Exam 18: Intervention for Flaccidity and Hypotonia

Which of the following characteristics distinguishes flaccidity from hypotonia?

A 57 year-old male recently suffered a hemorrhagic stroke and is referred to you for outpatient therapy.Upon exam you find the patient presents with a flaccid upper extremity.He has absent deep tendon reflexes,absent muscle tone and no resistance to passive movement.You can elicit no voluntary movement and you observe no associated reactions (e.g.,involuntary movements occurring with higher stress activities).You also note a three-finger shoulder subluxation.He has not been given any shoulder support and is complaining of mild shoulder pain.Given the known long-term benefits and risks of various shoulder supports,which of the following would you NOT recommend for this patient?

You are working with a 32 year-old female who was admitted to the inpatient acute rehabilitation unit today.She suffered a stroke while trail running 3 days ago.The patient presents with a flaccid upper extremity.Which of the following tests and measures would you include in your patient exam because it will tell you the most about the quality and level of her upper extremity hypotonia?

Which of the following medical conditions would produce hypotonia of central origin?

Weight-bearing in functional positions is often integrated into positioning and handling treatment techniques with flaccid and hypotonic upper and lower extremities.Which of the following would most likely NOT be a component of your rationale for use of weight-bearing techniques?

You are working with an 85 year-old patient who was admitted to the inpatient acute rehabilitation unit this afternoon;3 days post right MCA CVA.The patient presents with a flaccid upper extremity and hypotonic lower extremity.The patient's spouse is very involved in the patient's care and wants to help out as much as possible.Which of the following would be MOST important to address with the spouse immediately?

You are working with a 6 year-old girl who recently had a brain tumor removed.As a result of the tumor removal she now presents with a left flaccid upper and lower extremity.Which of the following would you consider appropriate supine positioning in bed?

You are working with a 53 year-old schoolteacher who is referred to outpatient therapy following a right anterior cerebral artery CVA.The biggest barrier to her function presently is her hypotonic foot and ankle.She can initiate ankle dorsiflexion for about 1/3 the range and her muscles easily fatigue.Which of the following interventions hold the MOST promise for functional motor dorsiflexion return for gait?

Natural aging may further compromise function in individuals with hypotonia.Which of the following would NOT influence recovery in the older adult?

You are working with a 78 year-old patient who was admitted to the inpatient acute rehabilitation unit this afternoon;4 days post right (R) middle cerebral artery (MCA) cerebral vascular accident (CVA).The patient presents with a flaccid upper extremity and hypotonic trunk and lower extremity.Which of the following would NOT be one of your initial safety considerations?