whole body involved in varying degrees
whole body involved but LEs>UEs; symmetrical or asymmetrical distribution; good head control and min/mod involement of UEs
one side involved (face, UE, trunk, LE)
one extremity involved
involvement of trunk and LEs to varying degrees
increased muscle tone of muscle groups, increased tension when lengthened, firm/tense on palpation, distribution between flexors and extensors is asymmetrical increased DTR/MSR, increased incrementally with rate/velocity, excitation and position change, clonus, decreased PROM with atypical firm end feel, increased cocontration and decreased reciprocal inhibition, primitive reflexes present, disuse atrophy
increased muscle tone of muscle groups,continuous or sometimes intermittent sustained muscle contraction even when appear relaxed, increased tension uniformly and immediately as lengthened, firm/tense on palpation, no change or increase in DTR/MSR, no change with rate/velocity and position, decreased PROM with atypical firm end-feel, distribution between flexors and extensors is equal, increased cocontraction and decreased reciprocal inhibition, disuse atrophy, LEAD-PIPE constant rigidity to movement throughout ROM; COGWHEEL alternative episodes of resistance and relaxation through ROM
decreased muscle tone of groups, decreased tension when lengthened, soft/mushy on palpation, decreased DTR/MSR, possible change with rate/velocity and position, increased PROM with hard or empty end-feel, distribution b/w flexors and extensors usually symmetrical (can be asymmetrical), decreased cocontration and reciprocal inhibition, some tonic reflexes, atrophy, weakness and decreased endurance
fluctusting/changeable/unfixed muscle tone, ROM not affected, asymmetrical distribution, may be mixed with spasticity and others, decreased cocontration and increased reciporcal inhabition (particularly extremities), primitive/tonic reflexes present, decreased strength.
involuntary movements without increase in muscle tone
abnormal posturing of limbs/head/trunk with unpredictable increases in tone
involuntary, unpredictable small movements of head and distal extremities, some say large, jerky movements.
increased mm tone which blocks involuntary movement
fluctuating becoming increased muscle tone that is severe and unrelieving/sustained increased tension with lengthening, tense/firm on palpation, increased DTR/MSR, decreased PROM with firm end-feel, persistent attitude or posture in one or other extremes of athetoid movement, tends to be in large axial muscles, may be mixed with athetosis and others
decreased muscle tone to fluctuating muscle tone, 'dance' of involuntary arrhythmic movements of a forceful rapid, jerky type, simple or complex patterns of movement purposeless, PROM not as affected, distribution variable, may be mixed with athetosis and others, proximal limb muscles involved in wide range and flinging movements= hemiballisums, chorea of one side of the body= hemichorea
low postural tone with occasional changes to above normal, abnormalities of intended movement, dyssynergia/ asynergia/ decompensation, dysmetria, dysdiadochokinesis, intention tremor, titubation, hypermobile, primitive reflexes modified in children but late
inability to hit targets, overshooting and undershooting
inability to rapidly alternate movements; for example, inability to
rapidly pronate and supinate the forearm or inability to rapidly alternate toe tapping.
a tremor seen in the trunk
disturbance of motility in which a clear minded individual with no weakness, spasticity, athetosis, atacia, or other extrapyramidal derangement, and no defects in sensation does not develop or loses the ability to excecute skills and gestures, may see hypotonia
failure to conceive or formulate an action spontaneously or on command; inability to perform dynamic, sequencial skill upon request.
failure to excecute an action despite having knowledge and memory of the planned action; inability to carry out simple, one step task upon request
course, rhythmic tremor of 3-5 Hz, alternating contractions of agonist/antagonist muscles, and amplitude varying with stress/fatigue/medications; seen in hands, forearms, feet, jaw, lips, or tongue when is in an 'attitude of repose': suppressed/lessened with active movement
irregular, mostly rhythmical, 2-3 Hz oscillations in several planes of movement observed during active movements especially those requireing precision or movements done when vision is impaired/blocked; may also see titubation
Postural and Action Tremor
present in limbs and trunk while actively maintaining a certain position and throughout movement; rhythmic bursts of avtivity occurring synchronously and simultaneously in opposing muscle groups; never at the degree of intention tremors
usually seen in one limb, gross in nature, and if retrain involved limb the tremor manifests in other limb; less regular quality, present during activity and repose.
arrhythmic lapses in sustained posture which allow gravity or muscle elasticity to produce movement followed by patient correction with overshoot.
series of uniphasic/monophasic contractions and relaxations as muscle subjected to sudden sustained stretch; seen in conditions of spasticity
shock-like contractions of a group of muscles which are irregular in rhythm and amplitude, mostly asynchronous, and asymmetrical in distribution
Pathological Startle Syndromes
greatly exaggerated startle reflex and other stimulus induced disorders where startle is predominant
Spasmodic Torticollis and Cranial-Cervical Spasms
intermittent, arrhythmic, brief or prolonged involuntary spasms of contractions of the facial, jaw, lingual, SCM, trapezius, and other neck muscles.
Tics and Habit Spasms
habitual movements which range from simple, highly personalized, idiosyncratic mannerisms to repetitive actions when individual becomes tense; sterotypy and irresitibility are main features.
Spastic Movement Quality
poverty of movement, labored movement, small/limited movements, move in midrange versus endranges, appears to dislike movement; difficulty with mobility level of motor control
Spastic Quadraplegia Movement Quality
spastic characteristics throughout entire body
Spastic Diplegia Movement Quality
spastic characteristics and good head control with mild/moderate UE deficits trunk and LE limited movement lacking variety; requires increased effort to move and transition.
Spastic Hemiplegia Movement Quality
spastic characteristics and integration of sides is lost so movement quality on both sides is incomplete and create a new midline center of the uninvolved side; missed development of controlled symmetry needed to relate sides and top to bottom; poor motor planning.
Athetosis including Chorea and Dystonia Movement Quality
latency, decreased grading and problems with termination of movement causes difficulty with timing; difficulty controlling midrange and sustaining posture, transitioning between positions, and with eccentric control; 'fixes' for stability and appears 'fearless' during movements.
Hypotonic Movement Qualities
difficulty with initiating, sustaining and terminating movement and postures, and is fearful of movement, uses phasic burts for activity and ligaments/joints in mechanical lock positions.
Ataxia Movement Qualitites
difficulty with initiation and cessation, timing/sequencing and grading, and fixation for sustained postural control through movements/transitions; fear/dislikes movement due to lack of control; uses joint structures or vision for 'fixing' and demonstrates poor motor planning; unreliable and uncoordinated balance/postural control responses and spontaneous movement.
Hyperkinetic Movement Qualities
awkward, clumsy, and difficulties with higher level balance/postural control, mature components of gross motor skills and fine motor skills; hyperkinesis with sensory defensiveness causing limited sensory motor experience and movement dysfunction.
Cerebral Palsy, Tramatic Brain INjury, Rett Syndrome
Parkinson's Disease, Near Drowning, Tuberous Sclerosis
Fragile X Syndrome, Prader-Willi Syndrome, Down Syndrome, Cri Du Chat Syndrome
Cerebral Palsy, Lesch-Nyhan Syndrome
Dystonia/Torsion Spasm Pathologies
Cerebral Palsy, Torsion Dystonia, Dystonia Musculorum Deformans
Cerebral Palsy, Huntington Chorea, Syndenham Chorea
Cerebral Palsy, Friedreich's Ataxia, Ataxia Telangectasia, Angelman Syndrome
Developmental Coordination Disorder (DCD)