4.16 Post-Stroke 2

Question 1

What is the Brunnstrom scale for?

Answer 1

stage someone’s recovery after a stroke

Question 2

How many stages in the Brunnstrom scale?

Answer 2

6

Question 3

Brunnstrom stage 1

Answer 3

• completely flaccid

- no movement of the limb can be elicited

Question 4

If flaccidity is caused by a neuro injury, what is the implication?

Answer 4

• cannot strengthen

- must have SOME motor response to strengthen

Question 5

If we can even elicit SOME motor, what is happening?

Answer 5

the brain is sending some kind of signal to the muscle

Question 6

Brunnstrom stage 2

Answer 6

• some basic limb synergies or some of their components may appear as associated reactions
• the smallest amount of movement, trace muscle contraction

Question 7

What are associated rxns?

Answer 7

UE and LE reactions are yoked

Question 8

Brunnstrom stage 3

Answer 8

• patient has some voluntary control to create a movement
• don’t have full innervation of the synergy
• stronger spasticity

Question 9

Brunnstrom stage 3: If we ask them to flex their elbow, what will they do?

Answer 9

they’ll start pulling up into the synergistic pattern

Question 10

Brunnstrom stage 4

Answer 10

• patient can now do some movements that don’t follow the synergistic pattern
• starting to gain voluntary functional control

Question 11

Brunnstrom stage 5

Answer 11

• more difficult movement patterns (brush teeth, feedings, etc.)
• multiple movements that are no longer controlled by synergy

Question 12

Brunnstrom stage 6

Answer 12

more coordinated, movement appears to be almost normal

Question 13

Brunnstrom stage 6: “normal:

Answer 13

• some people, you’d never know they had a stroke

- some people say that if you stress them enough, they may have some issues come back up

Question 14

Why is the Brunnstrom scale important for us?

Answer 14

• allows us to scale, helps us give a prognosis, could potentially use for goals
• use the body’s actions after a stroke to their advantage
• The sooner we see progress, typically will have a better recovery

Question 15

How would we use the body’s normal actions after stroke to their advantage for recovery?

Answer 15

strengthen the synergy » hopefully progress them to the next stage

Question 16

What is the school of thought that says you shouldn’t encourage any abn movements?

Answer 16

NDT

Question 17

Which synergy must be tested first?

Answer 17

weaker

Question 18

Why must the weaker synergy be tested first?

Answer 18

if you test the stronger one, it will override the weaker

Question 19

synergies: what do the fingers do?

Answer 19

go into flexion (fingernails can grow into the hand)

Question 20

How do pts go through the Brunnstrom stages?

Answer 20

progress through each one, even though you may not see it