IPHREHAB : HYPERTONIA

IPHREHAB

HYPERTONIA

§Hypertonia is a condition marked by an abnormal increase in the tightness of muscle tone and a reduced ability of a muscle to stretch (i.e. an increased stiffness). It is generally accompanied by (increased) spasticity of the particular muscles.

§Damage to upper motor neurons causes hypertonia, as well as spasticity (overactive reflexes) and rigidity (constant muscle contractions).

§ A form of hypertonia is known as Paratonia which is associated with dementia.

§Hypertonia is a condition marked by an abnormal increase in muscle tension and a reduced ability of a muscle to stretch.

§It is caused by injury to motor pathways in the central nervous system, which carry information from the central nervous system to the muscles and control posture, muscle tone, and reflexes.

§When the injury occurs in children under the age of 2, the term cerebral palsy is often used.

§Hypertonia can be so severe that joint movement is not possible. Untreated hypertonia can lead to loss of function and deformity.

§Hypertonia may result from injury, disease, or conditions such as spasticity, dystonia (prolonged muscle contractions that cause twisting and repetitive movements or abnormal posture), rigidity, or a combination of factors.

§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.

§Dystonic hypertonia refers to muscle resistance to passive stretching (in which a therapist gently stretches the inactive contracted muscle to a comfortable length at very low speeds of movement) and a tendency of a limb to return to a fixed involuntary (and sometimes abnormal) posture following movement. It is seen is the different forms of dystonia and sometimes in parkinsonism.

§Rigidity is an involuntary stiffening or straightening out of muscles, accompanied by abnormally increased muscle tone and the reduced ability of a muscle to stretch. This type of hypertonia is most common in parkinsonism 

Treatment

• Drugs such as baclofen, diazepam, and dantrolene may be prescribed to reduce spasticity. All of these drugs can be taken by mouth, but baclofen may also be injected directly into the cerebrospinal fluid. 
• Injections of botulinum toxin are a recent treatment for chronic hypertonia in cerebral palsy, spasticity, and other disorders.. 

§Rehabilitative treatment may involve range of motion exercises, active stretching exercises, and occupational therapy.  

§In severe cases, clinicians may use selective dorsal rhizotomy, a surgical procedure in which the nerves that cause spasticity are cut.  

§Dystonic hypertonia and rigidity can be treated with therapies directed to the underlying disorders