Assessment of Muscle Tone in Pediatrics

Barker, K. H. (Director) (2013, January 3). Assessment of Muscle Tone. Lecture conducted from Center for Pediatric Therapies, Inc, Danville, Va.

-3 Severe Hypotonia
Active: inability to resist gravity; lack of cocontraction at proximal joints for stability; apparent weakness
Passive: no resistance to movement imposed by examiner; full or excessive range of motion; hyperextensibility

-2 Moderate Hypotonia
Active: decreased tone primarily in axial muscles and proximal muscles of extremities; interferes with length of time
posture can be sustained
Passive: very little resistance to movements when imposed by examiner; less resistance encountered in movement around
proximal joints; joint hyperextensibility at knees and ankles at weight bearing

-1 Mild Hypotonia
Active: interferes with axial muscle cocontraction; delays initiation of movement against gravity; reduces speed of
adjustment to postural change
Passive: some resistance to joint changes; full passive joint ROM; hyperextensibility limited to joints of hand, ankles,
and feet

-0 Normal Muscle Tone
Active: quick and immediate postural adjustment during movement ability to use muscles in synergistic and reciprocal
patterns for stability and mobility depending on task of movement
Passive: body parts resist displacement; momentarily maintain new posture when placed in space; can rapidly follow changing
movement imposed by examiner

+1 Mild Hypertonia
Active: increased muscle tone causes delay in postural adjustment; movements are slow, coordination may be affected
Passive: resistance to change of posture in part of or throughout range; poor ability to accommodate passive movements

+2 Moderate Hypertonia
Active: increased tone limits speed, coordination, variety of movement patterns, and active ROM at some joints
Passive: resistance to change of posture throughout range; limited passive ROM at some joints

+3 Severe Hypertonia
Active: severe stiffness of muscles in stereotypic patterns; limited active ROM; little or no ability to move against
gravity; great effort needed to overcome stiffness when moving
Passive: passive ROM limited; unable to overcome resistance of muscles to complete full range without modifying position or
stabilizing other body parts

IT: Intermittent Abnormal Tone
Active: occasional and unpredictable resistance to postural changes altering with normal adjustment or lack of resistance;
may have difficulty initiating active movement or sustaining posture; sudden collapsing
Passive: unpredictable resistance to imposed passive movements alternating with complete absence of resistance












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