neurology
Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
physio
rehab
revision notes
,Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
Tone:
Muscle tone is the natural, slight tension or resistance in your muscles when
What they are at rest. It helps keep your muscles ready for action and maintains
posture without conscious effort. For example, even when you're not actively
moving, muscle tone ensures that your body stays upright and stable.
• Abnormally increased muscle tone or stiffness.
• Symptoms: Muscles resist movement, making them harder to stretch or
Hypertonia flex.
• Causes: Damage to the brain or spinal cord (e.g., stroke, cerebral palsy,
MS)
• Effects: Reduced flexibility, pain, and impaired movement coordination.
• velocity-dependent increase in muscle tone, where faster movements
cause greater resistance. It occurs due to overactive stretch reflexes,
leading to exaggerated tendon reflexes and increased muscle stiffness.
• Decreased muscle tone, causing floppiness or reduced resistance to
movement.
Hypotonia • Symptoms: Weak muscles, poor posture, and difficulty with movements
like sitting or standing.
• Causes: Can result from brain, spinal cord, or nerve damage, or genetic
conditions.
• Effects: Delayed motor skills, reduced strength, and joint instability.
A type of abnormal tone where there is increased muscle stiffness, usually
Spasticity velocity-dependent (resistance increases with faster movement).
It is caused by overactive stretch reflexes due to nervous system damage.
Hypertonia is increased muscle tone, leading to stiffness and resistance to
Summary movement.
Hypotonia is decreased muscle tone, causing weakness and a floppy or
relaxed feel in muscles.
Spasticity is a form of hypertonia with velocity-dependent muscle stiffness
and exaggerated reflexes.
Effect of Base of Support on Tone
The more surface area the body contacts (e.g., lying down), the lower the muscle tone, and
the less surface contact (e.g., standing), the higher the muscle tone
Remember for assessing (postural sets)
, Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
SUBJECTIVE
Presenting Condition:
• Diagnosis, symptoms, functional abilities, and limitations.
History of Condition:
• Onset of symptoms to present.
• Admission details, progression, recovery, investigations, and interventions.
Previous Medical History:
• Prior MSK issues or other conditions affecting function and ability.
• Baseline ability before the current issue.
Drug History:
• Current and past medications.
• Consider timing and effects on tone, energy, and pain.
• Example: Baclofen for managing high tone.
Social History:
• Occupation and hobbies to formulate goals and provide motivation.
• Home circumstances: Do they need support?
OBJECTIVE
Observational:
• Patient's posture and appearance on arrival: lying, sitting, or talking.
• Document tone at rest (lowest at rest).
Range of Movement (ROM):
• Remember Test the unaffected limb first for baseline comparison.
Active ROM/Strength:
• If the patient moves actively, it shows strength therefore test
• Test isometrically or isotonically.
• If no active movement, skip strength testing initially.
Passive ROM:
• If the patient cannot move, assist the limb passively through its range.
3 EXTRA NEURO:
Proprioception: (body's ability to sense its position and movement in space)
• Ask the patient to close their eyes.
• Replicate a movement on affected side (e.g., physio passively moves the foot up/down).
• Ask them to describe the movement.
Sensation:
• Use two tubes (warm/cold water) or tools like sponges or neuro tips.
• Apply with eyes closed; ask the patient to identify:
o Warm vs cold.
o Light touch vs pressure.
Coordination: (Skip if no limb activity is present.)
Tests:
o Heel-to-shin test.
o Finger-to-nose test.
Tone: Perform a velocity stretch test to assess tone.
Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
physio
rehab
revision notes
,Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
Tone:
Muscle tone is the natural, slight tension or resistance in your muscles when
What they are at rest. It helps keep your muscles ready for action and maintains
posture without conscious effort. For example, even when you're not actively
moving, muscle tone ensures that your body stays upright and stable.
• Abnormally increased muscle tone or stiffness.
• Symptoms: Muscles resist movement, making them harder to stretch or
Hypertonia flex.
• Causes: Damage to the brain or spinal cord (e.g., stroke, cerebral palsy,
MS)
• Effects: Reduced flexibility, pain, and impaired movement coordination.
• velocity-dependent increase in muscle tone, where faster movements
cause greater resistance. It occurs due to overactive stretch reflexes,
leading to exaggerated tendon reflexes and increased muscle stiffness.
• Decreased muscle tone, causing floppiness or reduced resistance to
movement.
Hypotonia • Symptoms: Weak muscles, poor posture, and difficulty with movements
like sitting or standing.
• Causes: Can result from brain, spinal cord, or nerve damage, or genetic
conditions.
• Effects: Delayed motor skills, reduced strength, and joint instability.
A type of abnormal tone where there is increased muscle stiffness, usually
Spasticity velocity-dependent (resistance increases with faster movement).
It is caused by overactive stretch reflexes due to nervous system damage.
Hypertonia is increased muscle tone, leading to stiffness and resistance to
Summary movement.
Hypotonia is decreased muscle tone, causing weakness and a floppy or
relaxed feel in muscles.
Spasticity is a form of hypertonia with velocity-dependent muscle stiffness
and exaggerated reflexes.
Effect of Base of Support on Tone
The more surface area the body contacts (e.g., lying down), the lower the muscle tone, and
the less surface contact (e.g., standing), the higher the muscle tone
Remember for assessing (postural sets)
, Copyright © 2024 Oliviahansonphysiotherapy All Rights Reserved
SUBJECTIVE
Presenting Condition:
• Diagnosis, symptoms, functional abilities, and limitations.
History of Condition:
• Onset of symptoms to present.
• Admission details, progression, recovery, investigations, and interventions.
Previous Medical History:
• Prior MSK issues or other conditions affecting function and ability.
• Baseline ability before the current issue.
Drug History:
• Current and past medications.
• Consider timing and effects on tone, energy, and pain.
• Example: Baclofen for managing high tone.
Social History:
• Occupation and hobbies to formulate goals and provide motivation.
• Home circumstances: Do they need support?
OBJECTIVE
Observational:
• Patient's posture and appearance on arrival: lying, sitting, or talking.
• Document tone at rest (lowest at rest).
Range of Movement (ROM):
• Remember Test the unaffected limb first for baseline comparison.
Active ROM/Strength:
• If the patient moves actively, it shows strength therefore test
• Test isometrically or isotonically.
• If no active movement, skip strength testing initially.
Passive ROM:
• If the patient cannot move, assist the limb passively through its range.
3 EXTRA NEURO:
Proprioception: (body's ability to sense its position and movement in space)
• Ask the patient to close their eyes.
• Replicate a movement on affected side (e.g., physio passively moves the foot up/down).
• Ask them to describe the movement.
Sensation:
• Use two tubes (warm/cold water) or tools like sponges or neuro tips.
• Apply with eyes closed; ask the patient to identify:
o Warm vs cold.
o Light touch vs pressure.
Coordination: (Skip if no limb activity is present.)
Tests:
o Heel-to-shin test.
o Finger-to-nose test.
Tone: Perform a velocity stretch test to assess tone.
