occurancce of incoordination
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| Ataxia | Impaired gross coordination and gait |
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| Adiadochokinesia | inability to perform rapid alternating movements...ex forearm supination and pronation |
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| Dysmetria | inability to judge the distance between two points |
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| Dyssynergia | movements appear jerky (mm have trouble working together.) |
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| Tremor | involuntary trembling or shaking | intention tremor: occurs during movement | resting tremor: Occurs during absence of movement...Pill-rolling tremor: appears to be rolling a pill between thumb and index finger(Parkinson's)
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| Rebound Phenomenon of Holmes | The inability to stop a movement already in motion to avoid striking something. |
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| Nystagmus | An involuntary movement of the eyeballs that is a normal response to the body trying to regain balance and orientation...(eyeballs move back n forth, up n down or rotating). |
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| Dysarthria | incoordination of the speech mechanism...speech is explosive or slurred. |
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| Choreiform movements | Uncontrolled, jerky, purposeless movements...often seen during sleep. |
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| Athetoid movements...Athetosis | movements that mainly occur in the distal extremities... slow and wormlike, without stability. |
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| Spasms | sudden involuntary contractions of a mm or group of mm. | Spinal cord injury, spasms often cause violent and involuntary straightening of the legs. |
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| Dystonia | Faulty mm tension or tone....Involves lg portions of the body, w distorted posturing and bizarre writhing movmts. |
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| Ballism | Projectile movmts of one side of the body...very rare symptom |
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| 8 Components of normal postural reflex mechanism | Postural tone...mm tone...integration of primitive reflexes...mass patterns of mvmt...righting reactions...equilibrium reactions...protective extension reactions...voluntary/intentional mvmt. |
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| Normal mm tone | A continuous state of mm contraction and readiness |
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| Preferred position for assessing mm tone is: | upright, either sitting or standing, since these are positions for occupational performance tasks. |
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| 3 Types of abnormal mm tone | HYPOtonicity (flaccidity)...HYPERtonicity (spasticity)...RIGIDITY |
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| HYPOTONICITY | Result of; peripheral nerve damage...cerebellar disease...or frontal lobe damage (seen temporarily in the 1st shock phase of a stroke or spinal cord injury). |
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| RIDIGITY | Both mm groups(agonist &antagonist) contract continually | Lead-pipe rigidity; constant resistance through ROM | Cogwheel rigidity; a rhythmic "give" during the resistance of ROM.
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| Suck/swallow reflex | Onset:28 wks...I:2-5 mo. | Non-integration interferes with eating, due to involuntary protrusion/retraction of the tongue |
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| Asymmetrical tonic neck reflex (ATNR) | Onset: 37 wks...I: 4-6 mo. | Interferes with maintaining head & U.E in midline | Interferes w grasping objects in line of vision and bringing objects to the mouth
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| Symmetrical tonic neck reflex | Onset: 4-6 mo...I: 8-12mo. | Interferes w; crawling...supine to sitting...sitting to standing |
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| Tonic labyrinthine reflex (TLR)..supine or prone | Onset: +37wks...I: 6 mo. | Severely limited mvmt..interferes w; supine to sitting...rolling supine to prone or vise versa. | difficulty sitting in a w/c for any length of time....can result in increased flexor tone.
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| Positive supporting reflex (PSR) | Stimulus: pressure to the ball of the foot | Response: leg ext. and plantar flexion of ankle. | Difficulty rising from a chair and descending steps, since leg remains in ext.
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| Crossed Extension reflex | Stimulus; flexion of one leg | Response; ext of the other leg | Difficulty w bridging and reciprocal walking
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| Palmar grasp reflex | Onset: 37 wks...I: 4-6 mo. | lack of integration causes inability to release objects from the hand |
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| Plantar grasp reflex | Onset: 28wks...I: 9 mo. | Difficulty keeping toes from curling in shoes. | Normal equilibrium responses in the foot do not develop
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| Brunnstrom's 9 Stages of motor recovery for a CVA | 1. no motion...2.reflex response...3.associat-ed reactions | 4.mass synergistic response...5. deviation from pattern...6. Wrist stability | 7. individual finger mvmt...8. selected pattern w overlay...9.Selective mvmt
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| HYPERTONICITY | Deep tendon reflexes and clonus(quick, repetitive, alternate contractions of antagonist and agonist mm) | Occurs in patterns of flexion or extension | Upper motor neuron disorders...ex. MS, CVAs, head injury, brain tumors and spinal cord injury or disease
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