Motor Control and Toe

Hierarchical theory

Movement progresses as the brain takes over movement and replaces reflexes

Reflex theory

Movement begins because of automatic inborne reflexes

Stage I of motor control

Mobility

Stage II of motor control

Stability

Stage III of motor control

Controlled mobility

Stage IV of motor control

Skill

Spastic UE in supine

Held against body with shoulder add, elbow flex, forearm supinated, and wrist/fingers flexed

Spastic LE in supine

extension, add, plantarflexion, and inversion

Normal tone

Light and responsive

Cogwheel tone

Ratchet-like jerky movement as a constant force is applied to bend the extremity

Clasp-knife tone

Increased tension in the extensor of a joint when passively flexed then suddenly giving way

Lead pipe rigidity

Increased muscle tone causes a sustained resistance to passive movement throughout entire range

Lead pipe rigidity (Cause)

Lesions in basal ganglia

Decorticate rigidity

Sustained contraction and posturing of the UE in flexion and LE in extension

Decerebrate rigidity

Sustained contraction and posturing of the trunk and limbs in full extension

Dystonia

Prolonged involuntary movement disorder characterized by twisting or writhing repetitive movements and increase muscular tone