CVA Synergy Patterns

What are synergy patterns after a CVA?

• Stereotyped movement patterns following CNS damage

• Higher brain centers lose normal control

• Lower/middle centers produce uncontrolled mass movement patterns

• Patient has difficulty performing isolated voluntary movements

What is the UPPER EXTREMITY flexor synergy pattern?

• Scapula → elevation + retraction

• Shoulder → abduction + lateral rotation

• Elbow → flexion

• Forearm → supination

• Wrist → flexion

• Fingers → flexion + adduction

• Thumb → flexion + adduction

What is the UPPER EXTREMITY extensor synergy pattern?

• Scapula → depression + protraction

• Shoulder → adduction + medial rotation

• Elbow → extension

• Forearm → pronation

• Wrist → extension

• Fingers → flexion + adduction

• Thumb → flexion + adduction

What is the LOWER EXTREMITY flexor synergy pattern?

• Hip → abduction + lateral rotation

• Knee → flexion

• Ankle → dorsiflexion + supination

• Toes → extension

What is the LOWER EXTREMITY extensor synergy pattern?

• Hip → extension + adduction + medial rotation

• Knee → extension

• Ankle → plantarflexion + inversion

• Toes → flexion + adduction

What is an easy way to remember UE flexor vs extensor synergy?

• Flexor synergy = arm comes UP and IN

  • Elbow flexion

  • Forearm supination

• Extensor synergy = arm pushes DOWN and OUT

  • Elbow extension

  • Forearm pronation