Brunnstrom Stage-Specific Rehabilitation Exercises - Mobilexo Arm (Pro Version)


Brunnstrom Stage-Specific Rehabilitation Exercises (Pro version)

Stage 1: Flaccidity (No Voluntary Movement)

Goal: Prevent stiffness, maintain joint mobility, stimulate sensory awareness.

  • Passive Range of Motion (PROM): Therapist moves the limb through full motion (shoulder, elbow, wrist, fingers, hip, knee, ankle).

  • Positioning: Use splints or pillows to prevent contractures (e.g., hand cone for fingers, ankle-foot orthosis).

  • Sensory Stimulation:

    • Brushing, tapping, or icing muscles to increase awareness.

    • Weight-bearing (e.g., placing the hand on a table to stimulate proprioception).

For Recovery suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice every day, each time 1.5 hrs 
ii. Practice 2 - 3 months recover to another level. 

Stage 2: Spasticity Begins & Basic Synergies Emerge

Goal: Encourage movement within synergies.

  • Facilitation of Synergistic Patterns:

    • Upper Limb (Flexor Synergy):

      • Shoulder shrug → elbow flexion → forearm supination.

      • Use tactile cues (tapping biceps) to trigger movement.

    • Lower Limb (Extensor Synergy):

      • Hip extension → knee extension → ankle plantarflexion.

      • Weight-shifting in sitting/standing to stimulate extension.

  • Assisted Movement:

    • Therapist helps guide the limb through synergy patterns (e.g., bending the elbow while lifting the arm).

For Recovery suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice every day, each time 1.5 hrs 
ii. Practice 3 - 4 months recover to another level. 


Stage 3: Peak Spasticity & Strong Synergy Dominance

Goal: Strengthen within synergies, prevent contractures.

  • Resisted Synergy Movements:

    • Arm Flexion Synergy: Patient lifts arm (elbow bent) against gentle resistance.

    • Leg Extension Synergy: Pressing foot down into the floor while seated.

  • Weight-Bearing Activities:

    • Leaning on the affected arm on a table to stimulate stability.

  • Stretching Spastic Muscles:

    • Wrist/finger extensors, ankle dorsiflexors (to counteract tightness).

For Recovery suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice every day, each time 1.5 hrs 
ii. Practice 3 - 5 months recover to another level. 


Stage 4: Decreasing Spasticity & Partial Synergy Breaking

Goal: Train movement outside synergies, improve coordination.

  • Breaking Synergies:

    • Arm: Lift arm without bending the elbow (isolated shoulder flexion).

    • Hand: Practice finger extension while keeping the wrist straight.

  • Weight-Shifting Drills:

    • Reaching sideways while sitting to dissociate trunk/arm movement.

  • Assisted Grasp & Release:

    • Picking up light objects (e.g., foam ball) with minimal synergy influence.

Stage 5: Further Synergy Breakdown & More Voluntary Control

Goal: Refine movement, increase independence.

  • Isolated Joint Control:

    • Finger Opposition: Touching thumb to each fingertip.

    • Ankle Dorsiflexion: Lifting toes while keeping the knee straight.

  • Functional Tasks:

    • Turning a doorknob, holding a cup, stepping over obstacles.

  • Bilateral Activities:

    • Clapping hands, carrying a tray (to improve coordination).

For Recovery suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice every day, each time 1.5 hrs 
ii. Practice 3 - 5 months recover to another level. 


Stage 6: Minimal Spasticity & Near-Normal Coordination

Goal: Improve fine motor skills, speed, and endurance.

  • Precision Tasks:

    • Buttoning a shirt, writing, using utensils.

  • Dynamic Balance:

    • Walking on uneven surfaces, tandem stance.

  • Resistance Training:

    • Light weights or resistance bands for strengthening.

Patient can do normal dialy jobs. 

For Recovery suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice every day, each time 1.5 hrs 
ii. Practice 1 - 2 months recover to another level. 


Stage 7: Normal Motor Function

Goal: Maintain gains, prevent compensatory habits.

  • High-Level Activities:

    • Sports, dancing, jogging.

  • Fine Motor Challenges:

    • Playing an instrument, typing, threading a needle.

Patient almost recover. 

For Practice suggestion (Mobilexo Arm - Pro Version) with Tharapist's instructions: 
i.  Practice 1-3 times a week , each time 1.5 hrs. 

Additional Techniques Used with Brunnstrom’s Approach

  • PNF (Proprioceptive Neuromuscular Facilitation): Diagonal movement patterns to reinforce coordination.

  • Mirror Therapy: For early-stage patients to stimulate motor imagery.

  • EMG Biofeedback: Helps patients activate weak muscles.

  • Constraint-Induced Movement Therapy (CIMT): For Stages 4+ to force use of the affected limb.

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