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Neuro E&I

Change in Muscle Tone after CNS Injury

Stiffness of a resting muscle. Resistance to active or passive elongation. Tone. note: assessment if a passive measure of stiffness
Increased resistance to passive stretch Hypertonicity => Includes spasticity and rigidity
Decreased resistance to passive stretch Hypotonicity
Excessive resistance to either active or passive muscle stretch. Muscle Hyperstiffness. (myoplasticity and overactive neural input)
Muscle Hyperstiffness occurs as a result of what two factors? Myoplasticity and Overactive Neural Input (more theoretical)
Adaptive changes in ms in response to a change in activity and prolonged positioning. Myoplasticity
Which UMN damage is a typically used term for pts. with stroke? Hyperstiffness
Unlike spasticity, what key factor is missing in hyperstiffness Hyperreflexia
What is the key difference between rigidity and spasticity? Rigidity is NOT velocity dependent. Spasticity is velocity dependent
Which subcategory of hypertonicity does one exhibit either a "lead-pipe" or "cog-wheel" resistance in the flexor muscles of the trunk and limb? Rigidity
What causes hyperreflexia and which branch of hypertonicity is it related to? Velocity dependent resistance to passive stretch that is cause by an increase in alpha motor neuron excitability. Related to SPASTICITY.
Slide: What causes increased ms stiffness post-stroke? Weakness, Myoplastic changes, UMN overactivity (theoretical)
Clinician definition of SPASTICITY refers to.... all UMN motor changes post-injury/disease. This list includes: Parasis Myoplastic Hyperstiffness Co-contraction Hyperreflexia
Velocity dependent resistance to passive stretch associated with exaggerated tendon reflexes Spasticity
Which is the most commonly used assessment tool for spasticity? How many grades are associated with it? What is the alternate method and what population is it gaining popularity with? Modified Ashworth Scale (MAS) =>0, 1, 1+, 2, 3, 4 Tardieu Scale =>gaining popularity in ped/research
How does the Tardieu Scale quanity muscle tone? Test involves varying the velocity of limb movement. -Measures the difference in the ANGLE OF RESISTANCE between slow and fast movement
What is the spasticity angle? Measures the difference in the ANGLE OF RESISTANCE between slow and fast movement R1 (fast speed)/R2 (slow speed) DYNAMIC WINDOW
True or False Reduced spasticity does not independently correlate with increased function. True. STRENGTH has a stronger relationship with function
Why is it an indication to reduce the use of anti-spasticity drugs? 2ยบ side-effect can include muscle weakness. STRENGTH has a stronger relationship with function, rather than reduced spasticity.
Assessment of Tone: Passive or Active measure of stiffness? Passive measure of stiffness
What is normal muscle tone characterized by? Minimal bonding of actin and myosin that exists on a continuum of tone from flaccidity to hypertonicity. Optimal Tone is TASK & ENVIRONMENT specific
What does resting muscle tone results from? Relaxed muscles are electrically silent. RMT results from intrinsic stiffness of muscles and tendons.
CHOOSE: Myoplasticity involves the selective atrophy/hypertophy of slow/fast twich fibers. Myoplasticity involves the selective atrophy of fast twich fibers.
List adaptive changes seen in myoplasticity 1. Contracture 2. Increase in number of Actin-Myosin bonds 3. Selective atrophy of fast twitch ms fibers
Discuss the relationship of the UMN and LMN in the Overactive Neural Input theory for hyperstiffness UMN stimulation of LMN producing sustained ms activity as a result of UMN injury
Rigidity is primarily seen with what types of injuries? Spasticity is primarily seen with what type of injuries? Rigidity: Results from Brain Stem or Basal Ganglia injuries. Ex. Parkinson's Disease Spasticity: As a result of UMN Lesion (SCI, MS, TBI, CP)
Created by: Phillypino