Brunnstrom Approach
Encyclopedia
History
The Brunnstrom Approach, developed by the Swedish physical therapist Signe Brunnstrom, emphasises the synergic pattern of movement which develops during recovery from hemiplegiaHemiplegia
Hemiplegia /he.mə.pliː.dʒiə/ is total paralysis of the arm, leg, and trunk on the same side of the body. Hemiplegia is more severe than hemiparesis, wherein one half of the body has less marked weakness....
. This approach encourages development of flexor and extensor synergies during early recovery, with the intention that synergic activation of muscles will, with training, transition into voluntary activation of movements.
Sequential Motor Recovery Following Stroke
The Brunnstrom Approach follows six proposed stages of sequential motor recovery after a strokeStroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
. A patient can plateau at any of these stages, but will generally follow this sequence if he or she makes a full recovery. The variability found between patients depends on the location and severity of the lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...
, and the potential for adaptation.
The 6 stages are as follows:
| Stage | >|- | stroke Stroke A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage... there is a period of flaccidity whereby no movement of the limbs on the affected side occurs. >- |
2 | spasticity Spasticity Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles... , increased reflexes and synergic movement patterns termed obligatory synergies. 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. >- | 3 |
Spasticity Spasticity Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles... becomes more pronounced and obligatory synergies become strong. The patient gains voluntary control through the synergy pattern, but may have a limited range within it. >- | 4 |
Spasticity Spasticity Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles... and the influence of synergy begins to decline and the patient is able to move with less restrictions. The ease of these movements progresses from difficult to easy within this stage. |
|---|
| Spasticity Spasticity Spasticity is a feature of altered skeletal muscle performance in muscle tone involving hypertonia, which is also referred to as an unusual "tightness" of muscles... continues to decline, and there is a greater ability for the patient to move freely from the synergy pattern. Here the patient is also able to demonstrate isolated joint movements, and more complex movement combinations. >- |
Assessment Methods
The six component stages of the Brunnstrom Approach have influenced the development of a variety of standardized assessment methods used by physiotherapists to evaluate and track the progress of persons recovering from strokeStroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
. The Fugl-Meyer Assessment of Physical Performance (FMA) is an example of one widely used scale. The FMA consists of five sub-scales that relate to various aspects of a patient's upper and lower extremity, and the sub-scales are as follows:
- Motor
- Balance
- Sensation
- Joint Range of Motion
- Pain
Each component of the FMA may be evaluated and scored individually or, a total possible summative score for all 5 sub-scales of 226 may be used to track a patient's degree of recovery.
The influence of the Brunnstrom Approach on the development of the FMA is most evident within the Motor sub-scale for both the upper and lower extremity where there is a strong emphasis on the evaluation of muscle synergies.
See also
- Occupational therapyOccupational therapyOccupational therapy is a discipline that aims to promote health by enabling people to perform meaningful and purposeful activities. Occupational therapists work with individuals who suffer from a mentally, physically, developmentally, and/or emotionally disabling condition by utilizing treatments...
- Physical therapyPhysical therapyPhysical therapy , often abbreviated PT, is a health care profession. Physical therapy is concerned with identifying and maximizing quality of life and movement potential within the spheres of promotion, prevention, diagnosis, treatment/intervention,and rehabilitation...
- DisabilityDisabilityA disability may be physical, cognitive, mental, sensory, emotional, developmental or some combination of these.Many people would rather be referred to as a person with a disability instead of handicapped...
- Rehabilitation medicine
- TherapyTherapyThis is a list of types of therapy .* Adventure therapy* Animal-assisted therapy* Aquatic therapy* Aromatherapy* Art and dementia* Art therapy* Authentic Movement* Behavioral therapy* Bibliotherapy* Buteyko Method* Chemotherapy...
- StrokeStrokeA stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
- HemiplegiaHemiplegiaHemiplegia /he.mə.pliː.dʒiə/ is total paralysis of the arm, leg, and trunk on the same side of the body. Hemiplegia is more severe than hemiparesis, wherein one half of the body has less marked weakness....
- Bobath conceptBobath conceptThe Bobath concept is a broad and ever-evolving approach in neurological rehabilitation that is applied in patient assessment and treatment . The goal of applying the Bobath concept is to promote motor learning for efficient motor control in various environments, thereby improving participation...