Brunnstrom

46 terms by mrgilot 

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What was Brunnstrom's main belief?

Any movement is better than no movement.

True or false? Flexion is the most dominant UE pattern and has the highest treshold to facilitation.

false, lowest treshold

True or false? Extension is the most dominant of the synergies in the LE

True, thus the first to appear

Is there a shoulder flexion in UE flexion synergy?

no

Describe the position of the elbow, forearm, wrist and fingers in the UE flexion synergy

elbow flexion
forearm supinated
wrist flexion
fingers flexed

Describe the position of the SHOULDER in the UE flexion synergy

Abducted to 90 degrees, external rotation or hyperextension

Describe the position of the shoulder GIRDLE in the UE flexion synergy

Elevation and retraction

Describe the position of the shoulder GIRDLE in the UE extension synergy

Depression and protraction

Describe the position of the elbow, forearm, wrist and fingers in the UE extension synergy

Elbow extension
Forearm pronation
Wrist extension
Fingers flexed

What is the position of the SHOULDER in the UE extension synergy?

ADduction and internal rotation

Which movement is absent in both UE synergy patterns?

Finger extension

True or false? flexion is the stronger component at the elbow

true. same for the wrist

Trus or false? ADduction is the weakest component at the SHOULDER

false,
shoulder flexion

Case: One of your patients is suddenly under stress. Describe the expected UE position

Shoulder ADduction
Elbow flexion
Forearm pronation
Wrist and fingers flexion

What are the 2 positions in which patients are not prone to UE pathological synergies?

1) shoulder flexion above 90 degrees
2) arm behind the back

Describe the position of the hip in the LE extension synergy

Hip extension, ADduction (strongest component) and internal rotation

Describe the position of the knee in the LE extension synergy

Extension (stronger component)

Describe the position of the ankle in the LE extension synergy

Ankle plantarflexion (strongest component) and inversion

Describe the position of the hip for the LE flexion synergy

Hip flexion, ABduction and external rotation

Describe the position of the knee in the LE flexion synergy

Flexion to 90 degrees

Describe the position of the ankle in the LE flexion synergy

dorsiflexion and inversion

What motion is absent in both LE synergies?

Ankle eversion

What is the typical Hemi leg posture?

Hip flexion and ADduction
Knee extension
Ankle plantarflexion

What is the purpose of postural reflexes?

To increase tone and movement for normal development. They are normal in infancy.

Describe Symmetrical Tonic Neck Reflex

Head is flexed arms flex and legs extend. If head is ext arms ext and legs flex

Describe Asymmetrical Tonic Neck Reflex

fully rotate infant's head and hold for 5secs -> extension of extremities on the face side, flexion of extremities on the skull side.

Describe Symmetrical Tonic Labyrinthine Reflex

Supine position yields maximal extension of all limbs
Prone position yields flexion (min extension) of all limbs

Describe the Asymmetrical Tonic Labyrinthine Reflex

In sidelying, the ceiling side of the head facilitates flexion of UE and LE whereas the floor side facilitates extension

Describe the Tonic Lumbar Reflex

Rotation "away" facilitates flexion of LE and extension of UE
Rotation "towards" facilitates extension of LE and flexion of UE

True or false? the tonic neck and labyrinthine reflexes have a greater effect on the UE

true

Describe the Marie-Foix Reflex

Moving into plantarflexion and inversion causes a reflex dorsiflexion at the ankle and hip flexion

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.

Describe associated reactions in the UE

flexion in uninvolved side leads to flexion in involved side. Extension in uninvolved side leads to extension in involved side.

Describe associated reaction in the LE

It is reciprocal. flexion in uninvolved side leads to extension in involved side. Extension in uninvolved side leads to flexion in involved side.

Homolateral synkinesis

A flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity. Same goes for extension.

Raimiste's Phenomenon

The involved lower extremity will abduct/adduct with applied resistance to the uninvolved lower extremity in the same direction.

Souqe's Phenomenon

Raising the involved upper extremity above 90 degrees with elbow extension will produce extension and abduction of the fingers.

Stage 1

No volitional movement initiated

Stage 2

Minimal voluntary movements or associated reactions. The beginning of spasticity.

Stage 3

The synergies are performed voluntarily; spasticity increases to its peak.

Stage 4

Spasticity begins to decrease. Some movement combinations out of synergy are mastered slowly.

Stage 5

A further decrease in spasticity is noted with ability to perform more difficult movements out of synergy.

Stage 6

Isolated joint movements are performed with nearly normal coordination. No spasticity with passive movements.

Stage 7

Normal motor function is restored.

True or false? UE and LE are always in the same Brunnstrom stage.

False

True or false? A Brunnstrom stage can't be skipped.

True

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