This contraction causes stiffness or tightness of the muscles and can interfere with normal movement, speech and gait. Often, in parkinsonism, there is a cogwheeling character to the hypertonicity cogwheel. Consequences of spasticity can include the development of contractures or chronic pain, functional problems with selfcare and mobility, seating problems, difficulty sleeping, as well as cosmetic appearance problems. Visit for extended videos from occupational therapist. Jan 01, 20 there is still some misuse of the terminology spasticity and rigidity.
Spasticity is defined as a hypertonia that is associated with one or both of the following signs. Whilst both spasticity and rigidity describe conditions in which one finds difficulty performing muscular motions, the difference between them arises in how such difficulty is brought about. Muscle movements are normally controlled by a complex system that allows some muscles to contract tighten while others relax. Aug 09, 2006 spasticity is a form of muscular hypertoncity excessive muscle tone with increased resistance to stretching. Spasticity can be distinguished from rigidity by its dependence on the speed of muscle stretch and characteristic distribution in antigravity muscle groups. The upper motor neuron syndrome is caused by a lesion proximal to the anterior horn cell. Spasticity is derived from the greek word spasticus, which means to pull. Spasticity and rigidity are 2 types of hypertonic states elicited when examining the tone of limbs.
A high degree of paresis and hypoesthesia at stroke onset has. Mas 3, though, was observed more frequently in the upper limb muscles 11. Sep 04, 2014 spasticity is a fertile area for research. The increased muscle tone may result in loss of joint motion, leading to contractures. Spasticity refers to an abnormality in muscle tone. Spasticity is characterized by increased muscle tone, hyperactive reflexes, and possible clonus or rigidity. Unlike spasticity, which is characteristic of upper motor neuron disease see chapter 15, rigidity, the hallmark of hypokinesia, is increased tone of both flexor and extensor muscles. This video is a part of a larger group of videos that were created during the symposium. It is important to differentiate between them to arrive at a correct diagnosis. It is also associated with mental health disorders. Spasticity is usually caused by damage to the portion of the brain or. Spasticity is a component of the upper motor neuron syndrome umns. Most clinicians distinguish spasticity from rigidity by repeatedly extending and flexing the patients limbs and observing the characteristics already noted. What is the main difference between rigidity and spasticity.
Both rigidity and spasticity are terms that generally refer to muscle. These definitions has no true differentiating power. Classification and definition of disorders causing hypertonia in. You would see movement that requires greater effort and with a lack of control and coordination. It is also colloquially referred to as an unusual tightness, stiffness, or pull of muscles. Both of them demonstrate hypertonic conditions, however, their causes, symptoms, and attributes differ.
Thus in patients with hypertonic muscles, dorsal root section also abolishes the rigidity and spasticity fbrster, 1911, 19a and b. Damage to nerves in the central nervous system can disrupt the pattern. Spasticity does not always cause harm and can occasionally assist in the rehabilitation process by enabling a patient to stand when their limb weakness would not otherwise allow it. Spasticity is a symptom of multiple sclerosis where the muscles feel stiff, heavy and difficult to move. Hypertonia due to soft tissue stiffness will not respond to antispasticity medications or chemodenervation. Examination of tone increased resistance to the passive movement of a joint is a. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Furthermore, how would differentiating them help localize the disease process. Disruption of the upper motor neuron inhibitory pathways by stroke, brain trauma, or spinal cord injury leads to muscle spasticity. More specifically, there is an increase in muscle tone. Furthermore, spasticity occurs due to damage to the corticoreticulospinal or pyramidal tracts, while rigidity occurs due to the dysfunction of extrapyramidal tracts and lesions in the spinal cord and mesencephalon. Apr 29, 2006 spasticity results from an umn lesionthere is resistance to any passive movements at the begining of the movement which then later gives way to more easy movement rigidity there is resisatnce to passive movement throughout the motion.
