Signs of progress

Our mood today was like the weather, restless and weary. I am heartened, however, by discovering the seven stages of rehabilitation as described by Brunnstrom.

Brunnstrom separates neurological recovery into seven separate stages based on progression through abnormal tone and spasticity. These seven stages of recovery describe tone, reflex activity, and volitional movement.

1. No volitional movement initiated.
2. The appearance of basic limb synergies. The beginning of spasticity.
3. The synergies are performed voluntarily; spasticity increases.
4. Spasticity begins to decrease. Movement patterns are not dictated solely by limb synergies.
5. A further decrease in spasticity is noted with independence from limb synergy patterns.
6. Isolated joint movements are performed with coordination.
7. Normal motor function is restored.

Jo would seem to be at Stage 3, moving to Stage 4. Before the cranioplasty she was “plateaued” at Stage 2.

This explains why she is finding standing and walking harder than before, even as she can move the limbs more, as spasticity has increased.