coordination

Question 1

cerebellum

Answer 1

**Role in movement control: **
— Timing, coordination & integration of
movements (including eye movement and
speech)
— Motor learning (adapts to requirements
of task)
.
* Cerebellar dysfunction ATAXIA
* Functional difficulties with UL and LL
movement, oculo-motor control, balance
and walking

Question 2

Ataxia Common presenting features:

Answer 2

• Postural unsteadiness
• Jerky or clumsy movements of trunk / limbs
• Low tone, especially proximally
  May have increased tone distally to gain some stability
• Tremor (intention tremors- increased tremors when trying to do a task)
• Gait abnormalities: wide based, staggering, high stepping
• May compensate to create stability e.g. hip flexion, increased points of contact,
  use of walking aids
• Dysarthria
• Visual changes (nystagmus)

Question 3

Ataxia - specific clinical signs

Answer 3

• Dysmetria – inaccurate (undershoot or overshoot) amplitude of movement of intended limb at end-position
• Dyssynergia – decomposition of movement, loss of smooth performance of multi-joint movements and lack of coordination between agonist and antagonist
• Dysdiadochokinesis - Inability to perform rapidly alternating movements of force or rhythm
• Tremor – movement oscillations due to lack of coordination between agonist and antagonist
  Intention tremor – exaggerated with movement
  Resting tremor – seen at rest, reduces with movement

Question 4

coordination/ cerebellar function tests

Answer 4

• Finger-to-nose test - Dysmetria / tremor
  Instruct patient to touch therapists finger and then their nose rapidly
• Heel shin test - Dyssynergia / tremor
  Patient lies supine, instruct patient to draw the heel of the limb to be tested
  down anterior edge of shin (along tibia)
• Rapid alternating movements - Dysdiadochokinesis
  Instruct patient to alternately tap back and palm of hand on thigh or heel to
  toe taps
  .
  n.b. Patients may also have difficulty functionally with:
  — bridging unless knees are braced or arms against bed (fixing)
  — Rolling knees / single knee fall out ex
  29

Question 5

Scale for the assessment & rating of Ataxia

Answer 5

SARA