Assessing Tone | Parkinson's Exam - MedSchool
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Parkinson's Exam
 
 
 

Assessing Tone

 
 
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Overview

    • How to Assess

    • Ask the patient to relax and allow you to move their arms. Move the shoulder, elbow, wrist and fingers passively through their range of motion, looking for rigidity.
    • Interpretation

    • Increased: resistance to passive movementUpper motor neuron lesion
    • Normal: minimal resistance
    • Decreased: no resistanceLower motor neuron or cerebellar lesion

Spasticity

  • Also known as clasp-knife rigidity.
    • Feel For

    • Velocity dependant rigidity, with quick flexion / extension of the joint. Works best on the knee or elbow.
    • Significance

    • Indicative of upper motor neuron lesion.

Lead Pipe Rigidity

    • Feel For

    • Continuous rigidity that is not velocity dependant, resulting in slow flexion and extension.
    • Significance

    • Caused by Parkinson's disease, other causes of parkinsonism, and contractures.

Cog Wheel Rigidity

    • Feel For

    • Rigidity associated with tremor, resulting in jerky start / stop movement of the joint.
    • Significance

    • Caused by Parkinson's disease, other causes of parkinsonism, and contractures.
Last updated on April 19th, 2019
 
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