Mind Map Gallery Coordination Examination

Coordination Examination

Identify the motor task requirements and movement capabilities addressed during an examination of coordination and balance.

Edited at 2020-10-10 07:02:40

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Coordination Examination

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Outline

Coordination Examination

Overview of Motor System

Motor Cortex

Descending Motor Pathways

Cerebellum

Basal Ganglia

Dorsal-Column-Medial Lemniscal Pathway

Feats. Coordination Impairments

Cerebellar Pathology

Basal Ganglia Pathology

Dorsal Column-Medial Lemniscal Pathology

Age-Related Changes Impacting Coordinated Movement

Screening

Examples of Screenings

ROM

Strength

Sensation

Feats. Coordination Tests

Gross & Fine Motor Movements

Nonequilibrium & Equilibrium (Bal) Tests

Motor Task Requirements

Movement Capabilities

Motor Task Requirements & Movement Capabilities Addressed During Examination of Coordination

Preparation for Administering Coordination Exam

Testing Environment

Pt. Preparation

Preliminary Observation

Coordination Exam

Recording Test Results

Table 7.3: Nonequilibrium Coordination Tests p. 212:

1. Finger-to-nose

2. Finger-to-PT's finger

3. Finger-to-finger

4. Alternate nose-to-finger

5. Finger Opposition

6. Mass Grasp

7. Pronation/Supination

8. Rebound test

9. Tapping (hand)

10. Tapping (foot)

11. Point & Past Pointing

12. Alternate heel-to-knee; heel-to-toe

13. Toe to PT's finger

14. Heel on shin

15. Drawing a circle

16. Fixation or Position Holding

Box 7.3 Equilibrium Coordination Tests p. 213

1. standing, comfortable posture with normal BOS

2. standing, feet together (narrow BOS)

3. standing in tandem position

4. standing on 1 foot

5. arm position may be altered in each of the above postures

6. perturbations: displays balance unexpectedly ( while carefully guarding pt)

7. standing, functional reach: forward trunk flexion with UE reach

8. standing, lateral flex trunk to each side

9. standing: eyes open to eyes closed; inability to maintain upright posture without visual input= positive Romberg sign

10. standing in tandem position eyes open to eyes closed (Sharpened Romberg)

11. tandem walking

12. walking along straight line drawn or tape to floor, or place feet on four markers while walking

13. walk sideways, backwards, or cross stepping

14. March in place

15. alter speed of ambulatory activities; observed pt. Walking at normal speed, as fast as possible & as low as possible

16. stop & start abruptly on command while walking

17. walk & pivot on command (90, 180, 360°)

18. walk in a circle, alternate directions

19. walk on heels or toes

20. walk with horizontal & vertical head turned on command

21. step over or around obstacles

22. stairclimbing with & without using hand rail; 1 step at a time, step overstep

23. jumping jacks

24. sitting on TherEx ball; alternate flexing & extending these (Chordata movement with upright balance)

Table 7.4 Sample Tests for Selected Coordination Impairments: p. 214

Dysdiadochokinesia

• Finger to nose• Alt nose-to-finger• Pronation/supination• Knee flx/ext• Walking, alter speed or direction

Dysmetria

• Pointing & past pointing• Join a circle or figure 8• Heel on shin• Placing feet on floor markers; sitting, standing

Dyssynergia

• Finger to nose• Finger to PT’s finger• Alternate heel to me• Toe to PT’s finger

Hypotonia

• Passive movement• DTRs

Tremor (intention)

• Observation during functional activities (tremor will typically increase as target is approached him movement speed increase)• Alternate nose to finger• Finger to finger• Finger to PTs finger• Toe to PTs finger

Tremor (resting)

• Observation of patient at rest; limb or jaw movements• Observation during functional activities (tremor will diminish significantly/disappear with movement)

Tremor (postural)

• Observation of steadiness abnormal posture; sitting, standing

Asthenia

• Fixation or position holding (UE & LE))• Application of manual resistance to determine ability to hold

Rigidity

• Passive movement• Observation during functional activities• Observation of resting posture(s)

Bradykinesia

• Walking, observation of arm swing & trunk motions• Walking, alter speed & direction• Request that a movement or gate activity be stopped abruptly• Observation of functional activities: timed tests

Disturbances of Posture

• Fixation or position holding (UE & LE)• Displace balance unexpectedly in sitting or standing (perturbations)• Standing, altar BOS

Disturbances of Gait

• Walking along a straight line• Walk sideways, backwards• March in place• Alter speed & direction of ambulatory activities• Walk in a circle

Quantitative Coordination Testing & Specialized Testing Instruments

CATSYS System

Postural Sway Analyzer

Choice Reaction Time Analyzer

Dynamic Posturography

Standardized Instruments: UE Coordination