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Motor Neurological Examination of the Hand and Upper Limb
Published in J. Terrence Jose Jerome, Clinical Examination of the Hand, 2022
Muscle tone refers to the tension within the muscle – irrespective of whether the muscle is in a state of active contraction or not. The muscle tone is defined as the resistance to passive motion due to the inherent attributes of muscles – viscosity, elasticity and extensibility. This resting muscle tone is greatest in anti-gravity muscles that maintain the body in an erect posture.
STRIVE Principles
Published in James Crossley, Functional Exercise and Rehabilitation, 2021
A person’s ability to stretch and move in function is less about the distensibility of muscle and fascia and more about the underlying level of tone within myofascia. Muscle tone is low-level muscle contraction working to maintain postural and positional stability. Muscle ‘tone’ is regulated by neurological mechanisms working to prevent uncontrolled motion and injury.
The patient with acute neurological problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
When patients are unable to obey commands, it is difficult to assess limb power. Muscle tone can be assessed by moving each limb through the normal range of passive movement. This reveals whether the limb is normal, flaccid or has increased tone.
Effects of therapeutic exercise on disease severity, balance, and functional Independence among individuals with cerebellar ataxia: A systematic review with meta-analysis
Published in Physiotherapy Theory and Practice, 2023
Stanley Winser, Ho Kwan Chan, Wing Ki Chen, Chung Yau Hau, Siu Hang Leung, Yee Hang Leung, Umar Muhammad Bello
Cerebellar ataxia is a heterogeneous group of movement disorders caused by damage to the cerebellum or its connections (Marsden and Harris, 2011). Health conditions that result in ataxia are categorized as non-hereditary or hereditary degenerative, or due to an acquired underlying cause (Manto and Marmolino, 2009). The global prevalence of the dominant form of hereditary ataxia is 2.7 per 100,000 (Ruano, Melo, Silva, and Coutinho, 2014). Individuals with cerebellar ataxia report a significant decline in quality of life (Pérez-Flores, Hernández-Torres, Montón, and Nieto, 2020) and a greater reduction in the performance of activities of daily living (Miyai, 2012; Winser et al., 2020). Impaired balance is associated with all types of ataxias. Falls due to impaired balance is common among individuals with cerebellar ataxia and more than 70% of individuals with cerebellar ataxia experience at least one fall within 12 months (Fonteyn et al., 2010). Improving balance among the population is crucial for improving community participation and reducing healthcare costs associated with accidental falls (Winser et al., 2020). Besides poor balance, individuals with cerebellar ataxia present with incoordination of limb and eyeball movement, speech impairment and altered muscle tone (Manto and Marmolino, 2009).
An expansion of phenotype: novel homozygous variant in the MED17 identified in patients with progressive microcephaly and global developmental delay
Published in Journal of Neurogenetics, 2022
Rafiullah Rafiullah, Alia M. Albalawi, Sultan R. Alaradi, Majed Alluqmani, Muhammad Mushtaq, Abdul Wali, Sulman Basit
Perinatal history of both affected individuals was unremarkable. Head circumference in both affected individuals was more than 2 SD below the mean. Patient IV:3 was diagnosed at the age of 4 months with severe ID and progressive microcephaly. The onset of seizures was noted at the age of 2 years. The EEG showed multifactorial spikes and poly spikes during sleep. Magnetic resonance imaging (MRI) findings at the age of 6months revealed mild atrophy of vermis, cerebellar, and cerebral as well as mild delay in myelination, small thalami, and thin brainstem (Figure 1(B)). Both patients never acquire speech and were unable to walk at the age of 3 and 5 years. Moreover, both patients experience severe eye tracking problems. Muscle tone was found high (hypertonia). Patients failed to move their upper or lower limbs and were completely bedridden.
Strychnine, old still actual poison: description of poisoning cases reported to French Poison Control Centers over the past thirteen years
Published in Toxin Reviews, 2022
Camille Paradis, Denis Dondia, Audrey Nardon, Ingrid Blanc-Brisset, Arnaud Courtois, Jules-Antoine Vaucel, Magali Labadie
In the gray matter of the spinal cord, Renshaw cells function as inhibitory interneurons associated with an alpha motor neuron. Renshaw cells receive excitatory collaterals from the alpha motor neurone and thus, upon excitation, could release glycine to the alpha motor neurone in order to exert an inhibitory feedback and prevent alpha motor neurone firing. Strychnine is a potent antagonist of glycine receptors thus acting as an inhibitor of an inhibitory signal. This results in a motor disturbance characterized by an increase in muscle tone, associated with muscular hyperactivity. Clinical symptoms of poisoning appear suddenly and rapidly after ingestion, and begin with painful muscle contractures spontaneous or triggered by even the slightest stimulus, trismus, an opisthotonus (a position which the whole body is arched backward in hyperextension) and generalized convulsions for the severe forms. Importantly, during the course of poisoning, consciousness is retained. The clinical picture is complicated by major acidosis and rhabdomyolysis. Death occurs due to the paralysis of respiratory muscles or a cardiac arrest (Baud and Garnier 2017).