Clinical Implications of Motor Disorders Overview

Question 1

what is distribution?

Answer 1

where in the body and how much of the body is involved

Question 2

what is degree/severity?

Answer 2

how significant/how much does it impact function

Question 3

what are the distributions of movement disorders?

Answer 3

• quadriplegia/tetraplegia
• diplegia
• hemiplegia
• monoplegia
• paraplegia
• isolated paralysis of one or muscle groups
• non-paralytic disorders of movement
• psychogenic causes
• muscle paralysis without visible changes in motor neurons/roots/nerves

Question 4

what are subjective qualifiers of muscle tone?

Answer 4

narrative descriptors of mild/moderate/severe

Question 5

what are some objective muscle tone grading scales?

Answer 5

• modified ashworth
• tardieu
• wilson-howe assessment of motor tone

Question 6

what are body structures/function integrities and impairments?

Answer 6

• spasticity
• rigidity
• hypotonia/atonia
• dyskinetic (dystonia/torsion spasm, athetosis, chorea)
• ataxia
  -apraxia

Question 7

what are the involved structures for spasticity?

Answer 7

motor cortex or shite matter projections to/from corticosensorimotor areas of the brain, pyramidal system, corticospinal tracts

Question 8

what are the common characteristics of spasticity?

Answer 8

• increased muscle tone of muscle groups (hypertonicity)
• increased tension when lengthened
  – spastic catch/clasp-knife response
• firm/tense on palpation, increased DTR/MSR
• increased incrementally with rate/velocity and position change
• clonus

Question 9

what are some other aspects of spasticity?

Answer 9

• decreased PROM with atypical firm end feel
• distribution more flexors or extensors and usually asymmetrical
• increased co-contraction/decreased reciprocal inhibition
• persistence of primitive reflexes
• disuse atrophy
• degree depends on amount of neural damage, general health, excitability, strength of stimulus