The Brunnstrom technique was founded by Swedish physiotherapist Signe Burnnstrom, and it is one of the commonly used treatment techniques at present.
Emphasize that the whole recovery process gradually develops to normal and complex movement patterns, so as to achieve the reorganization of the central nervous system, and the joint movement of limbs and other abnormal movement patterns are a process that patients must go through before returning to normal voluntary movement. Therefore, it is advocated to use these abnormal patterns in the early stage of recovery to help patients control the common movement of limbs, and finally achieve the purpose of independent movement by themselves.
The most basic treatment method of this technology is: make full use of all methods to cause the active response of the limbs in the early stage, and use various movement patterns, such as joint movement and joint reaction, and then guide and separate the normal components from the abnormal pattern, and finally break away from the abnormal pattern. Gradually return to normal function.
Brunnstrom divided the recovery process of hemiplegic limb function into six stages according to the changes of muscle tension and motor function to evaluate the recovery process of motor function after stroke.
Stage | Sports characteristics | upper limb | hand | lower limb |
Ⅰ. Lag period | no voluntary movement | no movement | no movement | no movement |
Ⅱ. Spasm period | elicit joint response, joint motion | Coordinated movement mode only | very slight buckling | minimal voluntary movement |
Ⅲ. Combined exercise period | random common movement | Coordinated movement can be initiated at will | May have a hooked grip, but cannot extend fingers | Synergistic flexion of hips, knees, and ankles in sitting and standing positions |
Ⅳ. Partial separation movement period | The co-movement pattern breaks down and separate movements begin to emerge | Activities that appear to dissociate from coordinated movement: When the shoulder is 0 degrees and the elbow is flexed 90 degrees, the forearm can be pronated and supinated; when the elbow is straightened, the shoulder can be flexed 90 degrees; the arm can touch the lumbosacral region | Able to pinch and release thumb laterally, with small, semi-voluntary stretches of fingers | In the sitting position, the knees can be bent more than 90 degrees, and the feet can slide backwards. Ankle dorsiflexion without heel off the ground |
Ⅴ. Separation movement period | Gradual recovery of muscle tone, separation of fine movements | Activities that are relatively independent of coordinated movement occur: when the shoulder is flexed 30-90 degrees, the forearm can be pronated and supinated; when the elbow is straightened, the shoulder can be abducted 90 degrees; when the elbow is straightened, the forearm is in a neutral position, and the upper limb can be raised overhead | Ball and cylinder grip possible, fingers extended simultaneously but not individually | Standing on the healthy leg, the sick leg can bend the knee first, then extend the hip; extend the knee, the ankle can be dorsiflexed |
Ⅵ, roughly normal exercise period | exercise near normal | The motor coordination is close to normal, and there is no obvious difference in distance between the fingers and the nose, but the speed is slower than that of the unaffected side (≦5 seconds) | Can perform all grips, but with less speed and accuracy than the unaffected side | Hip abduction to the extent that the pelvis on that side can be lifted in standing position; straight knee in sitting position can rotate lower extremity internally and externally, combined with foot valgus |
Therefore, its treatment policy is: always pay attention to the sense of movement; early patients place their limbs on the bed; use common movement patterns; promote separation movements; and finally achieve various movements at will.
Sunlion recovery hand rehabilitation robotic glove is a good aid for storke hand to exercise, to help patients to rebuild send of hand movement.
What You Need to Know to Learn the Brunnstrom Technique
1. Joint reaction
A very voluntary movement or reflexive increase in muscle tone after craniocerebral injury. When the patient's limb on the key side exerts excessive force, the limb on the affected side will move accordingly.
2. Common movement
Co-motion is an uncontrollable specific movement pattern of the affected limb after stroke. When the patient moves a joint of the affected limb, he cannot move a single joint, and an uncontrollable movement occurs in adjacent joints or even the entire limb. common activities. For example, joint movement of flexors or extensors often occurs when the arms are raised in the upper limbs; joint movement of flexors or extensors is easy to be seen when the lower limbs are standing and walking, and the performance is more prominent during vigorous activities.