BRUNNSTROM MOVEMENT THERAPY IN HEMIPLEGIA PDF

The Brunnstrom Approach What is the Brunnstrom approach? Above: Functional movement rehabilitation exercises supervised by a specialist neurological physiotherapist Principles of the Brunnstrom approach The Brunnstrom treatment approach is based around two principles: 1st Principle - Normal movement how a healthy individual moves requires muscles working together synergistically following damage to the CNS the muscles will not work as well together. During recovery muscles will start working together better. The sequence is: Immediately after the onset of injury there may be no "voluntary" movement. Spasticity increased muscle tone appears, basic movement reflexes appear.

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The Brunnstrom Approach What is the Brunnstrom approach? Above: Functional movement rehabilitation exercises supervised by a specialist neurological physiotherapist Principles of the Brunnstrom approach The Brunnstrom treatment approach is based around two principles: 1st Principle - Normal movement how a healthy individual moves requires muscles working together synergistically following damage to the CNS the muscles will not work as well together.

During recovery muscles will start working together better. The sequence is: Immediately after the onset of injury there may be no "voluntary" movement. Spasticity increased muscle tone appears, basic movement reflexes appear. Patient begins to gain voluntary control over their reflexes. This may cause an increase in spasticity. Basic movement patterns are developed. This leads to a reduction in spasticity. As progress continues, more complex movement patterns are learnt and there is a further decrease in spasticity.

Spasticity disappears and individual movements become possible and coordination approaches normal. Normal function is restored. Brunnstrom Treatment Physiotherapists using the Brunnstrom approved aim to maximise recovery and restore normal function as soon as possible following an injury to the CNS.

Treatment includes: Encouraging whatever movement is possible and building on it, through; strengthening, sensory stimulation, positive reinforcement, verbal feedback, and the use of reflexes. Treatments will involve tasks that are difficult but achievable. As soon as the task is achieved new goals will be set.

Movement will be progressed in the correct sequence. Abnormal movement always comes first following injury and there is a normal pattern of recovery before normal patterns of movements are obtained. The Brunnstrom approach acknowledges that before normal movement can be restored there will be a period of abnormal movement.

It is the job of the physiotherapist to get their patients through the stages of abnormal movement to achieve normal movement and function. Benefits of the Brunnstrom approach The Brunnstrom approach emphasises the ability to recover normal movement by facilitating reflexes, basic muscle synergies and sensory stimulation. This type of treatment will help:.

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Brunnstrom Approach

The Brunnstrom stages also called the Brunnstrom Approach are used by many physical therapists to assess how well their patients are recovering. The seven Brunnstrom stages were developed in the s by Swedish physical therapist Signe Brunnstrom as a framework to understand how muscle control can be restored after stroke. What makes the Brunnstrom approach so unique is how it views spasticity and involuntary muscle movement. Instead of seeing these as symptoms to fight, the Brunnstrom approach views them as part of the recovery process and utilizes them to aid recovery! Stage 1: Flaccidity The first stage of the Brunnstrom approach is the period immediately after a stroke when the connection between the muscles and brain are so damaged that flaccid paralysis flaccidity sets in.

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The Brunnstrom Approach

Minimal voluntary movements may be present Patient gains voluntary control over synergies Increase in spasticity Some movement patterns out of synergy are mastered synergy patterns still predominate Decrease in spasticity If progress continues, more complex movement combinations are learned as the basic synergies lose their dominance over motor acts Further decrease in spasticity Individual joint movements become possible and coordination approaches normal Normal function is restored The 6 stages are as follows: [1] [2] [3] Stage Description 1 Immediately following a stroke there is a period of flaccidity whereby no movement of the limbs on the affected side occurs. These obligatory synergies may manifest with the inclusion of all or only part of the synergic movement pattern and they occur as a result of reactions to stimuli or minimal movement responses. The patient gains voluntary control through the synergy pattern, but may have a limited range within it. The ease of these movements progresses from difficult to easy within this stage. Here the patient is also able to demonstrate isolated joint movements, and more complex movement combinations.

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