Hypotonicity/Atrophy

Question 1

Hypotonicity

Answer 1

abnormally decreased or deficient muscle tone

Question 2

Muscle Atrophy

Answer 2

decrease in size of muscle cells causing severe degree of hypotonicity and wasting of muscle tissue

Question 3

True Atrophy

Answer 3

loss of function due to denervation of muscle tissue through disease process or trauma

Question 4

Disuse Atrophy

Answer 4

occurs secondary to any primary lesion causing immobility or due to lack of exercising the part

Question 5

Causes of Atrophy

Answer 5

• may result from necrosis & resorption of both contractile & nervous tissue cells, pressure from muscle tightness or appliances, ischemia, malnutrition, or decreased activity
• loss of function and/or immobility due to pathology or trauma
• due to an inflammatory process
• true atrophy can be a loss of function due to denervation of muscle tissue or degeneration of muscle tissue itself

Question 6

Disuse Palpation

Answer 6

• some degree of hypotonicity
• feel flabby, spongy
• may be fibrocystic nodules or adhesions

Question 7

True Palpation

Answer 7

• extreme flaccidity, fibrous material will increase with length or time pathology has existed
• tissue may be cool & may feel boggy
• may or may not be contractures present
• hypertonicity, trigger points & possible spasm in compensatory mm groups

Question 8

Muscle Testing Disuse vs. True Atrophy

Answer 8

Disuse = weak and painless
True = weak/trace or nonexistent and painless

Question 9

Contraindications for True Atrophy

Answer 9

• deep work or any work which stretches the tissue, tapotement (except pincement/tapping)
• protective neurological functions are lost, and their is a risk of damaging tissues
• extremes of temperature
• passive forced stretch

Question 10

Contraindications for Disuse Atrophy

Answer 10

deep work

Question 11

Hydrotherapy for Atrophy

Answer 11

• Contrast applications to increase circulation (venous return)
• tissue health (warm/cool only)
• brief cold (ice stroking)

Question 12

Treatment for Atrophy

Answer 12

General Massage:
- massage over non-atrophied or non-hypotonic tissues to address compensations, mm tension, TP’s, fascial restriction, etc.

Question 13

Remedial Exercise for Hypotonicity & Disuse Atrophy

Answer 13

• active exercise is the most important modality in tx
• need to progress slowly (optimal loading)
• aims are to increase tone and strength
• can use active assisted (AA), active free (AF), active resisted (AR), or passive relaxed (PR)

Question 14

Remedial Exercise for True Atrophy

Answer 14

• passive mvmt to prevent contractures - no stretching
• as innervation is regained, use a slow exercise progression to avoid overworking tissues, beginning w/ AAROM