R1 angle of catch seen at velocity v2 or v3 r2 full range of motion achieved when muscle is at rest and tested at v1 velocity interpretation. Some aspects of the pathophysiology of spasticity and rigidity. Clinical outcome measures to assess spasticity at the bedside cannot completely account for the myriads of spasticity experiences. Complex physiologic work on gamma systems of muscle spindles provides a working hypothesis to account for both spasticity and rigidity as well as for differential action of certain agents. Paralysis occurs mainly due to the failures in the nervous system. View the entire article with references and supplemental information on the wiley online library. Spasticity and muscle tightness is commonly treated with medications, physical and occupational therapy. Calculate spasticity angle the difference between the two angles of r2 and r1 assign spasticity grade to.
Difference between spasticity and rigidity pg blazer. Rather, the main symptoms are weakness and loss of dexterity which is greater in distal than in the proximal muscles. Neurology topic 14 parkinsons disease examining a patient duration. As a result, many muscles may contract all at once. Tardieu is a scale for measuring spasticity that takes into account resistance to passive movement at both slow and fast speed. The points of difference between spasticity and rigidity have been summarized below. The most recent versions of the scale use the following criteria. Clonus tends to coexist with spasticity in many cases of stroke and spinal cord injury likely due to. Interrater reliability varied between as and mas, between muscle groups hip adductors hip extensorsflexors ankles plantarflexors, and between limbs. Rigidity is a hypertonia where the resistance to joint movement is present at low speeds of movement and does not depend on velocity, does not exhibit a speed or angle threshold. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. Reference links embedded in the article below will also take you to the article on the wiley online library. Spasticity is a condition in which certain muscles are continuously contracted. Tone is the resistance of muscles to passive stretch or elongation, basically the amount of tension a muscle has at rest.
Spasticity is a form of muscular hypertoncity excessive muscle tone with increased resistance to stretching. Animal studies show that muscle immobilization at short lengths reduces serial sarcomere number 7 and. On the other hand, spastic paralysis is a condition that gives rise to muscle stiffness. Muscle tone represents the resistance to passive movement of a joint. Rigidity and spasticity are two distinct types of hypertonia that arise from distinct anatomical pathways. Spasticity can be a significant problem in upper motor neuron disorders. There is still some misuse of the terminology spasticity and rigidity. There are a number of other factors that potentially confound the distinction between rigidity and spasticity. Jan 07, 2012 what is the difference between flaccid and spastic paralysis. Spasticity means over activity in muscles and is a common ms symptom. The pyramidal tract is the system which balances muscle tone. Tardieu scalemodified tardieu scale rehabmeasures database. It usually occurs in the flexor muscles of the arms and legs. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext.
Spasticity versus rigidity stanford 25 skills symposium, 2015. Multiple sclerosis ms is a chronic autoimmune, tcellmediated inflammatory disease affecting the central nervous system. Rigidity definition is the quality or state of being rigid. Rigidity these terms come up a lot, and im having trouble differentiating what they mean. Some consider clonus as simply an extended outcome of spasticity. Find out more about spasticity and spasms, and new treatment strategies in this az entry. Spasticity, however, is a particular type of hypertonia in which the muscles spasms are increased by movement.
The often used clinical scales for evaluating spasticity is the ashworth or modified. Both describe forms of hypertonic states affecting an individuals muscles, joints, and limbs, but a differentiation between the two must be acquired to. Spasticity versus rigidity stanford 25 skills symposium. Spasticity and clonus result from an upper motor neuron lesion that disinhibits the tendon stretch reflex. Spasticity is common in many neurological disorders, such as stroke and multiple sclerosis. The examination of tone is rarely undertaken without knowledge of the history, and this often influences the way in which muscle tone is evaluated in an individual. Pocket knife more force has to be applied in the initial phase of opening as in clasp knife spasticity.
What separates spasticity from rigidity is that the increase in resistance from a spastic muscle is velocity dependent. Flaccid paralysis is a condition that gives rise to limp and floppy muscles that lack firmness. This is our first video release from our 2015 stanford 25 skills symposium. Whilst spasticity and spasms arent always painful, if it does occur it can feel like a pulling or tugging of the muscles, particularly around joints, or a lengthy episode of cramp. A recent study showed that the prevalence of spasticity does not differ between the upper and the lower limbs.
