2.21 Motor System 4 Flashcards
tools used to measure hypotonia
- EMG recordings
- Ashworth scale
benefit to using EMG to measure hypotonia
to determine which factors are contributing to movement impairment
factors that may contribute to movement impairment
- contracture
- hyperreflexia
- cocontraction
- inappropriate timing of muscle activity
What does the Ashworth scale provide?
a subjective clinical assessment of resistance to passive stretch
UMN lesion types
- spastic CP
- stroke, middle cerebral artery
- SCI
common characteristics of UMN lesions
- paresis
- abn timing of muscle activity
- Babinski’s sign
- myoplasticity
In spasticity, what factors lead to movement dysfunction?
- abnormal supraspinal influences
- failure of normal neuronal selection
- consequent aberrant muscle development
motor disorders in spastic CP include:
- problems with coordination
- abnormal tonic stretch reflexes both at rest and during movement
- reflex irradition
- lack of postural preparation before movement
- abnormal cocontraction of muscles
What does stroke most commonly affect?
middle cerebral artery
two important things affected after stroke
- myoplasticity
- voluntary movement
movement disorders after middle cerebral artery stroke are consequences of
- paresis
- decreased fractionation of movement
- myoplasticity
hyperreflexia and stroke
rarely does hyperreflexia contribute significantly to movement limitations
What tract provides voluntary movement of the paretic limbs following stroke?
reticulospinal tract
complete SCI
all descending neuronal control is lost below the level of the lesion
incomplete SCI
function of some ascending and/or descending fibers is preserved within the spinal cord
After SCI, what produces excessive resistance to muscle stretch?
- excessive stretch reflexes
- muscle contracture
- increased cross-bridge binding
What limits movement in people with SCI?
- hyperreflexia
- contracture
With CP, what is the primary impairment interfering with balance recovery?
paresis of agonist postural muscles
effect on spasticity of LE strengthening in children with spastic CP
has no effect on spasticity
spasticity and LE dysfunction in children with spastic CP
spasticity is not a significant contributor to LE dysfunction in children with spastic CP
improved movement in people after stroke has been demonstrated with:
- hand and finger movements against resistance
- robotic therapy for UE
- constraint-induced movement
- botox injections as an adjunct to therapy
- cycling
- task-oriented gait training
- gait training using treadmill
activity based therapy
rehab that activates the NM system below the level of the lesion in SCI pts
treadmill training with BW support in pts with SCI vs overground walking
NM activation
somatosensory input to spinal cord during treadmill training with BW support elicits neuromuscular activation that does not occur during overground walking
FES
functional electrical stimulation
FES for SCI pts
- provided via implanted or skin surface electrodes
- If FES promotes recovery of NM function, FES can be withdrawn and walking will continue to be possible
- If continued, FES is required for walking and acts as a neuroprosthesis
causes of spasticity
- hyperreflexia
- brainstem UMN overactivity
What do medications do for spasticity?
interfere with UMN mechanisms
What are the common meds used for spasticity?
- baclofen
- tizanadine
- dantrolene
