Cerebellum Flashcards
2 types of examination for cerebellum
Equilibrium
Non-equilibrium (test this first)
which movements do pts c cerebellar problems usually find hard to do
fast movements
things to test for in non-equilibrium
1 UE
1 LE
1 Equilibrium
Finger to nose
Pt’s shoulder is abducted to 90º and is asked to bring tip of index finger to tip of their nose
Finger-to-Therapist’s finger
PT and pt sit opposite each other; pt is asked to touch PT’s index finger with their index finger
Finger to finger (huii)
Both shoulders abducted to 90º; pt is asked to bring both hands to midline and approximate both index fingers
Alternate nose-to-finger
Pt alternately touches his nose and the PT’s finger
Finger opposition
Pt touches the tip of the thumb to the tip of each finger in sequence
Mass grasp
Alternation is made between opening and closing fist
Pronation/Supination
Elbow flexed to 90º and held close to the body, pt alternately pronates/supinates (also in shoulder flexed to 90º c elbows extended)
Rebound test
Pt positioned in 90º elbow flex; PT applies sufficient resistance to produce isometrics of biceps then resistance is suddenly released
Tapping (hand)
Elbow flexed and FA pronated, pt is asked to tap the hand on the knee
Tapping (foot)
Pt is asked to tap the ball of one foot on the floor s raising the knee; heel maintains contact c the floor
Pointing and past pointing
PT and pt sit opposite each other; both PT and pt’s shoulders flexed to 90º c elbows extended; pt is asked to fully flex the shoulder and return to a horizontal position such that index fingers will again approximate
Alternate heel-to-knee; heel-to-toe
Supine: pt is asked to touch the knee and big toe alternately c the heel of opposite extremity
Toe-to-examiner’s finger
Supine: pt is instructed to touch the great toe to the examiner’s finger
Heel on shin
Supine: heel of one foot is slid up and down the shin of the opposite LE
Drawing a circle
Pt draws an imaginary circle in the air with either UE or LE
Fixation or opposition holding
UE: pt holds arms horizontally in front (sitting or standing)
LE: pt is asked to hold the knee in an extended position (sitting)
Non-Equilibrium Testing Grade: 4
Normal Performance
Non-Equilibrium Testing Grade: 3
Minimal Impairment: able to accomplish activity, slightly less than normal control, speed, and steadiness
Non-Equilibrium Testing Grade: 2
Moderate Impairment: able to accomplish activity; movements are slow, awkward, and unsteady
Non-Equilibrium Testing Grade: 1
Severe Impairment: able to only initiate activity s completion; movements are slow c significant unsteadiness, oscillation and/or extraneous movements
Non-Equilibrium Testing Grade: 0
Activity impossible
Equilibrium Coordination Testing Grade: 4
Normal
static: able to maintain steady balance s handhold support
dynamic: accepts maximal challenge and can weight shift easily within full range in all directions
Equilibrium Coordination Testing Grade: 3
Good
static: able to maintain balance s handhold/external support, limited postural sway
dynamic: accepts moderate challenge; able to maintain balance while picking object off floor
Equilibrium Coordination Testing Grade: 2
Fair
static: able to maintain balance c handheld support; may require occasional minimal assistance – no external support
dynamic: accepts minimal challenge; able to maintain balance while turning head/trunk s any support
Equilibrium Coordination Testing Grade: 1
Poor
static: requires handheld support and moderate to maximal assistance to maintain position – requires external support and PT’s support
dynamic: unable to accept challenge or move s loss of balance
Equilibrium Coordination Testing Grade: 0
Absent
unable to maintain balance
