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The greater the tone development (flexor tone), the brisker the recoil will be. [1] This correlates to more advanced gestational age on the Ballard Scale. [4] Leg recoil can be assessed following the same principle. [5]
Whereas the neurological criteria depend mainly upon muscle tone, the physical ones rely on anatomical changes. The neonate (less than 37 weeks of age) is in a state of physiological hypotonia. This tone increases throughout the fetal growth period, meaning a more premature baby would have a lesser muscle tone. It was developed in 1979. [1]
The Paratonia Assessment Instrument (PAI) was also used in a physiotherapic setting for the assessment of oppositional paratonia. [ 12 ] In 2017 facilitatory and oppositional paratonia have been assessed with surface electromyography , allowing a quantitative measure and better characterization of paratonia. [ 13 ]
A neurological examination is the assessment of sensory neuron and motor responses, especially reflexes, to determine whether the nervous system is impaired. This typically includes a physical examination and a review of the patient's medical history , [ 1 ] but not deeper investigation such as neuroimaging .
Both the extensor and flexor muscles are involved in the maintenance of a constant tone while at rest. In skeletal muscles, this helps maintain a normal posture. Resting muscle tone varies along a bell-shaped curve. Low tone is perceived as "lax, flabby, floppy, mushy, dead weight" and high tone is perceived as "tight, light, strong".
Disuse atrophy of the muscle occurs i.e., shrinkage of muscle fibre finally replaced by fibrous tissue (fibrous muscle) Other causes include Guillain–Barré syndrome, West Nile fever, C. botulism, polio, and cauda equina syndrome; another common cause of lower motor neuron degeneration is amyotrophic lateral sclerosis.
Spastic hypertonia involves uncontrollable muscle spasms, stiffening or straightening out of muscles, shock-like contractions of all or part of a group of muscles, and abnormal muscle tone. It is seen in disorders such as cerebral palsy, stroke, and spinal cord injury. Rigidity is a severe state of hypertonia where muscle resistance occurs ...
The outside environment is a drastic change for the neonate, therefore the neonate must be assessed frequently and thoroughly. The Apgar scale is an assessment performed immediately following birth. It consists of the assessment of heart rate, respiratory effort, muscle tone, reflex irritability, and generalized skin color.