Deans' stroke musings: Brunnstroms stages of recovery

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Tuesday, February 8, 2011

Brunnstroms stages of recovery - spasticity

http://www.ncbi.nlm.nih.gov/books/bv.fcgi?indexed=google&rid=physmedrehab.section.726
Brunnstrom (1966, 1970) and Sawner (1992) also described the process of recovery following stroke-induced hemiplegia. The process was divided into a number of stages:

Brunnstrom (1966, 1970) described the process of recovery following stroke-induced hemiplegia. The process was divided into a number of stages:
Synergy. A whole series of muscles are recruited when just a few are needed. Trying to reach forward, The arm wings outward, the shoulder lifts, the wrist curls down. Lots of this is from spasticity

1. Flaccidity (immediately after the onset)
No "voluntary" movements on the affected side can be initiated
2. Spasticity appears
Basic synergy patterns appear
Minimal voluntary movements may be present
3. Patient gains voluntary control over synergies
Increase in spasticity
4. Some movement patterns out of synergy are mastered (synergy patterns still predominate)
Decrease in spasticity
5. If progress continues, more complex movement combinations are learned as the basic synergies lose their dominance over motor acts
Further decrease in spasticity
6. Disappearance of spasticity
Individual joint movements become possible and coordination approaches normal
7. Normal function is restored

Where are the answers to this?
A lot of problems here are because spasticity is subjectively measured, if you can't properly measure something you can't figure out how to fix it.