Brunnstrom techniques…I tried at least…

I took a bunch of notes out of my OT for Physical Dysfunction book, on the Brunnstrom section for dealing with stroke. Needed new ideas….I ended up trying most of it with minimal success, but I guess I can't expect miracles after a single session! I am copy/pasting my notes just to share the kind of stuff i looked at – do NOT try any of this stuff without reading up on it on your own as a lot of this is out of context and/or abbreviated!!

Brunnstrom Ideas 

Extensor synergy evoked by applying resistance to horizontal adduction of uninvolved UE.  

Resisted grasp of uninvolved hand causes grasp reaction in involved hand. Mirror synkinesis.  

Push pt off balance toward involved side

Then push pt off balance toward uninvolved side. 

Cross arms with uninvolved hand hander involved elbow. Therapist supports patient under elbows, assists in trunk flexion forward.  

Push pt backwards, regain active posture. Then go forward flexion in oblique directions.  

Trunk rotation with head movement in opposite direction of rotation (so tonic neck and lumbar reflexes can elicit shld components).  

Lateral flexion of neck toward involved side, to intiate scapular evelation. With pt’s arm supported on table in shld abd with elbow flexion, therapist gives resistance to head and shld while pt asked to hold head and not let it move  

Try bilat scap elevation, resist uninvolved scap. If involved scap elevates associatedly, add resistance 

Stroke upper trapezius to facil muscle contraction. Hold, don’t let me push your shoulder down. Repeat holding, some resistance, then try to let shld down slowly.  

Extensor  synergy assisted in initation

Hold therapists arms in horizontal abd/add, tell them to bring arms together, apply resistance to uninvolved arm proximal to elbow. Don’t let me pull your arms apart.  

Bilat weight bearing to develop arm extension 

Rowing: Therapist resists pronated uninvolved LUE while guiding involved extremity into extensor synergy. Then guide into reverse motion of flexion and supination. Keep trying and trying until feel some active extension. If so, apply bilat resistance.  

Extend elbow, support at wrist, bring up wrist extensors, over and over again,  

FINGERS: Hold thumb in extension and abduction. While holding thumb, SLOWLY and rhythmically supinate and pronate the forearm.

Apply cutaneous stim over dorsum of hand while forearm is supinated

With forearm supinated, apply rapid, repeated stretch to extensors of fingers by repeatedly rolling toward palm. Continue until flexion releases.

Slowly pronate forearm, elevate above horizontal to evoke finger extensor response

Sep 04, 2010 | Category: Occupational Therapy | Comments: none

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