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How Do I Examine Rigidity and Spasticity?

Conor Fearon1, Laura Doherty1, Tim Lynch1

  • 1Dublin Neurological Institute at the Mater Misericordiae University Hospital Dublin Ireland.

Movement Disorders Clinical Practice
|October 27, 2018
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Summary
This summary is machine-generated.

This study differentiates spasticity and rigidity, two types of hypertonia. Understanding their distinct anatomical origins aids in neurological localization and diagnosis.

Keywords:
Rigidityspasticity

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Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Examination

Background:

  • Tone, or increased resistance to passive joint movement, is a key neurological examination component.
  • Hypertonia presents as spasticity or rigidity, originating from distinct anatomical pathways.
  • Differentiating spasticity and rigidity offers crucial information for neurological localization.

Purpose of the Study:

  • To describe an approach for examining patients with rigidity and spasticity.
  • To highlight the clinical utility of differentiating these two forms of hypertonia.
  • To emphasize the importance of tone examination in neurological assessments.

Main Methods:

  • Assessment of joint passive movement to evaluate muscle tone.
  • Distinguishing spasticity based on velocity-dependent, asymmetric increases in tone with a "catch."
  • Identifying rigidity by constant, velocity-independent tone throughout the range of motion, often described as "lead pipe" or "cogwheeling" with tremor.

Main Results:

  • Spasticity results from corticospinal (pyramidal) tract damage, affecting antagonistic muscles.
  • Rigidity stems from extrapyramidal pathway dysfunction (e.g., basal ganglia) or lesions in the mesencephalon and spinal cord.
  • Rigidity is velocity-independent and uniformly affects muscle groups, potentially coexisting with tremor.

Conclusions:

  • Accurate differentiation between spasticity and rigidity is essential for precise neurological localization.
  • Understanding the underlying pathophysiology of hypertonia aids in diagnosing conditions affecting the central nervous system.
  • A systematic approach to tone examination enhances diagnostic capabilities in clinical neurology.