Evaluation of Motor Systems Flashcards
what is Brunnstrom stage 1?
flaccidity
what is Brunnstrom stage 2?
in synergy
some spasticity
what is Brunnstrom stage 3?
marked spasticity
what is Brunnstrom stage 4?
out of synergy
less spasticity
what is Brunnstrom stage 5?
selective control of movement (fractionated movt)
isolated/coordinated
what is Brunnstrom stage 6?
isolated/coordinated movt (fractionated movt)
what is the goal of the motor screen and examination?
to determine WHERE in the process of recovery a PwStroke may be
what three things are included in the motor screen and exam?
1) muscle tone
2) muscle activation
3) muscle strength
what is the muscle tone portion of the motor screening and exam for?
testing for hypotonicity, clinical hypertonicity, spasticity, or rigidity
what is the difference bw rigidity, spasticity, and clinical hypertonicity?
rigidity-velocity independent hypertonicity generally effects both agonist and antagonist; BG pathology
spasticity-velocity dependent hypertonicity; either antagonist or agonist more effected
clinical hypertonicity-stress/effort of movt makes underlying spasticity worse but is not coming from the brain, coming from inefficient movt
what is clinical hypertonicity?
stress/effort of movt makes underlying spasticity worse
not coming from the brain, coming from inefficient movt
what is involved in the the muscle activation portion of the motor screening and exam?
testing for isolated or fractionated irritation of movt, muscles sequencing, timing, or firing
what is involved in the muscle strength portion of the motor screening and exam?
testing for paralysis or weakness on the uninvolved side or on the involved side in the presence of good activation
what are the scales for muscle tone?
mAS
Tardieu
t/f: mAS and Tardieu are used on all pts post stroke
true
are DTRs always tested post stroke?
no, but sometimes
t/f: clonus should always be performed on pts with a stroke
TRUE
why is clonus always tested post stroke?
bc it effects gait when transferring weight onto the ball of the foot during ambulation
are the Babinski and Hoffman reflexes tested post stroke?
NOPE
why aren’t the Babinski and Hoffman reflexes tested post-stroke?
bc they are testing for UMN involvement, but we already know there is UMN involvement post stroke
if reflexes are bw 2-4, what brunnstrom level are they likely in?
Brunnstrom 3
if reflexes are 0, what Brunnstrom level are they likely in?
Brunnstrom 1
if reflexes are bw 1 and 1+, what Brunnstrom level are they likely in?
Brunnstrom 2 (a significant % of pts are here)
what is the Tardieu test?
test for tone
measure goni angle where resistance starts b4 and after intervention
what are 4+ reflexes?
very brisk, hyperactive w/clonus
what are 3+ reflexes?
brisker than average, slightly hyperreflexive
what are 2+ reflexes?
average, expected response, normal
what are 1+ reflexes?
somewhat diminished
what are 0 reflexes?
no response, absent
t/f: DTRs post stroke are NOT an assessment of nerve roots, but of the state of alpha motor neuron pools to determine the degree of underlying hypertonicity
true
what are synkinesias?
involuntary movt accompanying coughing or yawning