Spasticity is the a hyperactive hand or arm when their is decreased ability to control the movement of the extremity and rigidity is a situation where the patient moves in a very stiff and robotic fashion. The ability to differentiate between these two entities therefore gives important information regarding localization. Difference between spasticity and rigidity difference. For patients who experience severe spasticity of cerebral origin must be at least 1 year post trauma in cases of traumatic brain injury a treatment for the management of severe spasticity for patients who have had ineffective results or intolerable side effects from oral. As nouns the difference between spasticity and rigidity is that spasticity is the state, quality or property of being spastic while rigidity is the quality or state of being rigid. This case of familial spastic paraparesis shows again how procaine may differentiate in its action between spasticity. Patients with hypokinetic disorders like parkinsons disease experience muscle rigidity and an inability to produce movement.
Spasticity is a term that is often used interchangeably with hypertonia. What is the difference between spasticity and spasms. Spasticity is defined as velocity dependent resistance to movement. The key difference between flaccid and spastic paralysis is that in flaccid paralysis, muscles cannot contract and stay weak and floppy while, in spastic paralysis, muscles stay in contraction, and it is too rigid paralysis is a condition we associate with the loss of muscle function. Oct 26, 2015 spasticity can be distinguished from rigidity by its dependence on the speed of muscle stretch and characteristic distribution in antigravity muscle groups. Spasticity is an increased resistance to the passive movement of a joint due to abnormally high muscle tone, and varies with the amplitude and speed of the joint motion. Mar 28, 2015 view the entire article with references and supplemental information on the wiley online library. Two common cases of resistance to movement are spasticity and rigidity. Understanding of spasticity and clonus from patient perspective and how it affects daily life is needed for clinical understanding and bedside practice. Understand rigidity vs spasticity in less than 3 minutes. Nov 17, 2016 understand rigidity vs spasticity in less than 3 minutes. However, it must be stressed that in such patients muscle hypertonia is a complex phenomenon, where spasticity represents only one aspect. Spasticity is a condition involving an involuntary increase in muscle tone that leads to resistance against normal movements of the body and may cause pain in some individuals.
The aim of this paper is to understand the effect of spasticity on daily life and identify bedside strategies that enhance patients function and improve comfort. Spasticity is responsible for the velocitydependence of muscle hypertonia in patients with umns. View the article pdf and any associated supplements and figures for a period of 48 hours. Movement and stretching exercises can help manage this. It is part of the upper motor neurone syndrome manifesting as increased tone, clonus, spasms, spastic. Sometimes spasticity and spasms change how you sit or lie which can also lead to pain. Clonus tends to not be present with spasticity in patients with significantly increased muscle tone, as the muscles are constantly active and therefore not engaging in the characteristic onoff cycle of clonus. Stiff, heavy and difficult to move muscles typify spasticity. Can you differentiate between spasticity versus rigidity. It is important to differentiate between them to arrive at a. Difference between spasticity and rigidity difference between. The main difference between spasticity and rigidity is that spasticity often affects antagonistic muscle groups, whereas rigidity occurs in both flexors and extensor muscles.
One of the two categories of movement disorders, hypokinesia is characterized by a partial or complete loss of muscle movement due to a disruption in the basal ganglia. Simulation of clasp knife and cog wheel rigidity youtube. Measure of resistance to passive movement 1 is not a measure of spasticity, but scores may by influenced by spasticity 2 is performed at one speed only onesecond1, so does not capture the velocitydependent component of spasticity good screening tool to indicate when further assessment needed 1. So, this is the key difference between flaccid and spastic paralysis. Because spasticity varies so much from person to person, it must be treated on an individual basis and demands a true partnership between the person with ms and his or her healthcare team e. Managing severe spasticity rady childrens hospital. It is distinguished from another disorder of increased muscle tone referred to as rigidity. Key difference ms vs parkinsons ms and parkinsons disease are two diseases affecting the central nervous system. Spasticity is a velocitydependent increase in muscle tone in response to passive movement. The ability to differentiate between these two entities. What is the difference between spasticity and rigidity.