The vast majority of children with cerebral palsy or central motor development disorders are spastic, or dystonic. Many parents, including therapists, have a one-sided perception on this issue, that no matter what, the muscle tone should be lowered, and lowering the muscle tone becomes the main technique and requirement for the treatment of cerebral palsy. This understanding has become a trend that wraps around rehabilitation physicians, therapists, and parents. Practice tells us that preserving a certain level of muscle tone is necessary for ankle stability, knee stability, and the prevention of muscle atrophy in children with cerebral palsy. This makes it more difficult to rehabilitate the child, because this method is not the result of central regulation.
General knowledge of muscle tone
Myotonia is the degree to which a muscle remains tense.
Resting tone
Postural tone
Motor muscle tone
Characteristics of normal muscle tone(1)
Effective simultaneous contraction of the proximal joints
The ability to move the limb with complete resistance to gravity and external resistance
The ability to hold the limb in a passive position in space and to maintain the limb in a constant position
Ability to maintain balance between active and antagonistic muscles
Characteristics of normal muscle tone(2)
Ability to move the limb from a fixed to a moving position and to change the position during movement at will
The ability to perform a synergistic movement of a muscle group when needed, or the ability to perform an independent motor function of a muscle
A certain degree of flexibility and mild resistance during passive movement
Characteristics of dystonia
Low muscle tone
Diminished or absent resistance to limb gravity
Reduced or absent muscle strength
Assessment of the degree of dystonia
Mild
Includes reduced muscle tone, decreased muscle strength, limb can only resist gravity for a short period of time when the limb is released from suspension, and still has some functional activity
Moderate to severe
Includes significant decrease or loss of muscle tone, zero or 1 level of muscle strength (MMT), immediate drop of the limb when the limb is released from the ceiling, and no functional activity
Characteristics of dystonic spasm
Evoked pullback reflex during passive movement
Resistance to passive movement
Disruption of the balance of muscle tone between the active and antagonistic muscles
Reduced range of motion and reduced or absent active movements