Muscle Tone And Reflex Assessment

Continuous state of mild contraction, or a state of preparedness in the muscle

Dependent on the integrity of peripheral and CNS mechanisms and the properties of the muscle

Resistance or tension when passively moving the extremities Page  2

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Effective co-activation (stabilization) at axial and proximal joints

Ability to move against gravity and resistance

Balance tone between agonist and antagonistic muscles

Ability to maintain the position of the limb if it is placed passively by the examiner and then relaxed

Ease of the ability to shift from stability to mobility and reverse as needed

Ability to use muscles in groups or selectively, if necessary

Resistance or slight resistance in response to passive movement Page  4

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Record the position of the patient’s because body and head position influence cerebral hypertonus. When testing for muscle tone of the upper extremity, the patient is placed in sitting Page  23

Grasp the patient’s limb proximal and distal to the joint being tested and move the joint slowly through its range to determine the free and easy ROM available. • Note the presence and location of pain. • If there is no active movement or the extremity feels heavy, record that the limb is flaccid or “0” in strength. • If the limb has some active movement and no evidence of increased tone, the affected muscle or muscle group may be labeled as “paretic” instead of hypotonic. Then muscle can then be graded in strength Page  24

Hold the limb on the lateral aspects to avoid giving tactile stimulation to the muscle belly of the muscle being tested. Note also if the limb feels light or heavy. Clinical assessment of tone involves holding the patient’s limbs as described and moving it rapidly through its full range while the patient is relaxed. Label the tone as “mild”, “moderate”, or “severe”. Page  25

Record findings for various muscle groups or movements • Grade 3 (MAS) spasticity on R elbow flexors • Moderate spasticity of R elbow flexors • Mild to moderate spasticity is evident in the R elbow flexors Page  26

Ashworth Scale and Modified Ashworth Scale Mild-Moderate-Severe Spasticity Scale Preston’s Three Step Hypertonicity Scale Page  27

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Mild • The stretch reflex (palpable catch) occurs at the muscle’s end range

Moderate • The stretch reflex (palpable catch) occurs in midrange

Severe • The stretch reflex (palpable catch) occurs when the muscle is in a shortened range Page  29

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