P10 - Co-ordination 1 (ataxia)

Question 1

What is motor coordination?

Answer 1

Motor coordination, or dexterity, refers to the ability to perform a motor task in an accurate, rapid, and controlled manner.

Question 2

What is proprioception?

Answer 2

Proprioception is the awareness of body position in space, using joint position sense and motion sense to respond to stress and movement.

Question 3

What is balance?

Answer 3

Balance is the ability to maintain an upright posture and transition between postures while resisting the forces exerted by gravity.

Question 3

How is upper extremity motor coordination assessed?

Answer 3

The upper extremity can be assessed using the finger-to-nose test.

Question 4

What test assesses lower extremity motor coordination?

Answer 4

The heel-to-shin test and the Lower Extremity Motor Coordination Test (LEMOCOT)

Question 5

How can functional coordination be assessed?

Answer 5

Functional tasks like throwing and catching, reaching for objects, and picking things up from the floor are used to assess coordination.

Question 6

How does Romberg’s test assess coordination?

Answer 6

Romberg’s test evaluates position sense by testing a person’s ability to balance with feet together and eyes closed.

Question 7

How is kinesthesia assessed?

Answer 7

Kinesthesia is assessed by moving a joint passively at 0.5° to 2° per second until the patient signals limb movement.

Question 7

What is joint position sense?

Answer 7

Joint position sense assesses the static position of joints, such as the thumb, great toe, or whole arm, to determine proprioception.

Question 8

How does Romberg’s test assess proprioception?

Answer 8

In Romberg’s test, a patient stands with feet together, first with eyes open and then with eyes closed, to assess reliance on visual and sensory feedback for balance.

Question 9

What is the Berg Balance Scale used for?

Answer 9

The Berg Balance Scale assesses a person’s ability to balance during various tasks

Question 10

What is the BEST test?

Answer 10

The BEST test evaluates balance across multiple systems, including stability, postural control, and dynamic balance.

Question 11

How is the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) used?

Answer 11

The mCTSIB assesses how well a person can maintain balance under different sensory conditions, like standing with eyes closed or on unstable surfaces.

Question 12

What is the Timed Up and Go (TUAG) test?

Answer 12

The TUAG test measures the time it takes for a person to stand up, walk a short distance, turn, and sit back down to assess functional mobility and balance.

Question 13

What does the 360-degree turn test assess?

Answer 13

The 360-degree turn test assesses dynamic balance by evaluating a person’s ability to complete a full circle while maintaining stability.

Question 14

What does the Functional Reach Test evaluate?

Answer 14

The Functional Reach Test measures how far a person can reach forward while maintaining their balance, indicating limits of stability.

Question 15

What is the HiMAT?

Answer 15

The High-Level Mobility Assessment Tool (HiMAT) assesses high-level balance and mobility tasks, often used in individuals with traumatic brain injury.

Question 16

What causes sensory ataxia?

Answer 16

Sensory ataxia is caused by impaired somatosensory nerves, disrupting sensory feedback and leading to poor body coordination.

Question 17

What are common symptoms of sensory ataxia?

Answer 17

Symptoms include a wide-based, high-stepping gait, uncoordinated multi-joint movements, delayed postural adjustments, and reduced equilibrium reactions.

Question 18

What is vestibular ataxia?

Answer 18

Vestibular ataxia results from damage to the inner ear or brainstem/cerebellum, affecting balance and spatial orientation.

Question 19

What are key symptoms of vestibular ataxia?

Answer 19

Symptoms include staggering, broad-based gait, head tilt, vertigo, nausea, and blurred vision.

Question 20

What is cerebellar ataxia?

Answer 20

Cerebellar ataxia is caused by damage to the cerebellum, resulting in a lack of smooth, coordinated movements due to issues with motor learning and movement timing.

Question 21

What are symptoms of cerebellar ataxia?

Answer 21

Symptoms include dysmetria, decomposition of movement, poor posture, gait incoordination, limb tremors, dysdiadokinesia, and nystagmus.

Question 22

What symptoms occur with damage to the vermis of the cerebellum?

Answer 22

Damage to the vermis can cause gait difficulties, low trunk tone, body sway, trunk tremor, and titubation.

Question 23

What happens with damage to the cerebellar hemispheres?

