Brunnstrom Approach

Brunnstrom Approach

The Brunnstrom Approach is a therapeutic method used in the rehabilitation of individuals who have suffered a stroke. Developed by physical therapist Signe Brunnstrom in the mid-20th century, this approach focuses on facilitating the recovery of motor control through the use of specific movement patterns and stages of recovery.

Overview

The Brunnstrom Approach is based on the observation that stroke recovery often follows a predictable sequence of stages. These stages reflect the progression from flaccidity to spasticity and eventually to voluntary control of movement. The approach emphasizes the use of reflexes and associated reactions to promote movement in the early stages of recovery.

Stages of Recovery

The Brunnstrom Approach outlines seven stages of recovery:

1. Flaccidity: Immediately following the stroke, there is no voluntary movement on the affected side.
2. Spasticity Appears: Basic limb synergies or associated reactions begin to appear, and spasticity develops.
3. Increased Spasticity: Spasticity increases, and voluntary control of movement begins within synergy patterns.
4. Decreased Spasticity: Spasticity begins to decline, and some movement combinations outside of synergy patterns become possible.
5. Complex Movement Combinations: More complex movement combinations are learned as spasticity continues to decrease.
6. Spasticity Disappears: Spasticity disappears, and individual joint movements become possible.
7. Normal Function Returns: Normal function is restored, and voluntary control is fully regained.

Therapeutic Techniques

The Brunnstrom Approach employs several techniques to facilitate recovery:

• Facilitation of Reflexes: Using reflexive movements to initiate voluntary movement.
• Associated Reactions: Encouraging involuntary movements that occur in response to voluntary movement in other parts of the body.
• Repetition of Synergistic Patterns: Practicing movements within synergy patterns to strengthen neural pathways.
• Progressive Movement Training: Gradually introducing more complex movements as the patient progresses through the stages of recovery.

Criticism and Limitations

While the Brunnstrom Approach has been influential in stroke rehabilitation, it has faced criticism for its emphasis on synergy patterns and reflexive movements, which some argue may not always lead to functional recovery. Modern rehabilitation often incorporates a more holistic approach, integrating elements from various therapeutic models.

Also see

• Stroke Rehabilitation
• Neuroplasticity
• Bobath Concept
• Motor Control
• Physical Therapy