Movement Pattern Coordination Deficits

Question 1

Tests and signs

Answer 1

STS: altered sequence of movement components during execution (usually insufficient DF of leg over foot)
P sway at ankle and may step at termination
Performance improves with practice and instruction
Unlikely to require significant physical assistance

Gait: variable foot placement or line of progression or may be guarded with slow, small steps
Improves with practice and instruction
Assistance for balance

Reach and grasp: slowed or awkward
Difficulty adjusting grip during transport of objects
Difficulty controlling force relative to task demands
Improves with repetition, during performance of sub scale tasks, and with instruction and practice

Postural control: increased latency in postural movement patterns
Inappropriate amplitude of postural adjustments or responses
Increased P sway during stance activities
Performance improves with practice

Question 2

Associated signs: movement

Answer 2

Generally fractionated movement against gravity t/o

Question 3

Associated signs: muscle tone

Answer 3

Normal or mild hyperexcitability or rigidity

Question 4

Associated signs: sensation

Answer 4

Normal or no more than mild loss of joint position sense at great toe or ankle
Normal to no more than mild loss of sharp/dull sensation or numbness in UE

Question 5

Associated signs: nonequilibrium coordination:

Answer 5

Normal to mild (to moderate) ataxia with reciprocal and synergistic movement
Normal or mild ataxia with tests of accuracy

Question 6

Differential movement dx:

Answer 6

Force production deficit
Sensory selection and weighting deficit
Sensory detection deficit

Question 7

Expected outcome:

Answer 7

Stable with standing ADLs
I ambulation in home and community (in familiar environments
Ambulate w/o AD, or with cane at most; may need AFO, but unlikely
Ascend/descend stairs reciprocally
Gait speed at least 75% of normal for age

Question 8

Associated medical dx:

Answer 8

CVA (mild)
MS (remitting)
PD (mild)
Generalized debilitation
Multisensory gait and balance disturbance
S/p LE surgery 
BPPV w/ postural instability

Question 9

What does it mean?

Answer 9

Inability to coordinate intersegmental task 2/2 deficit in timing and sequencing of one segment r/t to another

Question 10

When is movement dysfunction typically observed?

Answer 10

In LE during postural control tasks

In UE during in-hand object manipulation and grasp and release, coupled w/ reaching

Question 11

Does motor performance improve with practice and instruction?

Answer 11

Yes

Question 12

Is movement fractionated?

Answer 12

Yes

Question 13

Is there spasticity?

Answer 13

Not usually - muscle tone usually normal or slightly hypertonic