Tone Flashcards
resistance offered by muscles when passively lengthened “stiffness”
muscle tone
Diagnostic indicator of UMN problem
hypertonicity
UMN or LMN problem
Hypotonicity
Connective tissue capsuleintrafusal muscle fibersGamma motor axonsSensory axons
Muscle spindle
What fires the same time as the alpha motor neuron to contract the edges of the muscle spindle
gamma motor neuron
muscle spindles ending in central region of intrafusal fibers
Sensory axon
Types of sensory axons int he muscle spindles
Ia primaryII secondary
Sensitive to low amplitude, high velocity stretch inputsresult of activation is autogenic facilitation and reciprocal inhibition
Ia primary sensory ending
Sensitive to slow, sustained stretchactivation results less clear
II secondary sensory ending
Innervate intrafusal fibers (polar regions)Cell bodies in ventral horn of spinal cord (with alpha motor neuron)Not involved in stretch reflex pathway
Gamma motor neuron
Loss of normal alpha-gamma coactivationslack spindle, no input
hypotonia
a hypertonia condition that is velocity dependent and associated with hyperreflexia
Spasticity
Severe, constant hypertonia that is not velocity dependent
Rigidity
Alpha motor neurons are more sensitive to input due to net increase in excitatory synaptic input and or net decrease in inhibitory synaptic inputs
Neural causes of hypertonia
Immobilization has effect of changing visco-elastic propertiesChange in muscle fiber structure
Non neural causes of hypertonia
Types of tone
Clasp knifecog wheellead pipe
Most resistance at the beginning
clasp knife (swiss army knife)
Resistance throughout the range
Cog wheel
High level of resistance throughout
Lead pipe
modified ashworth scaleno increase in muscle tone
1
modified ashworth scaleslight increase in muscle tone, manifested by a catch or by minimal resistance at the end of the range of motion when the affected part is moved in flexion or extension
1
modified ashworth scaleSlight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder of the ROM
1+
modified ashworth scalemore marked increase in muscle tone through most of the ROM, but affected part easily moved
2
modified ashworth scaleConsiderable increase in muscle tone, passive movement difficult
3
modified ashworth scaleaffected parts rigid in flexion or extension
4
modified ashworth scaleUnable to test
9
x= spasticity angle (threshold)y= spasticity grade (gain)
Tardieu scale
Tardieu scaleno resistance
0
Tardieu scaleslight resistance
1
Tardieu scale clear catch, interrupting movement
2
Tardieu scaleFatigable clonus
3
Tardieu scaleUnfatigable clonus
4
pharmacological treatment for hypertonicity
baclofenvaliumbotox injection
multi muscle activation problems
Sequencing problemsAbnormal synergies
Coactivation across joint
sequencing problems
inability to move a single joint without simultaneous movement in other joints
Abnormal synergies
Brunnstrom stages after stroke
UE” flexor synergy is greater than extensorLE: extensor synergy is greater than flexor
Brunnstrom Stages of synergyno movement
stage 1
Brunnstrom Stages of synergyinvoluntary movement only
stage 2
Brunnstrom Stages of synergyabnormal synergy only
stage 3
Brunnstrom Stages of synergyisolate one joint
stage 4
Brunnstrom Stages of synergyisolate 2 joints
stage 5
Brunnstrom Stages of synergyisolate all joints
stage 6
Brunnstrom Stages of synergy normal movements
stage 7
activation problems in the LE
standing transfersgait
activation problems in the UE
manipulation and dexterity
tests for motor control or rehab assessment after stroke
Fugl meyerStreamS-Stream
