SPASTICITY-UMNS MANIFESTATIONS

SUMMARY

POSITIVE SIGNS (ABNORMAL BEHAVIORS)

1. Hypertonia & spasticity: initially flaccid paralysis & areflexia, hypertonia classically sets in after period of spinal shock (8-12 weeks).
2. Hyper-reflexia.
3. Release of primitive reflexes: extensor plantar response, Hoffman's sign (UL sign), clonus

4. Extrapyramidal signs: athetosis, dystonia.
5. Extensor posturing (UL flexors > UL extensors & LL extensors > LL flexors).

NEGATIVE SIGNS (PERFORMANCE DEFICITS)
1. Pronator drift: first to occur, before weakness or reflex changes.
2. Hemiplegia/hemiparesis, paraplegia/paraparesis (weakness of LL).
3. Loss of abdominal reflexes on the affected side.

4. No muscle wasting.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.