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?
Describe the position of the elbow, forearm, wrist and fingers in the UE flexion synergy
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
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?
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
Case: One of your patients is suddenly under stress. Describe the expected UE position
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?
What is the typical Hemi leg posture?
Hip flexion and ADduction
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
Describe the Marie-Foix Reflex
Moving into plantarflexion and inversion causes a reflex dorsiflexion at the ankle and hip flexion
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.
A flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity. Same goes for extension.
The involved lower extremity will abduct/adduct with applied resistance to the uninvolved lower extremity in the same direction.
Raising the involved upper extremity above 90 degrees with elbow extension will produce extension and abduction of the fingers.
No volitional movement initiated
Minimal voluntary movements or associated reactions. The beginning of spasticity.
The synergies are performed voluntarily; spasticity increases to its peak.
Spasticity begins to decrease. Some movement combinations out of synergy are mastered slowly.
A further decrease in spasticity is noted with ability to perform more difficult movements out of synergy.
Isolated joint movements are performed with nearly normal coordination. No spasticity with passive movements.
Normal motor function is restored.
True or false? UE and LE are always in the same Brunnstrom stage.
True or false? A Brunnstrom stage can't be skipped.