Fractionated Movement Deficit Flashcards
What does it mean?
Inability to fractionated (isolate) movement associated w/ moderate or greater hyperexcitability; may be in UE, LE, or both
With what is it ALWAYS associated?
Central neurological deficit
Presentation?
Weak outside of synergy pattern
What do they want to take advantage r/t strength to completing functional activities?
Moving within they synergy pattern
Key tests and signs: movement
Unable to fractionated movement
Variability in ability to move against gravity
Slow; unable to make rapid reversals in movement
Unable to generate force rapidly
Key tests and signs: muscle tone
Moderate or greater hyperexcitability
Associated signs: STS and transfers
Stiffness of involved limbs; slow
No dissociation of movement at one joint from movement at another joint
May see associated reactions w/ increased effort
In forms w/ less antigravity movement, unable to stand
Associated signs: gait
Compensatory movement strategy of hip hiking, vaulting, or circumduction to initiate swing of involved extremities
Stiffness of hip or knee flexion during swing
Hip and knee often flexed during stance of involved extremities
May require AFO
Likely to require AD at least in early course
In forms w/ less antigravity movement, unable to stand
Associated signs: reach and grasp
Able to reach in very limited range (< 60 deg - 90 deg)
Hand closure w/ minimal relaxation or minimal opening
Associated signs: postural control
In forms w/ more antigravity movement, able to sit unsupported early in course but asymmetrically
Stability may improve w/ practice, but symmetry will not improve w/ practice
Differential movement dx:
Force production deficit
Expected outcome
R/t degree of antigravity movement
In forms w/ more antigravity movement, ambulation in home and community w/ significant deviations and significant reduction in speed w/ or w/o a cane; ascend and descend stairs foot over foot w/ or w/o railing
In forms w/ 4-limb involvement, WC for locomotion (most likely power or being pushed by someone)
In all but forms w/ 4-limb involvement, stable w/ sitting and reaching tasks
Able to use UE as “assist” w/ ADLs
Associated medical dx:
CVA TBI SCI MS CP
If MCA…
UE > LE
How do they move?
In massed patterns bc stiff and slow
