MOVEMENT THERAPY FOR HEMIPLEGIA - BRUNNSTROM APPROACH

DAY 1 - CONTENTS:

• Lecture and Hands on Techniques
Introduction to stroke:
• Relevant facts in Neuroanatomy & Neurophysiology of Brain related to Stroke, Circle of Willis and its significance. Stroke, TIA, RIND - Definition, Statistics, Types. Clinical features of MCA, PCA and ACA.
Impairments
• Motor, Sensory, Visual, Cognitive & Perceptual.
Motor Control
• Definition, Theories, Neurophysiological basis, Prerequisites of Motor Control, Clinical Implications, Therapeutic Applications.
Voluntary Control
• Definition, Components of Voluntary Control, Theories, Neurophysiological basis, Assessment of Voluntary Control/Movement, Therapeutic Applications.
Motor Learning
• Definition, Stages of Motor Learning, Theories, Neurophysiological basis, Clinical Implications, Factors affecting Motor Learning, Concepts Determine Motor Learning, Therapeutic Applications.
Neuroplasticity
• Definition, Theories, Neurophysiological basis, Principles, Recent evidence on recovery.
Evolution of concept
• Theory of origin, Physiological basis, Theories strengthening the approach.
Synergy and its facilitation
• Normal movement, Definition of synergy, Types of Synergy, Flexor Synergy of Upper Limb & Lower Limb and its components, Extensor Synergy of Upper limb & Lower limb and its components.
Postural reflexes
• Tonic Neck Reflexes (TNR) - Asymmetric Tonic Neck Reflexes (ATNR), Symmetric Tonic Neck Reflexes (STNR), Tonic Labyrinthine Reflexes (TLR), Tonic Lumbar Reflex (TLR). Influences on movement.
Associated Reactions
• Definition, Theories, Physiology, Homolateral Synkinesis, Raimste’s Phenomena, Traction Response, Grasp Reflex, Instinctive Grasp Reaction (IGR), Instinctive Avoiding Reaction (IAR), Soques Phenomena. Influences on Movement, Clinical Importance.
Principles and Assumptions
• Evaluation principles, Procedures, Seven Stages of Recovery. Recovery Stages - Upper Limb, Wrist, Hand, Lower Limb. Special Features, Brunnstrom Concepts.

PRINCIPLES & HAND’ S ON TRAINING :

Day 2 - Contents

Lecture and Hands on Techniques

Upper Limb Training Cont’d

Trunk Control Training
• Evoking balance responses
• Trunk bending
• Trunk Rotation
• Facilitation
• Weaning of Reflexes

Head and Neck Training (Facilitation of Head/Neck movements with)
• Reflex
• Associated reactions

Upper Limb Training
• Initiation and Facilitation of Synergy with Postural Reflexes, Associated Reactions, Proprioceptive/Exteroceptive Stimulus.
• Training synergy combinations and Dissociations
• Training with functional context
• Training isolated movements

Wrist and Hand Training
• Initiation and facilitation of movements with associated reactions, hand reactions, reflexes.
• Wrist fixation techniques.
• Finger flexor release techniques.
• Activation of extensors, release of grasp – Manipulations.

Lower limb Training:
• Hip, knee, ankle movements – initiation, activation, dissociation, association, isolated movements – through reflexes, associated reactions, proprioceptive-exteroceptive stimulus, etc.