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Signs and Symptoms in Psychiatry
Published in Mohamed Ahmed Abd El-Hay, Essentials of Psychiatric Assessment, 2018
Abnormal posture may be induced by others (catalepsy), or assumed spontaneously by the patient (posturing): Catalepsy: a condition of diminished responsiveness characterized by maintenance of postures imposed by the examiner for a long period of time. It occurs in organic or psychiatric disorders, or under hypnosis. It is usually accompanied by waxy flexibility.Waxy flexibility: the patient shows slight even resistance while moving limbs into imposed positions that are maintained for long periods of time.Posturing: purposeless, voluntary assumption of inappropriate or bizarre postures that are maintained for long periods of time.
Management of painful spasticity
Published in Peter R Wilson, Paul J Watson, Jennifer A Haythornthwaite, Troels S Jensen, Clinical Pain Management, 2008
Abnormal posture will also result in changes in normal weight bearing and weight distribution, once again often resulting in pain. The most common example of this is the equinovarus foot and associated knee hyperextension during standing and walking. The knee hyperextension itself is usually due to a combination of plantar flexion/knee hyperextension coupling, quadriceps weakness, and quadriceps spasticity. The consequence, with respect to pain is two-fold. The abnormal posturing of the foot in equinovarus (plantar flexed and inverted) means that during standing and walking the anterolateral border of the foot becomes the primary weightbearing portion of the foot. This will lead to pain in the foot and ankle on weight bearing and often to skin breakdown.Chronic knee hyperextension in gait will often lead to stretching of the posterior cruciate ligament and the knee capsule leading to chronic knee joint pain and eventual instability and arthritis of the knee.
Clinical management
Published in Alistair Burns, Michael A Horan, John E Clague, Gillian McLean, Geriatric Medicine for Old-Age Psychiatrists, 2005
Alistair Burns, Michael A Horan, John E Clague, Gillian McLean
This is a sustained, abnormal posture, either focal or generalised. Focal dys- tonias may be task-specific (e.g. writer's cramp). The commonest dystonia is spasmodic torticollis, in which there is persistent contraction of the neck muscles. Dystonia is common in patients with Parkinson's disease taking dopamine agonists.
Effect of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy
Published in Developmental Neurorehabilitation, 2022
Meysam Roostaei, Parvin Raji, Khosro Khademi Kalantari, Elham Faghihzadeh, Maria Fragala-Pinkham
Children with hemiplegic cerebral palsy (HCP) have non-progressive upper neuron motor symptoms that occur in the non-mature brain and are triggered by prenatal, natal, or postnatal events.1 Motor impairments such as spasticity, poor selective motor control, and abnormal posture predominantly appear on the more affected side of the body.2 Shevell et al. indicated that 96% of children with HCP demonstrate independent walking and are classified at Gross Motor Function Classification System Revised & Edited (GMFCS R & E) Levels I–II (walk independently without assistive device but may have difficulty walking on stairs or performing gross motor skills of running and jumping).3 Although most children with HCP walk independently, they present with decreased postural control and balance compared to typically developing children.4 In one study, parents reported that on average their children had several trips or falls per month.5 Since impairments in postural control and balance can impact gross motor function and contribute to falls, physical, and occupational therapists need additional information to design interventions to improve postural control and balance and reduce falls in children with HCP.
Symptoms and impact of aromatic l-amino acid decarboxylase (AADC) deficiency: a qualitative study and the development of a patient-centred conceptual model
Published in Current Medical Research and Opinion, 2021
Kate Williams, Hanna Skrobanski, Christian Werner, Sian O’Neill, Katharina Buesch, Sarah Acaster
Nearly all caregivers stated that the individual they care for had severe muscle weakness across their entire body. They described how this muscle weakness limited their motor function, including their ability to hold their head up, sit unsupported, stand, walk and use their upper limbs. Others reported that this muscle weakness made the individual tired or fatigued, or affected their ability to talk. Muscle weakness was sometimes attributed to the individual having low or no muscle tone. Some described them as being like a “rag doll” or “floppy” and explained how this made it very difficult for them to control their muscles and prevented them from making purposeful movements. As well as struggling to make purposeful movements, some caregivers described how the individuals made involuntary movements, such as muscle twitches or spasms. A few caregivers also mentioned that the individual sometimes experienced muscle or joint stiffness, or had a rigid or abnormal posture, which was sometimes attributed to scoliosis.
Comparative efficacy, safety, and cost-effectiveness of abobotulinumtoxinA and onabotulinumtoxinA in children with upper limb spasticity: a systematic literature review, indirect treatment comparison, and economic evaluation
Published in Journal of Medical Economics, 2021
N. Danchenko, K. M. Johnston, K. Haeussler, J. Whalen
Spasticity may occur in the upper limbs, lower limbs, or neck. Common presentations of spasticity in the upper limbs of children include the thumb-in-palm with clasp hand, shoulder adduction with internal rotation, and elbow/wrist flexion with pronation4. In infants, limited upper limb function may affect activities such as grasping, releasing, reaching, and balance, acting as a barrier to early development5. As children grow, spasticity can cause pain and abnormal posture in addition to difficulty with activities of daily living such as hygiene, dressing, self-care, movement, and sleep6,7. Without proper management, structural and functional complications may worsen and continue to negatively impact quality-of-life in adulthood8,9.