Impairment: Weakness And Abnormal Tone Flashcards
Motor Components: Impairment factors
- Strength
- Muscle Performance
- Muscle Endurance
- Muscle Weakness
- Paralysis/Plegia/Paresis
- Atrophy
Strength
Muscle force or group of muscle force to overcome resistance
Muscle Performance
Capacity of a muscle or group of muscles to generate force
Muscle Endurance
Ability to sustain force
Muscle Weakness
Inability to generate normal levels of force
Paralysis/Plegia
Absence of strength
Paresis
Mild or atrial weakness
Paralysis/plegia/paresis
Decreased voluntary motor unit recruitment
Atrophy
Loss of muscle bulk
Muscle Weakness (paresis) overview:
- musculoskeletal and/or NM problems
- primary cause of “FUNCTIONAL LIMITATIONS”
Assessing Functional Limitations: (list)
- Rolling. - Supine-to-sit
- Stable sitting. - Sit-to-stand
- Stable standing. - Transfers
- Ambulation. - Climbing stairs
Assessing Weakness: (list)
- AROM. - MMT
- Functional mm testing. - Hand-held dynamometer
- Isokinetic dynamometer. - EMG
- Endurance/fatigue. - UMNL vs LMNL
- Cranial N. testing
Task-Oriented: Treatment of Muscle Weakness
- REPETITION, REPETITION, REPETITION
Abnormal Muscle Tone: TONE definition
Tension attained at any moment between the origin and insertion of a muscle
Normal Tone:
A certain amount of muscle tone is “typical” especially w/ postural control
Abnormal Tone:
- Hypertonia: increased resistance w/ PROM when person is relaxed
- Hypotonia: low, flaccid
- Dystonia: impaired, involuntary repetitive twisting
Hypertonia types: (list)
- Spasticity
- Clonus
- Babinski Sign
- Rigidity
- Decerebrate
- Decorticate
Spasticity Post-Stroke:
- Appears UNRELATED to functional disability and contribution to motor disability may be slight
Assessing Impairment: ABNORMAL TONE
- Modified Ashworth
Typical Resting Postures for an UMNL (UE)
UE
- Scapula: retracted, down rot
- Shoulder: Add/IR/depression
- Elbow: Flexion
- Forearm: Pron
- Wrist: Flexed/ADD
- Hand: flexed/ add
Typical Resting Postures for a UMNL: (LE)
- Pelvis: retracted (hip hike)
- Hip: add/IR/ext
- Knee: ext
- Ankle: PF/Inversion, flexed toes
- Trunk: Lat Flex/ rotation
Modified Ashworth Scale:
0: none
1: catch at end range
1+: <50%
2: Easily moved but throughout most ROM
3: PROM difficult
4: rigid
Tardieu Scale: definition
- patient supine
- measurements take place at 3 velocities
- V1: slow as possible
- V2: speed of gravity
- V3: fast as possible - Identifies SPASTICITY vs. STIFFNESS
Tardieu Scale: Scale
- X (0-5)
- Y (angle which reaction occurs)
0: normal
1: slight resistance no clear point
2: clear catch
3: fatigable clonus <10 sec
4: Unfatigable clonus >10 sec
5: immovable
Abnormal MOVEMENT synergy patterns: FLEXION UE
- Scapular: retraction OR elevation/hyperextension
- Shoulder: ABD, ER
- Elbow: FLEXION
- supination
- wrist/finger: flexion
Flexion pattern: LE
HIP: FLEXION, ABD, ER
Knee: flex
Ankle: DF, inv
Toe: flex
Extension: UE
Scapular: protraction
Shoulder: ADDUCTION, IR
Elbow: ext
Wrist: PRONATION, flexion
Extension: LE
Hip: ext, ADDUCTION, IR
Knee: EXTENSION
Ankle: PLANTAR FLEXION, inversion
Toe: PF
Bronnstrom’s Stages:
- 1: flaccidity, no movement can be elicited
- 2: basic limb synergies can appear
- 3: voluntary control of movement synergies
- 4: some movement out of synergy patterns
- 5: progression to more difficult movement patterns
- 6: individual movements become possible
- 7: NORMAL
STNR: (symmetrical tonic neck reflex)
- neck flexed = arms flex / legs extend
- neck extend: = arms extend / legs flex
ATNR: (asymmetrical tonic neck reflex)
- neck rotates to one side = jaw limbs extend and skull limbs flex
TLR or STLR: (symmetrical tonic labyrinthine reflex)
- prone = total flexion
- supine = total extension
