Motor Control - Updated

Cortical Lesion: Hemiplegic Posture

Retraction & depression of scapula; internal rotation of the shoulder; flexion of elbow, wrist, fingers; pronation of the forearm; lateral flexion of trunk toward involved side; elevation & retraction of pelvis; internal rotation of hip; extension of hip / knee; supination of foot; plantar flexion of ankle/toes.

Cortical Lesion: Hypotonia

Deceased muscle tone - less-than-normal resistance of a muscle to passive elongation - affected limb feels limp and heavy

Cortical Lesion: Hypertonia

Increased muscle tone - more-than-normal resistance of a muscle to passive elongation - neural (spasticity) & mechanical (soft-tissue stiffness) factors contribute

Cortical Lesion: Spasticity

Neural component of hypertonus - velocity-dependent increase in tonic stretch reflexes and exaggerated tendon reflexes (often with clonus & clasp-knife reflex). 

Cortical Lesion: Clonus

Oscillating contraction & relaxation of limb segment - alternating patterns of stretch reflex & inverse stretch reflex of a specific muscle  

Cortical Lesion: Clasp Knife

Resistance to passive stretch of a spastic muscles that suddenly gives way (like the blade of a jack knife). 

Cortical Lesion: Loss of Fractionation

Inability to move a single joint without producing unnecessary movements in other joints - predictable, repetitive combinations of movements that occur together (rather than selective, flexible movement patterns).

Cortical Lesion: Apraxia

Inability to perform goal-directed motor activity in the absence of paresis, ataxia, sensory loss, or abnormal muscle tone - omissions, disturbed order of submovements within a sequence, clumsiness, preservation 

Cortical Lesion: Lead Pipe Rigidity

Hypertonus in agonist and antagonist muscles, resistance to movement that is not velocity dependent, felt throughout the range of motion

Cerebellar Lesion: Intention Tremor

Rhythmic oscillating movement, develops during intentional movements, involuntary alternating contractions of opposing muscles. 

Cerebellar Lesion: Dysmetria

Inability to judge distance accurately, overshooting or undershooting a specific target.

Cerebellar Lesion: Dysynergia

Movements broken up into multiple simple movements (rather than one smooth movement)

Cerebellar Lesion: Dysdiadochokinesia

Impairment in ability to perform repeated alternating movements, such as pronation & supination, rapidly & smoothly.

Cerebellar Lesion: Adiadochokinesia

Loss of ability to perform rapid alternating movements

Cerebellar Lesion: Ataxia

Unsteadiness, incoordination, clumsiness.

Cerebellar Lesion: Ataxic Gait

Wide-based, unsteady, staggering gait, tendency to veer side to side. 

Basal Ganglia Lesions: Tremors at Rest/Nonintentional Tremors

Stop at the initiation of voluntary movement - resume during the holding phase of motor tasks when attention wanes or is diverted to another task - fatiguing

Basal Ganglia Lesions: Hypokinesia

Slowness or reduced amount or range of spontaneous movement - symptoms are reflected in lack of facial expression, monotone speech, reduced eye movements, diminished arm swing during walking,

Basal Ganglia Lesions: Hypokinesia - Akinesia

Difficulty initiating voluntary movements

Basal Ganglia Lesions: Hypokinesia - Bradykinesia

Slowness in carrying out movements

Basal Ganglia Lesions: Festinating Gait

Small, fast, shuffling steps propel the body forward at an increasing rate - difficulty stopping or changing directions

Basal Ganglia Lesions: Athetosis

 Slow, writhing involuntary movements - neck, face, and extremities - tone may be increased or decreased

Basal Ganglia Lesions: Dystonia

Powerful, sustained contractions of muscles - cause twisting & writhing of limb or whole body - distorted postures trunk and proximal extremities

Basal Ganglia Lesions: Chorea

Sudden involuntary purposeless, rapid, jerky movements and/or grimacing - primarily in the distal extremities and face (e.g., Huntington chorea)

Basal Ganglia Lesions: Hemibllismus

Unilateral chorea - violent, forceful, flinging movements of extremities on one side of the body