CVA

BY Dr.A.Sridhar

Brunnstroms stages
Stage -1 flaccidity

Stage -2 little or no active finger flexion

Stage -3 Mass Grasp; use of hook grasp but no release; no voluntary finger extension; possibly reflex extension of digits

Stage -4 Lateral Prehension, release by thumb movement ; semivoluntary finger extension, small range
Stage-5 Palmar prehension; possibly cylindrical and spherical grasp, awkwardly performed and with limited functional use; voluntary mass extension of digits variable range Stage -6 all prehensile types under control; skills improving; full range voluntary extension of digits; individual finger movements present, less accurate than on opposite side

Lower limb and trunk

Stage -1 flaccidity Stage -2 Minimal voluntary movements of the lower limb

Stage -3 Hip-Knee-ankle flexion in sitting and standing

Stage -4 Sitting, Knee flexion beyond 90 degrees with the foot sliding backward on the floor; voluntary dorsiflexion of the ankle without lifting the foot off the floor Stage -5 Standing, isolated non weight bearing knee flexion , hip extended or nearly extended; standing, isolated dorsiflexion of the ankle, knee extended, heel forward in a position of a short step Stage -6 standing, hip abduction beyond range obtained from elevation of the pelvis; sitting reciprocal action of the inner and outer hmnstring muscle, resulting in inward and outward rotation of the leg at the knee, combined with inversion and eversion of the ankle

Attitude or postural reflexes

Tonic neck reflex
Symmetrical Asymmetrical

Tonic labyrinthine reflex Tonic lumbar reflex

Associated reaction
Automatic activities which fix or alter the posture of a part or parts when some other parts of the body is brought into action by either voluntary effort or reflex stimulation

 Homolateral limb synkinesis rt hip flex right ul flex Raimistes phenomenon

Abductor phenomenon Adduction phenomenon

Souques finger phenomenon Evolution in reverse(Jackson 1884)

Find out .
Grasp reflex
Catching phase Holding phase

Dr.A.Sridhar, MPT(Neurology)

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