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Neuromuscular Control > TI For Alteration In Muscle Tone (2) > Flashcards

TI For Alteration In Muscle Tone (2) Flashcards

1
Q

How can you measure flaccidity/hypotonia?

A

PROM with palpation for contraction (move slowly first then quickly)

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2
Q

What are the scales used to measure spasticity?

A

Modified ashworth scale (0=normal)

Tardieu scale (R1 and R2)

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3
Q

What is R1 in the tardieu scale?

A

First catch in motion

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4
Q

What is R2 in the tardieu scale?

A

Max range after catch occurs

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5
Q

What does it mean in the tardieu scale if there is a large difference between R1 and R2?

A

More severe spasticity

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6
Q

What does it mean in the tardieu scale if there is a small difference between R1 and R2?

A

More MSK tightness

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7
Q

What are the affects of flaccidity/hypotonia on body structure?

A

Over stretching

Loss of muscle bulk

Loss of ROM

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8
Q

What are the effects of flaccidity/hypotonia on function?

A

Can’t move correctly (development of compensations)

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9
Q

What are the safety issues of flaccidity/hypotonia?

A

MSK damage

Swallowing and respiration

Pain

Balance and falls

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10
Q

What is important in interventions for flaccidity/hypotonia?

A

Maintain mobility (ROM/flexibility)

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11
Q

What do flaccidity/hypotonia interventions begin with?

A

Stability

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12
Q

Why do you want to use compensatory strategies with flaccidity/hypotonia?

A

Minimize risk of injury or secondary impairment

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13
Q

What are the interventions for applied functional activity for flaccidity/hypotonia in the UEs?

A

Estim or orthotic device that can increase functional movement of hand/wrist

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14
Q

What are the interventions for applied functional activity for flaccidity/hypotonia in the LEs?

A

Estim device that substitute for weak DF in swing

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15
Q

What are the positive effects of hypertonia on body structures?

A

Helps maintain muscle bulk, skin integrity, bone density, and BP

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16
Q

What are the negative effects of hypertonia on body structures?

A

Decreased ROM/contracture

Muscle weakness

Pain

Greater energy expenditure

Impaired coordination and balance

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17
Q

What are the positive effects of hypertonia on function?

A

May assist with sit to stand

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18
Q

What are the negative effects of hypertonia on function?

A

Limits isolated movements so functional tasks often require compensations to complete

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19
Q

What are safety issues in hypertonia?

A

Increased risk of fall and skin breakdown due to contracture

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20
Q

What are interventions for hypertonia?

A

Sustained positioning and PROM

Handling and physical inhibition

Equipment

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21
Q

How is sustained positioning achieved in hypertonia?

A

Splinting or serial casting

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22
Q

What is the handling intervention used for hypertonia?

A

NDT

23
Q

What type of muscle is a spastic muscle?

A

Weak muscle

24
Q

What muscles may also grow weak due to hypertonia?

A

Muscles that oppose spastic muscles

25
Q

How do you want to strengthen muscles with hypertonia?

A

Isometric (first)

Eccentric (second)

Concentric (third)

26
Q

Does strengthening increase spasticity?

A

No

27
Q

What are the interventions applied to functional activities in hypertonia?

A

Aquatic therapy

Quadruped

Rolling

Weight bearing

28
Q

Why is aquatic therapy used in hypertonia?

A

Buoyancy increases ease of movement (warm temp can be inhibitory to spasticity)

29
Q

Why is quadruped used in hypertonia?

A

Weight bearing position with fewer degrees of freedom

30
Q

Why is rolling used in hypertonia?

A

With rhythmic initiation and rhythmic rotation

31
Q

Why is weight bearing activities used in hypertonia?

A

To achieve good alignment

32
Q

What is the oral med used for muscle tone issues?

A

Baclofen

33
Q

What are side effects of baclofen?

A

Drowsiness

Dizziness

Weakness

34
Q

What are the pros of baclofen?

A

Non invasive and non permanent

35
Q

What are the cons of baclofen?

A

Not continuous problem solving, must take on a schedule, sedation, and danger with withdrawal

36
Q

What is chemical neurolysis?

A

Alcohol applied to nerve via injection with EMG guidance (lasts 6 months)

37
Q

What does chemical neurolysis cause?

A

Demyelination of axons

38
Q

What is a neuromuscular blockade?

A

Neurotoxin injected into muscle, binds to Presynaptic cholinergic nerve terminal and blocks release of AcH (Botox)

39
Q

What are the pros of chemical neurolysis?

A

Better effect on larger muscles and is cheap

40
Q

What are the cons of chemical neurolysis?

A

Difficult procedure

Risk of sensory complications

Muscle can become fibrotic with repeated injections

41
Q

What are the pros of neuromuscular blockade?

A

Less painful, easier to perform, no sensory side effects, not permanent

42
Q

What are the cons of neuromuscular blockade?

A

Another injection every 3 months, expensive, and can develop antibodies

43
Q

What is intrathecal baclofen?

A

Baclofen diffused into CSF in intrathecal space

44
Q

What does intrathecal baclofen inhibit?

A

Both mono and polysynaptic reflexes

45
Q

What are the pros of intrathecal baclofen?

A

Reversible

Fewer side effects

Improved function

46
Q

What are the cons of intrathecal baclofen?

A

Mechanical complications

Refills every 3 months

Expensive

47
Q

What are the types of orthopedic surgeries done for problems with muscle tone?

A

Lengthening

Tendon transfer

Releases

48
Q

What is selective dorsal rhizotomy?

A

Selective destruction of problematic nerve roots (most common in children)

49
Q

How does oral and intrathecal baclofen affect spasticity?

A

Reversible and globally

50
Q

How does neuromuscular blockade affect spasticity?

A

Reversible and focal

51
Q

How does selective dorsal rhizotomy affect spasticity?

A

Permanent and globally

52
Q

How does surgery affect spasticity?

A

Permanent and focal

53
Q

What is key in interventions when it comes to alterations in muscle tone?

A

Maintaining mobility and creating stability

Neuromuscular Control (41 decks)

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