Beruflich Dokumente
Kultur Dokumente
Prepared by
Lesions produce:
1. Slowness of movement.
2. Involuntary movement.
3. Disturbance of muscle tone.
4. Diminished postural reactions.
Clinical features of basal ganglia
dysfunction:
1. Bradykinesia:
• “Abnormally slow movements.”
• “Decreased arm swing; slow, shuffling
gait; difficulty initiating or changing
direction of movement; lack of facial
expression; or difficulty stopping a
movement once begun.”
2. Rigidity.
3. Dystonia.
4. Resting tremor.
5. Akinesia:
• “Inability to initiate movement; seen in
the late stages of parkinsonism.”
• Associated with fixed postures.
• “Tremendous amount of mental
concentration and effort is required to
perform even the simplest motor
activity.”
6. Chorea (choreiform movements):
• “Involuntary, rapid, irregular, jerky
movements; clinical feature of
Huntington’s disease.”
7. Athetosis (athetoid movements):
• “Slow, involuntary, writhing, twisting,
“wormlike” movements; clinical feature of
cerebral palsy.”
8. Choreoathetosis:
• Chorea + athetosis.
9. Hemiballismus:
• “Sudden, jerky, forceful, wild, flailing,
motions of one side of the body.”
• “Results from a lesion of the contralateral
subthalamic nucleus.”
Dorsal columns
Primary function:
• Mediate proprioceptive input from joint and
muscle receptors.
Lesions produce:
• Coordination and balance deficits that are
less characteristic than those produced by
other CNS lesions due to compensation
from visual feedback. Thus, these deficits
are exaggerated in dark or with closed
eyes.
Clinical features of dorsal columns
dysfunction:
1. Dysmetria: visual feedback reduces the
manifestations of dysmetria.
2. Slowed movements: because visually
guided movements are more accurate
when the speed is reduced.
3. Disorders of gait:
• Wide base.
• Sway.
• Uneven step length.
• Excessive lateral displacement.
• Watching feet during ambulation.
• “Advancing leg may be lifted too high and
then dropped abruptly with an audible
impact.”
Changes in coordinated
movement with age
1. Decreased strength.
2. Slowed reaction time.
3. Loss of flexibility.
4. Faulty posture.
5. Impaired balance.
Assessment of coordination
• Assessment must be done bilaterally even
in unilateral lesion
• Assessment must be done in quiet place
to avoid distraction
• Age and psychological state must be
considered
Assessment of coordination
contain:
Motor assessment including muscle tone and
muscle test
Sensory assessment including superficial and
deep sensation
ROM
Orofacial function assessment including facial
expression ,lip &jaw closure
Senstivity of face
Coordination of respiration with swallowing and
speech
Coordination assessment including non equilibrium and
equilibrium subtypes
Stationary finger-to-
nose with eyes closed
Heel to knee test
Rapid Alternating Movements