Impairment: Weakness And Abnormal Tone

Question 1

Motor Components: Impairment factors

Answer 1

• Strength
• Muscle Performance
• Muscle Endurance
• Muscle Weakness
• Paralysis/Plegia/Paresis
• Atrophy

Question 2

Strength

Answer 2

Muscle force or group of muscle force to overcome resistance

Question 3

Muscle Performance

Answer 3

Capacity of a muscle or group of muscles to generate force

Question 4

Muscle Endurance

Answer 4

Ability to sustain force

Question 5

Muscle Weakness

Answer 5

Inability to generate normal levels of force

Question 6

Paralysis/Plegia

Answer 6

Absence of strength

Question 7

Paresis

Answer 7

Mild or atrial weakness

Question 8

Paralysis/plegia/paresis

Answer 8

Decreased voluntary motor unit recruitment

Question 9

Atrophy

Answer 9

Loss of muscle bulk

Question 10

Muscle Weakness (paresis) overview:

Answer 10

• musculoskeletal and/or NM problems

- primary cause of “FUNCTIONAL LIMITATIONS”

Question 11

Assessing Functional Limitations: (list)

Answer 11

• Rolling. - Supine-to-sit
• Stable sitting. - Sit-to-stand
• Stable standing. - Transfers
• Ambulation. - Climbing stairs

Question 12

Assessing Weakness: (list)

Answer 12

• AROM. - MMT
• Functional mm testing. - Hand-held dynamometer
• Isokinetic dynamometer. - EMG
• Endurance/fatigue. - UMNL vs LMNL
• Cranial N. testing

Question 13

Task-Oriented: Treatment of Muscle Weakness

Answer 13

• REPETITION, REPETITION, REPETITION

Question 14

Abnormal Muscle Tone: TONE definition

Answer 14

Tension attained at any moment between the origin and insertion of a muscle

Question 15

Normal Tone:

Answer 15

A certain amount of muscle tone is “typical” especially w/ postural control

Question 16

Abnormal Tone:

Answer 16

• Hypertonia: increased resistance w/ PROM when person is relaxed
• Hypotonia: low, flaccid
• Dystonia: impaired, involuntary repetitive twisting

Question 17

Hypertonia types: (list)

Answer 17

• Spasticity
• Clonus
• Babinski Sign
• Rigidity
• Decerebrate
• Decorticate

Question 18

Spasticity Post-Stroke:

Answer 18

• Appears UNRELATED to functional disability and contribution to motor disability may be slight

Question 19

Assessing Impairment: ABNORMAL TONE

Answer 19

• Modified Ashworth

Question 20

Typical Resting Postures for an UMNL (UE)

Answer 20

UE

• Scapula: retracted, down rot
• Shoulder: Add/IR/depression
• Elbow: Flexion
• Forearm: Pron
• Wrist: Flexed/ADD
• Hand: flexed/ add

Question 21

Typical Resting Postures for a UMNL: (LE)

Answer 21

• Pelvis: retracted (hip hike)
• Hip: add/IR/ext
• Knee: ext
• Ankle: PF/Inversion, flexed toes
• Trunk: Lat Flex/ rotation

Question 22

Modified Ashworth Scale:

Answer 22

0: none
1: catch at end range
1+: <50%
2: Easily moved but throughout most ROM
3: PROM difficult
4: rigid

Question 23

Tardieu Scale: definition

Answer 23

• patient supine
• measurements take place at 3 velocities
  - V1: slow as possible
  - V2: speed of gravity
  - V3: fast as possible
• Identifies SPASTICITY vs. STIFFNESS

Question 24

Tardieu Scale: Scale

Answer 24

• X (0-5)
• Y (angle which reaction occurs)
  0: normal
  1: slight resistance no clear point
  2: clear catch
  3: fatigable clonus <10 sec
  4: Unfatigable clonus >10 sec
  5: immovable

Question 25

Abnormal MOVEMENT synergy patterns: FLEXION UE

Answer 25

- Scapular: retraction OR elevation/hyperextension - Shoulder: ABD, ER - Elbow: FLEXION - supination - wrist/finger: flexion

Question 26

Flexion pattern: LE

Answer 26

HIP: FLEXION, ABD, ER Knee: flex Ankle: DF, inv Toe: flex

Question 27

Extension: UE

Answer 27

Scapular: protraction Shoulder: ADDUCTION, IR Elbow: ext Wrist: PRONATION, flexion

Question 28

Extension: LE

Answer 28

Hip: ext, ADDUCTION, IR Knee: EXTENSION Ankle: PLANTAR FLEXION, inversion Toe: PF

Question 29

Bronnstrom's Stages:

Answer 29

- 1: flaccidity, no movement can be elicited - 2: basic limb synergies can appear - 3: voluntary control of movement synergies - 4: some movement out of synergy patterns - 5: progression to more difficult movement patterns - 6: individual movements become possible - 7: NORMAL

Question 30

STNR: (symmetrical tonic neck reflex)

Answer 30

- neck flexed = arms flex / legs extend | - neck extend: = arms extend / legs flex

Question 31

ATNR: (asymmetrical tonic neck reflex)

Answer 31

- neck rotates to one side = jaw limbs extend and skull limbs flex

Question 32

TLR or STLR: (symmetrical tonic labyrinthine reflex)

Answer 32

- prone = total flexion | - supine = total extension