Question | Answer |
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. |