Spasticity

Question 1

What is spasticity?

Answer 1

An abnormal and uncontrolled
increase in muscle tone.

Question 2

What abnormal presentation of the limb is caused by spasticity?

Answer 2

1. Contracture
2. Deformity

Question 3

What velocity dependent muscle sign is associated with spasticity?

Answer 3

Clonus

Question 4

True or False: Spasticity is not associated with exaggerated DTRs.

Answer 4

False. It is associated with exaggerated deep tendon reflexes.

Question 5

How is spasticity measured?

Answer 5

Modified Ashworth Scale

Question 6

No increase in muscle tone:

Answer 6

Grade 0 (Modified Ashworth Scale)

Question 7

Grade 1 on Modified Ashworth Scale

Answer 7

Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension.

Question 8

Grade 1+ is defined as:

Answer 8

Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM.

Question 9

Affected part(s) rigid in flexion or extension is:

Answer 9

Grade 4 (Modified Ashworth Scale)

Question 10

Grade 2 (Modified Ashworth Scale)

Answer 10

More marked increase in muscle tone through most of the ROM, but affected part(s) easily moved.

Question 11

Considerable increase in muscle tone, passive movement difficult is:

Answer 11

Grade 3 (Modified Ashworth Scale)

Question 12

Two positive signs for spasticity are:

Answer 12

1. Babinski (extensor plantar response - fanning of toes upward when feet stroked with hammer)
2. Hoffmann’s Sign

Question 13

“An involuntary and rhythmic muscle contractions caused by a permanent lesion in
upper motor neurons.”

Answer 13

Clonus

Question 14

What are the phases of Spasticity?

Answer 14

Initial dynamic phase
Transition period
Static contracture

Question 15

List the conditions that can cause spasticity:

Answer 15

Cerebral Vascular Accident (CVA)
Traumatic brain Injury (TBI)
Cerebral Palsy (CP)
Multiple sclerosis (MS)
Amyotrophic lateral sclerosis (ALS)
Primary lateral sclerosis (PLS)
Spinal cord injury

Question 16

What are the orthotic management goals for spasticity?

Answer 16

1. Prevent contracture
2. Decrease pain
3. Stability
4. Mobility

Question 17

List the classes of Orthoses for management:

Answer 17

1. Static
2. Dynamic or functional
3. Progressive
4. Serial

Question 18

Lap board, arm supports and slings are:

Answer 18

Shoulder Orthoses

Question 19

Long arm cast, dropout cast and dynamic elbow orthoses are:

Answer 19

Elbow Orthoses

Question 20

Short arm cast, volar wrist splint, resting WHO, dynamic WO:

Answer 20

Wrist and hand orthoses

Question 21

Produced by bacterium clostridium Botulinum:

Answer 21

Botulinum Toxin

Question 22

Blocks release of Acetylcholine:

Answer 22

Botulinum Toxin

Question 23

What are the adverse effects of Botulinum Toxin?

Answer 23

Muscle weakness.
Allergic reaction – rare.
Occasional flu-like symptoms.

Duration: 3-4mths

Question 24

C-bar, a component of thumb splints, prevents with deformity?

Answer 24

Thumb-in-palm deformity

Question 25

Split Ring Orthoses:

Answer 25

Position proximal interphalangeal joint for functional use.

Question 26

Maintains finger position, provides support but less useful for improving motion:

Answer 26

Static Hand Splint

Question 27

What are the four principles of tone reducing orthoses?

Answer 27

1. Inhibition of reflexes
2. Full contact
3. Pressure over insertions
4. Stretch

Question 28

What is the MOA of full contact orthoses?

Answer 28

Improves proprioception, which reduces spasticity.