Are synergy patterns only seen in stroke? Can they be seen in PT post TBI?

Yes, synergy patterns can – and do – appear in patients with TBI. According to the article in the American Academy of Orthotists and Prosthetists, the extent of the brain injury will determine whether the patient presents as hemiplegic, diplegic, or quadriplegic. Although the degree of involvement may vary among each case, numerous common characteristics can be observed.

Upon initial evaluation, each affected limb should be examined to determine the flexor or extensor synergy patterns.

A recently injured patient can present as flaccid and later develop a synergy pattern or remain flaccid. According to Brunnstrom, synergy occurs when muscles are firmly linked together and the patient is unable to master individual joint movements. These limb synergies can emerge as either reflexive, voluntary, or both.

A reflexive pattern can be defined as an involuntary evoked response to a physical agent, such as stretch, touch, or vibration.

A voluntary pattern is produced through volitional movement, such as active knee extension. Once the dominant synergy pattern is determined, a visual gait analysis and a standing muscle test should be performed.