Brunnstrom tx approach - 2 Flashcards

1
Q

associated reactions include

A

UE

LE

homolateral limb synkinesis

ramiste phenomenom

raimiste like phenomen

souques phenomen

rowing patterns

marie foix reflex

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2
Q

UE associated reactions

A

flexion typically leads to flexion

extension typically leads to extension

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3
Q

LE associated reactions

A

flexion of the unaffected LE may result in extension of the affected LE

extension of the unaffected LE may result in flexion of the affected LE

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4
Q

homolateral limb synkinesis

A

movement of the unaffected UE/LE promotes movement of the other extremity of affected side in same direction at the same time

both UE or LE move into flexion or extension direction

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5
Q

when is homolateral limb synkinesis common

A

spastic hemiplegia

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6
Q

raimiste’s phenomenon

A

ABD of ADD or the unaffected LE results in the same motion of the affected LE

this is with the knee straight and bent

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7
Q

ramiste-like phenomenon –> ABD & ADD

A

of the unaffected UE results in the same motion of the affected UE

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8
Q

souques pehnomenon

A

reflex finger extension when the affected arm is passively stretched past 90 degrees of flexion

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9
Q

rowing patterns

A

capitalizing on B/L symmetrical activity

another form of an associated reaction

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10
Q

as pt to pull back with non-involved arm –> rowing pattern

A

hope to see involved arm move as wel

can use thumb grip or shake hands with pt

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11
Q

marie-foix reflex

A

not a postural reflex

movement into PF and inversion causes a reflex DF at the ankle and hip flexion at the hip

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12
Q

how many stages does brunnstrom have

A

7

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13
Q

recovery from CVA

A

no stage is revisited

no stage is skipped

pt can plateau at any stage

UE and LE may be in different stages

no set amount of time you will spend in each stage

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14
Q

brunnstrom stage 1

A

flaccid involved limb

no voluntary movement

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15
Q

when does brunnstrom stage 1 present

A

immediately following acute episode of CVA/neurologic event

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16
Q

as recovery begins –> brunnstrom stage 2

A

minimal movement present/minimal associated reactions

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17
Q

how is movement available –> brunnstrom stage 2

A

present in synergy

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18
Q

what is starting to develop –> brunnstrom stage 2

A

spasticity

dominant muscle groups are already in synergy

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19
Q

brunnstrom stage 3

A

voluntary control if movement synergy

20
Q

movement –> brunnstrom stage 3

A

may not be able to go through the full available motion w/in synergy

21
Q

brunnstrom stage 3 has

A

peak spasticity

often severe

22
Q

what does the pt begin having –> brunnstrom stage 4

A

basic movements outside of synergy

23
Q

basic movements outside of synergy –> brunnstrom stage 4

A

very difficult at first

pt can place hand behind their body

elevate arm to forward horizontal position

pronation/supination available w/ elbow flexed to 90

24
Q

what is happening w/ spasticity –> brunnstrom stage 4

A

slowly starting to decline

still obvious

25
Q

spasticty –> brunnstrom stage 5

A

continued decreasing spasticity

26
Q

what is now possible –> brunnstrom stage 5

A

difficult movements out of synergy are possible

27
Q

what does brunnstrom stage 5 include

A

decreased dominance of synergy patterns

28
Q

decreased dominance of synergy patterns –> brunnstrom stage 5

A

can raise arm to side w/ elbow straight

arm can now be raised (flexed) and possible overhead

pronation/supination w/ elbow extended is now possible

29
Q

what is occurring in brunnstrom stage 6

A

individual isolated movements

30
Q

approaching –> brunnstrom stage 6

A

normal

31
Q

what may a well trained eye see –> brunnstrom stage 6

A

awkwardness w/ movement d/t basic limb strategies

not obvious

32
Q

spasticity –> brunnstrom stage 6

A

none w/ passive movements of the limb

33
Q

brunnstrom stage 7

A

normal motor fxn

34
Q

normal motor fxn –> brunnstrom stage 7

A

pt can resume all former fxn at optimal level

35
Q

how many people progress through stages of motor recovry

A

no clear data

36
Q

what do we do if a pt seems to have difficulty w/ activity in a certain stage

A

make easier

37
Q

ultimate goal

A

progress pt through stages of recovery

38
Q

what should we facilitate

A

normal fxn as we can

39
Q

how do we separate stages

A

1-3

4-6

7

40
Q

stages 1-3

A

pt synergy and spasticity is increasing

41
Q

stages 4-6

A

pt synergy and spasticity is decreasing

42
Q

stage 7

A

pt is “normal” and can now work on other things

43
Q

trunk technique

A

arm cradling

44
Q

what is arm cradling

A

unaffected extremity supports the affected extremity

45
Q

trunk movements

A

flexion

oblique flexion

lateral movements

rotation

rotation w/ alternate head movements