Muscle Tone and Movement Assessments

Question 1

Motor control

Answer 1

ability to make dynamic postural adjustments and regulate body and limb movement

Question 2

components of CNS that make motor control possible

Answer 2

cerebral cortex
basal ganglia
cerebellum

Question 3

aspects necessary for motor control

Answer 3

normal postural tone
normal postural mechanisms
normal muscle tone, selective movement
coordination

Question 4

standardized assessments for motor function

Answer 4

Fugl-Meyer

Wolf Motor Function Test

Question 5

parts of CNS/PNS that function to maintain normal tone

Answer 5

cerebellum
motor cortex
basal ganglia
midbrain
vestibular system
spinal cord fxns
neuromuscular system
normal functioning stretch reflex

Question 6

characteristics of normal tone

Answer 6

• effective coactivation (stabilization at axial and proximal joints)
• ability to move against gravity and resistance
• ability to maintain postition of the limb if it is placed passively by the examiner and then released
• balanced tone between agonist and antagonist muscles
• ease of ability to shift from stability to mobility and vice versa as needed
• ability to use muscles in groups or selectively if necessary
• resilience or slight resistance in response to passive movement

Question 7

3 ways abnormal tone is usually described as

Answer 7

1. flaccid
2. hypertonic
3. rigid

Question 8

how to evaluate UE muscle tone

Answer 8

1. record test position of pt (should be sitting if possible)
2. grasp limb proximal and distal to joint being tested
3. move joint slowly through its range and to determine the free and easy ROM available. (note if limb feels heavy or light, indicating ability of limb to adapt automatically to changes in position against gravity)
4. move limb rapidly through full ROM while patient is relaxed
5. muscle tone is measured clinically by observing response of muscle to passive stretch
6. facilitate maintenance of symmetrical sitting position for testing
7. record findings for muscle groups or movements

Question 9

flaccidity

Answer 9

AKA hypotonicity

• decrease of normal muscle tone
• muscles feel soft and offer no resistance to passive movement
• will feel heavy
• deep tendon reflexes are diminished or absent

Question 10

flaccidity usually a result of

Answer 10

peripheral nerve injury
disruption of the reflex and neuron level
cerebellar disease
frontal lobe damage
temporally seen in the shock phase after CVA or SCI

Question 11

hypertonicity

Answer 11

AKA spasticity

• increased muscle tone
• increased or hyperactive stretch reflex causing an increased resistance to passive stretch

Question 12

hypertonicity usually a result of

Answer 12

premotor cortex
basal ganglia
cerebellum

Question 13

characteristics of hypertonicity

Answer 13

• hyperactive deep tendon reflexes
• clonus (repetitive movement, ie. arm shaking)
• usually occurs in definite patterns of flexion or extension
• patterns of hypertonicity usually occur in the antigravity muscles of the upper and lower extremities

Question 14

rigidity

Answer 14

increase of muscle tone of agonist and antagonist muscles simultaneously
-both groups of muscles contract steadily, resulting in increased resistance to passive movement in any direction and throughout ROM

Question 15

characteristics of rigidity

Answer 15

-feeling of constant resistance occurs throughout ROM when the part is moved passively in any direction
-deep tendon reflexes are normal or only moderately increased
Cogwheel type: rhythmic give in resistance throughout ROM; often noted in Parkinson’s

Question 16

Ashworth Scale

Answer 16

0= normal
1= minimal/mild
1+= mild/moderate
2= moderate
3= severe
4= rigid; no movement
*use words