Chp 7 Examination and Coordination Flashcards
So how do we define Coordination Impairments
Ueven, unaccurate, arkward or extraneous
So why does a Coordination test help therapists
Diagnosing underlying origin of impairment
Noting functional limitations that are related to a type, extent and location of some CNS pathologies
Purpose of performing Coordination Assessments
Determine muscle activity during voluntary movements
Assess muscles ability to perform a task
Determine skill and efficiency level
Identify ability to initiate, control, and terminate movements
Determine timing, sequencing, accuracy
Assist with diagnosis of impairment, FL, disability
Establish goals to remediate impairment, formulating outcomes to remediate FL & disabilities,
direct interventions
Determine effects of therapeutic & pharmacological interventions on function over time
Assist with determining a prognosis
Specific Coordination Deficits &Central Nervous System Involvement of CEREBELLUM
Primary function is regulation of movements, postural control, and muscle tone
Lesions produce typical patterns of motor function deficits, impaired balance, and decreased muscle tone
Functions as a comparator & error correcting mechanism
Describe an open loop movement and give an example
Stereotypical movements (gait)
Rapid, short duration movements
Those not allowing for FB to occur
Control originates centrally from a motor program
Motor program is in memory or a preprogrammed pattern of information for coordinated movement
Clinical features of Cerebellar Pathology/Dysfunction
Ataxia- comprehensive term (CD & sensory dysfunction) Hypotonia Dysmetria Dysdiadochokinesia Tremor Movement decomposition Disorders of gait Dysarthria Nystagmus Rebound phenomenon asthenia
Characteristics of Hypotonia
Decrease in muscle tone
Diminished resistance to passive movement
Muscles feel soft & flaccid
Diminished deep tendon reflexes may be noted
Charateristics of Dysmetria
Disturbance in judging distance or range of movements
Hypermetria (overestimation of range needed)
Hyometria (underestimation)
Dysdiadochokinesia
Impaired ability to perform rapid alternating movements (RAM)
Rapid loss of range & rhythm (especially as speed increases)
Tremors what are the 2 types
Involuntary oscillatory movement resulting from alternate contractions of opposing muscle groups
Postural/static tremor-
Back & forth oscillatory body movements during standing
Up/down oscillatory limb movement when held against gravity
Titubation= head oscillations
Intention/kinetic tremor-
occurs during voluntary motion of a limb
increases upon reaching intended goal
when speed is increased
Diminished or absent at rest
Movement decomposition (dyssynergia) just think like robotic movement
Performance of a movement in sequence of parts rather than smooth, single activity
Asynergia- loss of ability to associate muscles together for complex movements
Disorders of gait
Broad base of support
High guard arm position
LE initiation starts slowly
Unexpected rapid flinging towards the floor with forceful audible sound
Unsteady, irregular, staggering gait with deviations from forward line of progression
Whats a rebound and no I am not talking about the rebound you are thinking of.
Loss of check reflex/factor which halts forceful active movements
Asthenia is???????
Loss of check reflex/factor which halts forceful active movements
Increased time required to initiate voluntary movements
Difficulty in stopping or changing force, speed, or direction
Basal Ganglia Pathology name somethings that go wrong and where it is happens think SN
Nuclei group- Caudate, Putamen, Globus Pallidas, sub cortical-subthalamic nucleus, substantia nigra
Initiation and regulation of gross intentional movements
Planning & execution of complex motor responses
Facilitation of desired motor responses/inhibitions of others
Automatic movements
Postural adjustments
Maintaining normal muscle background tone (inhibit motor cortex & lower brainstem)
Influences perceptual & cognitive functions
