muscle tone and reflex assessment
DESCRIPTION
This material was developed for use by students of OT180, AY 09-10, College of Allied Medical Professions, University of the Philippines, Manila. Please obtain permission before use.TRANSCRIPT
Continuous state of mild contraction, or a state ofpreparedness in the muscle
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Dependent on the integrity of peripheral and CNSmechanisms and the properties of the muscle
Resistance or tension when passively moving theextremities
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Effective co-activation(stabilization) at axialand proximal joints
Ability to moveagainst gravity and
resistance
Balance tonebetween agonist andantagonistic muscles
Ability to maintain theposition of the limb if
Ease of the ability toshift from stability to
Ability to use musclesin groups or
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position of the limb ifit is placed passivelyby the examiner and
then relaxed
shift from stability tomobility and reverse
as needed
in groups orselectively, ifnecessary
Resistance or slightresistance in
response to passivemovement
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Record the position of thepatient’s because body andhead position influencecerebral hypertonus.
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cerebral hypertonus.
When testing for muscle tone ofthe upper extremity, the patientis placed in sitting
Grasp the patient’s limb proximal and distalto the joint being tested and move the jointslowly through its range to determine thefree and easy ROM available.
• Note the presence and location of pain.
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• Note the presence and location of pain.• If there is no active movement or the extremity feels
heavy, record that the limb is flaccid or “0” in strength.• If the limb has some active movement and no evidence
of increased tone, the affected muscle or muscle groupmay be labeled as “paretic” instead of hypotonic. Thenmuscle can then be graded in strength
Hold the limb on the lateral aspects to avoidgiving tactile stimulation to the muscle belly ofthe muscle being tested. Note also if the limbfeels light or heavy.
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Clinical assessment of tone involves holding thepatient’s limbs as described and moving itrapidly through its full range while the patientis relaxed. Label the tone as “mild”, “moderate”,or “severe”.
Record findings for variousmuscle groups or movements
• Grade 3 (MAS) spasticity on R elbowflexors
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flexors• Moderate spasticity of R elbow flexors• Mild to moderate spasticity is evident
in the R elbow flexors
Ashworth Scale andModified Ashworth Scale
Mild-Moderate-SevereSpasticity Scale
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Spasticity Scale
Preston’s Three StepHypertonicity Scale
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Mild
• The stretch reflex (palpable catch) occurs at themuscle’s end range
Moderate
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• The stretch reflex (palpable catch) occurs inmidrange
Severe
• The stretch reflex (palpable catch) occurs whenthe muscle is in a shortened range
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