Answer 23

Damage leads to poor limb coordination, tremors, dysdiadokinesia, nystagmus, dysarthria, and reduced motor learning.

Question 24

What is the SARA ataxia scale?

Answer 24

The Scale for the Assessment and Rating of Ataxia (SARA) evaluates the severity of ataxia symptoms, including gait, speech, and coordination.

Question 25

What does the Romberg’s test assess in cerebellar impairment?

Answer 25

Romberg’s test checks balance and position sense, important for diagnosing cerebellar ataxia.

Question 26

What is the PINARDS mnemonic for cerebellar symptoms?

Answer 26

PINARDS stands for Past pointing, Intention tremor, Nystagmus, Ataxia, Rebound reflexes, Dysdiadokinesia, and Slurred speech, used to remember key cerebellar ataxia signs.

Question 27

What does the DANISH mnemonic represent in cerebellar assessments?

Answer 27

DANISH stands for Dysdiadokokinesia, Ataxia, Nystagmus, Intention tremor, Slurred speech, and Heel-shin positive test, summarizing major cerebellar dysfunctions.

Question 28

What is sensory ataxia?

Answer 28

Sensory ataxia is caused by the impairment of somatosensory nerves, leading to a disruption in sensory feedback, which results in body incoordination.

Question 29

What are common symptoms of sensory ataxia?

Answer 29

• Wide-based, high-stepping gait
• Uncoordinated multi-joint movements
• Incorrect speed and distance of movement
• Delayed postural adjustments
• Reduced equilibrium reactions (ER)
• Intact righting reactions (RR)

Question 30

What causes vestibular ataxia?

Answer 30

Vestibular ataxia is caused by central (brainstem/cerebellum lesions) or peripheral (inner ear) disruptions affecting balance.

Question 31

What are symptoms of vestibular ataxia?

Answer 31

• Staggering, broad-based gait
• Fixed head and trunk posture
• Head tilt (often away from the lesion)
• Leaning backward
• Vertigo, nausea, blurred vision, and nystagmus

Question 32

What causes cerebellar ataxia?

Answer 32

Cerebellar ataxia is caused by damage to the cerebellum, leading to poor coordination, movement timing issues, and inaccuracy in voluntary movements.

Question 33

What are the primary symptoms of cerebellar ataxia?

Answer 33

• Dysmetria (errors in the distance of movement)
• Decomposition of movement (breaking movements into parts)
• Inability to maintain intended postures
• Errors in velocity, direction, and force of movements

Question 34

What are specific symptoms of cerebellar ataxia from damage to the vermis?

Answer 34

Damage to the vermis leads to:

• Gait and equilibrium difficulties
• Low trunk tone
• Body sway and trunk tremor
• Titubation (rhythmic head movement)

Question 35

What are symptoms of cerebellar hemisphere damage?

Answer 35

• Poor limb coordination
• Limb tremor
• Dysdiadokinesia (inability to perform rapid alternating movements)
• Nystagmus
• Dysarthria (slurred speech)
• Reduced motor learning

Question 36

How is cerebellar impairment assessed?

Answer 36

The SARA ataxia scale
Romberg’s test and sharpened Romberg’s test

Question 37

What does the PINARDS mnemonic stand for in cerebellar ataxia?

Answer 37

• Past pointing
• Intention tremor
• Nystagmus
• Ataxia
• Rebound reflexes
• Dysdiadokinesia
• Slurred speech

Question 38

What is dysdiadokokinesia?

Answer 38

Dysdiadokokinesia is the inability to perform rapid alternating muscle movements, often assessed by flipping one hand rapidly in the palm of the other.

Question 39

What is past pointing?

Answer 39

Past pointing occurs when a patient overshoots while trying to touch a specific point, a sign of cerebellar dysfunction.

Question 40

What is an intention tremor?

Answer 40

An intention tremor is a wide tremor that occurs during voluntary movements, such as holding out the hands or reaching for an object.

Question 41

What is nystagmus?

Answer 41

Nystagmus is an involuntary, repetitive oscillation of the eyes, often associated with cerebellar or vestibular dysfunction.

Question 42

How does rebound reflex indicate cerebellar dysfunction?

Answer 42

In cerebellar dysfunction, pushing down on an outstretched arm may cause it to rebound past its original position, due to poor control over muscle adjustments.