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neuro4 Brunnstrom

Movement therapy in hemiplegia: developed by Signe Brunnstrom, is based on the hierarchical model by Hughlings Jackson.
Brunnstroms approach created and defined the term synergy and initially encouraged the use of synergy patterns during rehabilitation.
Brunnstroms belief was to immediately practice synergy patterns and subsequently develop combinations of movement patterns outside of the synergy.
Synergies are considered primitive patterns that occur at the spinal cord level as a result of the hierarchical organization of the central nervous system.
Reinforcing synergy patterns is rarely utilized now as research has indicated that reinforced synergy patterns are very difficult to change.
Brunnstrom developed . the seven stages of recovery, which are used for evaluation and documentation of patient progress
Associated reactions: An involuntary and automatic movement of a body part as a result of an intentional active or resistive movement in another body part.
Homolateral synkinesis: A flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity.
Limb synergies: A group of muscles that produce a predictable pattern of movement in flexion or extension patterns.
Raimiste's phenomenon: The involved lower extremity will abduct/adduct with applied resistance to the uninvolved lower extremity in the same direction.
Souque's phenomenon: Raising the involved upper extremity above 100 degrees with elbow extension will produce extension and abduction of the fingers.
Brunnstrom Evaluation of strength focuses on patterns of movement rather than straight plane motion at a joint
Brunnstrom Sensory examination is required to assist with treating motor deficits
Brunnstrom Initially limb synergies are encouraged as a necessary milestone for recovery
Brunnstrom Encourage overflow to recruit active movement of the weak side
Brunnstrom Use of repetition of task and positive reinforcement
Brunnstrom A patient will follow the stages of recovery, but may experience a plateau at any point so that full recovery is not achieved
Brunnstrom Movement combinations that deviate from the basic limb synergies should be introduced in stage 4 of recovery
Brunnstrom separates neurological recovery into seven separate stages based on progression through abnormal tone and spasticity.
Seven Stages of Recovery Stage 1: No volitional movement initiated.
Seven Stages of Recovery Stage 2: The appearance of basic limb synergies. The beginning of spasticity.
Seven Stages of Recovery Stage 3: The synergies are performed voluntarily; spasticity increases.
Seven Stages of Recovery Stage 4: Spasticity begins to decrease. Movement patterns are not dictated solely by limb synergies.
Seven Stages of Recovery Stage 5: A further decrease in spasticity is noted with independence from limb synergy patterns.
Seven Stages of Recovery Stage 6: Isolated joint movements are performed with coordination.
Seven Stages of Recovery Stage 7: Normal motor function is restored.
Created by: micah10



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