Saturday, January 16, 2016

Caregiver: Brunnstrom's Stages of Stroke & Other Things the Doctors Don't Tell You

The Pink House On The Corner
Sunday, April 3, 2011

I recently picked up a book called Stronger After Stroke by Peter Levine. The author is a researcher in the field of "neuromotor recovery" and I am amazed at the stuff in this book that was never explained to me by any of the doctors that treated Bob. One of those things is Brunnstrom's Six Stages of stroke recovery and just to know this and know that every stroke survivor goes through these stages is so enlightening that I thought I'd share it with you. I mean, this something everyone should know! Here they are:

Stage 1: Immediately after a stroke. The whole "bad" side of the body is limp. Everything including torso, face, mouth and tongue, arm and leg are limp.

Stage 2: Spasticity (muscle tightness) creeps in. This is a good thing! (I was under the impression it was bad, at least that's how the doctors acted...) Spasticity means that "messages" are getting through to the affected side from the nervous system. Involuntary movements are seen in this stage (one doctor in the ICU told me that Bob's involuntary movements were "posturing" and it meant he was close to death!!!!)

Stage 3: Spasticity gets stronger, even severe, however, the patient begins to control his movements. Movements in this stage are "synergistic movements" meaning that if the person attempts to move his foot, the whole leg moves with it.

Stage 4: Spasticity begins to decline. Movements outside of synergy begin to appear.

Stage 5: Spasticity continues to decline. Synergy continues to decline. Patient is moving better.

Stage 6: Individual joint movements become possible and coordination approaches normal. Total recovery is possible in this stage.

Well, how about them apples? It's so good to know what Bob is going through is "normal". Now I see, his right leg is in Stage 4, though his right arm is still at Stage 2. The book also goes on to say that movements begin at "the top" (example: at the shoulder and move down the arm) and that typically the leg improves before the arm and the hand is always the last thing to improve. Well! Why didn't anyone tell me this stuff? And it's not for the lack of me asking questions. Believe me, I've been peppering everyone with questions and the only answers I'm getting are "everyone is different" or "it's going to take a long time" or (one doctor) "he'll never walk again, don't get your hopes up".

Just knowing about these stages has brought me a tremendous amount of relief: the knowing that Bob's recovery process is "normal". That every stroke survivor goes through these exact stages, in order. (Of course, not everyone makes it all the way to Stage 6, that's where hard work and prayer come in to play.)  I think this is something everyone should know and I wish I had known it five months ago. I hope by sharing it here, it might help someone someday.

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