Brunnstrom Stages of Recovery

Authors

Affiliations

Nate Yomogida, PT, DPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, PT, DPT

Doctor of Physical Therapy

B.A. in Neuroscience

Table 1: Sequential Motor Recovery Stages Following Stroke¹

Stage	Hallmark	Description
1	Flaccidity	No voluntary movement, muscle tone is absent
2	Spasticity begins	Appearance of basic limb synergies as associated reactions, minimal voluntary movement, spasticity begins
3	Spasticity Increases	Voluntary control of synergy patterns, spasticity may become severe
4	Spasticity declines	Some movement outside of synergy patterns emerges
5	More complex movements	Synergies lose dominance, more voluntary movement control
6	Isolated movement	Spasticity disappears, coordination and movement return toward normal (not all patients reach this stage)
7	Normal movement	Normal motor function is restored

References

1.

Fulk GD, Chui KK, eds. O’Sullivan and Schmitz’s Physical Rehabilitation. 8th ed. F. A. Davis Company; 2024.