coordination pathologies/cases

cerebellar or basal ganglia dysfunction, loss of somatosensation, UMN lesion, loss of ROM, LMN lesion or weakness

these different pathologies could cause coordination impairments

decomposition

break down movements to one joint at a time

ataxia

lack of muscle coordination

Dysdiadochokinesia

inability to perform rapid alternating movements

dysmetria

inability to control the distance, power, and speed of a muscular action

Dyssynergia

breakdown in movement resulting in joints being moved separately to reach a desired target as opposed to moving in a smooth trajectory; decomposition of movement

Hypotonia

reduced muscle tone or tension

rebound phenomenon

Inability to halt forceful movements after resistive stimulus removed; patient unable to stop sudden limb motion

intention tremor

involuntary trembling when an individual attempts a voluntary movement

Postural tremor

occurs during maintenance of a position against gravity and increases with action

Titubation

Rhythmic oscillations of the head; axial involvement of the trunk

midline

titubation tremor would affect which part of the cerebellum

lateral

postural temor would affect which part of the cerebellum

rxn, overshooting, moving, speed, halting

someone with a cerebellar lesion would present with:

Delayed blank time

Increased time to complete task due to blank or undershooting

More pronounced if target is blank

Accuracy suffers with increased blank

Difficulty with blank or altering movement

speed, co-activation, terminating, coordination, extraneous

basal ganglia dysfunction:

decreased blank

increased blank

difficulty blank movement

impaired multi-joint blank

blank movements

bradykinesia

slow movement

Akinesia

inability to initiate movement

chorea

sudden, rapid, jerky, purposeless movement involving limbs, trunk, or face

Athetosis

bizarre, slow, twisting, writhing movement, resembling a snake or worm

Choreoathetosis

movement disorder with features of both chorea and athetosis

Dystonia

a condition of abnormal muscle tone that causes the impairment of voluntary muscle movement

hemiballismus

Large-amplitude sudden, violent, flailing motions of the arm and leg of one side of the body

Rigidity

stiffness

resting tremor

a tremor that is apparent when the client is at rest and diminishes with activity

inter-joint, speed, multi-joint, eyes

somatosensory loss:

• Difficulty with accuracy, dysmetria

• Difficulty with BLANK coordination

• Errors increase with: Increasing BLANK (even if vision present)

• BLANK movement

• BLANK closed

small, spasticity, slow, overshooting

UMN lesion:

Expected Coordination Impairments

• Movement is slow with BLANK amplitude, in part due to BLANK

• BLANK alternating motion rates (but can be accurate if enough ROM available)

• BLANK and undershoot with close and distant targets, respectively

syngeries, trunk, bilateral

UMN lesion:

• Difficulty with

• Sequencing of multi-joint movements, may

display BLANK

• Isolating movements, for example:

Increased BLANK motion when reaching with upper extremity

Excessive activation of BLANK muscles

sva, sci, ms

what conditions could lead to umn coordination deficitsd

decreased ROM

Expected Coordination Impairments with BLANK

• Unable to fully complete task due to ROM • May influence reciprocal motion, fixation/limb holding

LMN lesion, weakness

Expected Coordination Impairments with BLANK

• Decreased ability to functionally activate muscles

• May influence reciprocal motion, movement composition, accuracy, fixation/limb holding

cerebellum

C or BG: ataxia

cerebellum

C or BG: dysdiadochokinesia

cerebellum

C or BG: dysmetria

cerebellum

C or BG: dyssnergia, asynergia

cerebellum

C or BG: hypotonia

cerebellum

C or BG: rebound phenomenon

cerebellum

C or BG: intention tremor

cerebellum

C or BG: postural tremor

cerebellum

C or BG: titubation

intention, postural, titubation tremor

which tremor types would someone with a cerebellar lesion present with?

basal ganglia

C or BG: bradykinesia, akinesia

basal ganglia

C or BG: athetosis

basal ganglia

C or BG: chorea

basal ganglia

C or BG: choreoathetosis

basal ganglia

C or BG: dystonia

basal ganglia

C or BG: hemiballismus

basal ganglia

C or BG: hyper and hypokenesis

basal ganglia

C or BG: rigdity

basal ganglia

C or BG: resting tremor

resting tremor

what type of tremor would someone with a basal ganglia lesion present with?