting beyond 90*, heel on ground
Dorsiflex ankle, heel on ground
Hand:
Lateral prehension
Partial finger extension
Brunnstrom stage 5
Movement independent of synergy
UE:
Arm overhead 180*
Abduct shoulder to 90*
Pronation/supination, elbows ext
LE:
Flex knee in standing to 90*
Dorsiflex ankle in standing (hip and knee extended)
Hand:
Palmar prehension
Cylindrical prehension
Spherical
Brunnstrom stage 6
Normal
MMT, speed tests, coordination tests (finger to nose, heel to shin, rapid opposition)
Executive-motor dysfunction basic test
Organize pieces, problem solve where they go
Perception/ Hemi-neglect
Pt only attentive to half the picture, only draw half the clock
Attention deficits
Cannot focus on instructions
Ideational apraxia
Difficulty with multilevel/multi-step tasks - unsure of sequence
Ideomotor apraxia
Difficulty with single-step tasks, can conceptualize task, but cannot execute motor pattern or mirror someone effectively - often phrasing is important to communicate with such a pt (ex. “Your hair is a mess” instead of “comb your hair”)
Pusher syndrome treatment (4)
Mirror
Surface/reaching
Poles
Full side-to-side arch in sitting
Ideomotor treatment progression
Complex to simple - breaking down task overtime
Part practice w/ functional/task oriented stim
- take away task oriented stim
- work on concept and sequencing
Ideational treatment progression
Simple to complex - building the task overtime
Demo - part practice
Understanding is lacking -> REPS, REPS, REPS
Brain area typically damaged in Ideomotor apraxia
Left parietal lobe
Brain area typically damaged in IDEAtional apraxia
Left parietal AND frontal lobes
Spatial neglect (3)
Poor working memory AND awareness of sensory info on one side
Lack of orientation on one side
Berg discharge score out of 56
41/56
TUG score for discharge
<12 s
