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1. Bangladesh Health Professions Institute
Department of Occupational Therapy
Masters of Science in Occupational Therapy
Occupational Therapy in Adult Neurology
The Brunnstrom Approach, also known as the Brunnstrom Movement Therapy, is a widely used
therapeutic approach in rehabilitation that focuses on promoting movement recovery and functional
improvement in individuals who have experienced a stroke or other neurological impairments. It was
developed by Swedish physical therapist and doctor, Signe Brunnstrom, in the mid-20th century.
Here is a brief overview of the development and history of the Brunnstrom Approach:
1. Background and Early Career:
Signe Brunnstrom was born in 1909 in Sweden. She pursued her education in physical therapy and
medicine and eventually became a licensed physical therapist and physician. Her early work mainly
revolved around orthopedics, but her career took a significant turn when she began treating patients with
neurological impairments, particularly those who had suffered from strokes.
2. Observations during the Polio Epidemic:
During the polio epidemic in the 1950s, Brunnstrom gained valuable insights into the recovery patterns of
individuals with neurological conditions. She observed that patients often progressed through specific
stages of recovery, starting with little to no movement and eventually regaining some degree of voluntary
motor control.
3. Development of the Brunnstrom Approach:
Based on her observations and experiences, Brunnstrom developed a systematic approach to help
individuals with neurological impairments regain motor function and movement. She outlined this
approach in her book titled "Movement Therapy in Hemiplegia: A Neurophysiological Approach," which
was first published in 1966.
The Brunnstrom Approach is built on the concept of the "synergistic movement pattern," where
movements are facilitated through the use of synergies or predictable patterns of muscle activation.
Brunnstrom categorized these synergies into six stages, known as the "stages of recovery," which
individuals with neurological impairments often progress through during rehabilitation.
The six stages are as follows:
- Stage 1: Flaccidity - no voluntary movement
- Stage 2: The beginning of spasticity - minimal voluntary movement, mainly through reflex activity
- Stage 3: Increased spasticity - voluntary movement within synergistic patterns
- Stage 4: Decreased spasticity - voluntary movement out of synergies, but with some spasticity

2. - Stage 5: Further decreased spasticity - more independence from synergies with only slight spasticity
- Stage 6: Near-normal function - voluntary movement with minimal spasticity
The Brunnstrom Approach emphasizes the importance of promoting and utilizing the existing synergistic
patterns in the early stages of recovery and gradually facilitating movements out of these patterns to
achieve more functional independence.
4. Influence and Legacy:
The Brunnstrom Approach has had a significant impact on neurological rehabilitation and continues to be
widely practiced by physical therapists and other healthcare professionals worldwide. While the approach
has also faced criticisms, particularly regarding the overemphasis on spasticity, it remains a valuable tool
in the rehabilitation of individuals with neurological impairments.
Overall, Signe Brunnstrom's work has greatly contributed to the understanding of movement recovery in
neurological conditions and has shaped the field of neurorehabilitation, helping countless patients regain
function and improve their quality of life.