Tone Abnormalities Flashcards
What is muscle tone?
Underlying tension in the muscle that serves as a background for contraction
What are some challenges to assessing muscle tone?
Patient can’t relax
Changes with movement, posture, intention, and environment
What is hypertonicity and what else is associated with it?
Abnormally high tone
- Rigidity (velocity independent)
- Spacticity (velocity dependent)
- Clonus (rhythmic oscillations or beats involuntary muscle contraction)
What is Hypotonicity?
Abnormally low tone
(flaccidity-total absence of tone)
-examples-down syndrome, polio
What are some types of dyskinesia?
Chorea - dance-like, sharp, jerky movements
Ballismus - ballistic or large throwing movements
Tremor - low-amplitude, high frequency oscillating movements
Athetoid - wormlike writhing motions
Dystonia - involuntary sustained muscle contraction
How can you measure muscle tone Quantitatively?
Quantitative (objective):
- Dynamometer - compare high and low velocity (resistance to high velocity means increased tone)
- Isokinetic testing
- EMG - can be used as a biofeedback system
- Pendulum test - tests for spacticity
How can you measure muscle tone Qualitatively?
Qualitative (subjective) (used most of the time)
- Clinical tone scale
- Muscle stretch reflex test
- Ashworth and Modified Ashworth scale
What are some consideration when measuring tone?
Position of patient
Standardize touch
Consider muscle strength
What happens with low muscle tone?
Insufficient activation of motor units
- difficulty developing enough force to maintain posture
- increased weight support through tight ligaments
What causes low muscle tone?
Alpha motor neuron damage - demyleniation diseases
-treat with Estim, hydrotherapy, and quick ice (beyond normal rehab of stretch strengthen and so on)
Insufficient excitation of alpha motor neuron (prolonged immobilization, stroke, MS)
What is high muscle tone associated with?
Muscle spasms Contractures Abnormal postures leading to skin ulcers Difficulty with assisted dressing, transfers, hygiene (Parkinsons)
What causes high muscle tone?
Pain, cold, stress
Spinal cord injuries (initial flaccidity followed by spasticity)
Cerebral lesions (stroke, parkinsons, MS, head injuries)
What is decorticate and decebrate posture?
Decorticate - Elbow flexion
Decebrate - Elbow extended (has more E’s)
How can fluctuating muscle tone happen?
Basal ganglia disease (Parkinsons) Cerebral palsy (involuntary writhing)
When don’t you want to use the jostling technique?
On a person with a history of dislocations
How long do you want to do the jostling technique?
10-30 seconds (no real exact time frame though)
Then reassess
