2. GENERALISED STAGES OF MOTOR
RECOVERY
• STAGE 1
Completely flaccid
no voluntary control
patient confined to bed
• STAGE 2
Basic limb synergy develops
no voluntary movement can be done as
spasticity develops but not marked
3. • STAGE 3
Basic limb synergy develops voluntarily and
develops marked spasticity
• STAGE 4
spasticity begin to reduce
4 movement combination possible and deviate
from basic limb synergies and become available
Eg- hands behind back, pronation and supination
with elbow 90 deg flexed, elevation of hand to
forward horizontal position
4. • STAGE 5
there is relative independence of basic limb
synergies
spasticity waning
eg- abduction flexion pronation supination in
elbow extension
• STAGE 6
isolated joint movements
5. STAGES OF BRUNSTROM FOR LE
• STAGE 1
Flaccidity
• STAGE 2
Spasticity develops with minimal voluntary control
• STAGE 3
Spasticity peaks
Flexion and extension synergy present
Hip knee ankle flexion in sitting and standing
6. • STAGE 4
knee flexion passed 90 degree in sitting with
foot sliding backward on floor
Dorsiflexion with heel on floor and knee flexed
to 90 degrees
• STAGE 5
Knee flexion with hip extended in standing
Ankle dorsiflexion with hip knee extension
7. • STAGE 6
Hip abduction in sitting or standing, internal or
external rotation of hip combined with
inversion or eversion of ankle with sitting
8. STAGES OF BRUNSTROM FOR UE
• STAGE 1
Flaccidity
• STAGE 2
Beginning of development of spasticity
Limb synergies or some of their components begin
to appear or associated reactions
• STAGE 3
Spasticity increases
Synergy patterns or some of their components can
be performed voluntarily
9. • STAGE 4
Spasticity declining
Movement combination deviating from synergies
are possible
• STAGE 5
synergy are no longer dominant
More movement combination deviating from
synergies performed with greater ease
• STAGE 6
Spasticity absent except when performed rapidly
Isolated joint movement are performed with ease
10. STAGES OF BRUNSTROM FOR HAND
• STAGE 1
No movement possible
• STAGE 2
Gross grasp begins
Minimal finger flexion occurs
• STAGE 3
Gross grasp present
Hook grasp possible but with no release
11. • STAGE 4
Gross grasp present
Lateral prehension develops
Small range of finger extension and
Some finger movements possible
• STAGE 5
Palmer prehension
Spherical and cylindrical grasp with release
• STAGE 6
All types of prehensions
Individual finger movement and full voluntary
extension possible
