NAME ABDUL BASEER KHAN

ROLL# 49
TOPIC BRUNNSTROMS APPROCH
HISTORY

The Brunnstrom Approach sets out a sequence of stages of

recovery from hemiplegia after a stroke. It was developed
by the Swedish physical therapist Signe Brunnström, and
emphasises the synergic pattern of movement which
develops during recovery. 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
PRINCIPLE
• Encourage synergy
• Tactile stimulation and proprioception
• Also hightlight verbal and visual command
USES
• The Brunnstrom approach is currently used to treat
many neurological conditions including those with:
Cerebral Palsy
• Head Injury
• Parkinsons disease
• Stroke
• Spinal Cord Injury
RECOVERY STAGES

STAGE 1………….FLACCIDITY STAGE

The first stage in Brunnstrom’s Approach is the initial
period of shock immediately after stroke where flaccid
paralysis sets in. Flaccid paralysis (flaccidity) is the
medical term for a complete lack of voluntary
movement. This paralysis is caused by nerve damage
that prevents the muscles from receiving appropriate
signals from the brain, whether or not the brain is still
capable of moving those muscles.
Stage 2: Dealing with the Appearance of
Spasticity….Pre synergy stage

The second stage in stroke recovery marks the redevelopment

of some basic limb synergies as certain muscles are
stimulated or activated and other muscles in the same
system begin to respond. Muscles begin to make small,
spastic, and abnormal movements during this stage. While
these movements are mostly involuntary, they can be a
promising sign during your recovery. Minimal voluntary
movements might or might not be present in stage two.
Stage 3: Increased Spasticity….synergy stage

Spasticity in muscles increase during stage three of stroke recovery

, reaching its peak
synergy patterns also start to emerge and minimal voluntary
movements should be expected
Muscles with severe spasticity, like the ones in stage 3 of stroke
recovery, are likely to be more limited in their ability to exercise
and may require help to do this. Patients and family/caregivers
should be educated about the importance of maintaining range of
motion and doing daily exercises. It is important to minimize
highly stressful activities this early in training.
Stage 4: Decreased Spasticity…post synergy

During stage four of stroke recovery, spastic muscle

movement begins to decline. Patients will regain
control mostly in the extremities, and they will have a
limited ability to move normally
The focus during this stage is to strengthen and improve
muscle control. Now that you are regaining motor
control and can start to make normal, controlled
movements on a limited basis, you can start to build
strength back in your limbs and continue work on
your range of motion. Continuing to stretch out your
muscles is still important in this stage. 
Stage 5: Complex Movement Combinations

• In stage 5, spasticity disappear. the muscles also

become more coordinated and allowing
voluntary movements to become more complex
• The patient will be able to make more controlled
and deliberate movements in the limbs that have
been affected by the stroke. Isolated joint
movements might also be possible.
Stage 6: Normal Function Return
• The last stage in Brunnstrom’s Approach
is when you regain full function in the
areas affected by the stroke. You are now
able to move your arms, legs, hands, and
feet in a controlled and voluntary
manner.