Tone Vs. Spastcitiy

Question 1

What is the modified Ashworth Scale?

Answer 1

0=No increase in muscle tone

1=Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end range of motion when the part is moved in flexion or extension/abduction or adduction, etc.

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

2=More marked increase in muscle tone through most of the ROM, but the affected part is easily moved

3=Considerable increase in muscle tone, passive movement is difficult

4=Affected part is rigid in flexion or extension (abduction or adduction, etc.)

Question 2

What affects tone?

Answer 2

Emotional state
Arousal
Depressants

Question 3

True or False: Tone is always pathological and bad

Answer 3

False

Question 4

Define Spasticity

Answer 4

disorder of the sensorimotor system characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the
stretch reflex.

Question 5

Cause of Spasticity

Answer 5

No known mechanism

*Proposed: alpha motor neuron disinhibition or decreased cortical control
—-or gamma motor neuron because there is an increase in fusimotor drive
on spindle afferents that occur and enhance the stretch
reflex

• Possibly neuronal regeneration associated with CNS injury

Question 6

Spasticity has a bias toward _______ muscles

Answer 6

anti-gravity

Question 7

Does spasticity increase central excitability or peripheral excitability?

Answer 7

• Increase in phasic stretch reflex (tendon jerk)
• Increase in tonic stretch reflex (resistance to passive stretch)
• Therefore, an increase in central excitability as well as peripheral excitability

Question 8

Positive UMN symptoms

Answer 8

• Spasticity
• increased muscle tone
• exaggerated DTR
• clonus
• disinhibited anti-gravity reflexes

Question 9

Negative UMN signs

Answer 9

• loss of dexterity
• loss of flexibility
• inadequate force generation
• delayed force generation
• difficulty sustaining force generation

Question 10

What are the biological changes that accompany spasticity?

Answer 10

• Stiffness
• Contracture
• Fibrosis
• Atrophy

Question 11

Are the positive or the negative symptoms more

important to the function of the patient?

Answer 11

The negative symptoms are often more
important to the function of the patient than the
positive ones

Question 12

Can you alter the tone of a child short term?

Answer 12

Yes

Question 13

Can you alter the tone of a child long term?

Answer 13

Bill says no

Question 14

Should you treat when tone is altered?

Answer 14

Yes but you might not get a lot of functional carryover

• High tone child in a relaxed state
• Low tone child in a heightened state
• Benefits and risks