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Alterations in Muscle Tone ll

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Alterations in muscle tone are common manifestations of neurological disorders and reflect dysfunction within different nervous system regions. Spasticity, paratonia, and dystonia represent distinct forms of hypertonia, each with unique mechanisms, clinical features, and diagnostic importance.CharacteristicsSpasticity happens from upper motor neuron lesions and is characterized by velocity-dependent resistance to passive movement. Clinical features include:Exaggerated deep tendon reflexesClonus...
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Rigidity and myotonia are distinct abnormalities of muscle tone that affect resistance and relaxation during movement. Although both involve altered muscle contraction, they arise from different neurological and muscular mechanisms.CharacteristicsRigidity is characterized by uniform resistance to passive movement across the entire range, independent of speed, affecting flexors and extensors equally. It may appear as lead-pipe rigidity (smooth, constant resistance) or cogwheel rigidity...
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Pediatric tone management.

Sathya Vadivelu1, Anne Stratton2, Wendy Pierce3

  • 1Division of Pediatric Rehabilitation Medicine, Department of Pediatrics, Rady Children's Hospital San Diego, University of California San Diego, 3020 Children's Way MC5096, San Diego, CA 92123, USA.

Physical Medicine and Rehabilitation Clinics of North America
|December 7, 2014
PubMed
Summary

Pediatric physiatrists manage tone in children with central nervous system lesions. Individualized treatment plans for hypertonicity, considering function and impairment, are crucial for improving movement and care.

Keywords:
BaclofenCerebral palsyDystoniaHypertoniaNeurotomyPediatricRhizotomySpasticity

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Area of Science:

  • Pediatric rehabilitation medicine
  • Neurology
  • Developmental pediatrics

Background:

  • Tone management is a key role for pediatric physiatrists.
  • Hypertonicity in children with central nervous system lesions can impede normal movement.
  • However, hypertonicity can sometimes enhance muscle function and aid a child's capabilities.

Purpose of the Study:

  • To review evidence-based treatments for hypertonicity in pediatric patients.
  • To emphasize individualized treatment approaches based on functional goals and impairment.
  • To highlight the importance of collaborative care planning.

Main Methods:

  • Literature review of historical and current evidence-based treatments for pediatric hypertonicity.
  • Analysis of factors influencing treatment decisions, including functional goals, impairment severity, and care interference.
  • Discussion of various nonsurgical and surgical treatment options.

Main Results:

  • Treatment approaches for hypertonicity must be tailored to each child's specific needs and functional objectives.
  • Collaboration among caregivers is essential for effective treatment plan development.
  • A wide range of etiologies and treatment modalities exist for pediatric hypertonicity.

Conclusions:

  • Individualized and collaborative care is paramount in managing pediatric hypertonicity.
  • Understanding the nuances of hypertonicity's impact on function is critical for physiatrists.
  • Evidence-based strategies, encompassing both surgical and nonsurgical options, guide effective treatment.