Motor Screen Flashcards
what is motor screen?
*To assess strength, active ROM, and passive ROM, tone, activation/sequencing
*Also included in MSK screen for ROM, end feel, muscle length, power, endurance
*Help determine if motor deficits are neurological (tone, paresis) or MSK (past or presents injury)
*May require additional positioning to fully assess (gravity eliminated)
*May also need to be done in a functional movement pattern
*Limitations to testing may be secondary to cognitive/attention/communication deficits
what is the primary motor cortex
*has the largest concentration of corticospinal neurons
-Anterior to the central sulcus and controls CONTRALATERAL VOLUNTARY movements
Requires stimuli of low response to elicit a motor response
Supplementary (SMA) and Premotor area (PMA)
Anterior to the primary motor cortex
Requires a higher intensity stimuli for motor response
SMA
-Axons that directly innervate motor units involved in initiation of movement
-Timing
-Sequential tasks
-Action monitoring
PMA
Innervates motor units that control trunk and proximal limb movements
Plan and prepare the body for movement
with the motor system
*Motor cortex receives information from the somatosensory cortex, the cerebellum, and basal ganglia
-Somatosensory information is relayed directly to the primary motor cortex from the thalamus
-Thalamus also relays information to the cerebellum and basal ganglia which allow integration and appropriate course of action
the motor system also has
*The cerebellum regulates movement, postural control, and muscle tone.
-Error correcting
-Compares the command for the intended movement transmitted to the motor cortex with the actual movement of the body
-If input from the feedback system does not compare appropriately, the cerebellum gives a counteractive influence.
-Cerebellum sends signals to the cortex to modify the movement
The motor system consist of asal ganglia which is ?
-Located in the cerebral cortex
-Main nuclei Caudate nucleus, putamen, globus pallidus
-Subthalamic nucleus and substantia nigra are subcortical but part of basal ganglia
Maintains normal background muscle tone
-Initiation and regulation of intentional movement, planning and executing motor responses, facilitation of desired responses while inhibiting others, accomplish automatic movements and postural adjustments
what is strength?
-ability to generate sufficient tension in a muscle for posture and movement
Results from musculoskeletal properties of the muscle and the neural activation
what is weakness
*inability to generate normal levels of force
Very common impairment in those with upper motor neuron lesions
what is paresis
*decreased voluntary motor unit recruitment
Difficulty recruiting motor units to generate movement
what is Paralysis
absence of muscle recruitment and inability to generate movement
what is muscle grades
0: no contraction
1: visible muscle twitch but no movement of the joint
2: weak contraction and unable to overcome gravity
3: weak but able to overcome gravity but not able to take additional resistance
4: weak but able to overcome gravity and some resistance but not full
5: Able to overcome gravity and full resistance
what is the process of strength testing
*Stabilize the trunk by testing in supine or sitting with back support
*Ask the patient to move the limb through ROM against gravity
-Observe for the quality of movement or any compensations (synergy)
*If patient cannot perform this against gravity, have them move to a gravity eliminated position
*You may also need to assist them in AAROM
*Graded same as in MSK
*Good evidence for progressive resistance training in stroke patient to improve strength.
what is tone?
Muscle tone: muscle’s resistance to passive stretch, caused by output from alpha and gamma motor neurons
