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REFLEXES-PLP.pptx
- 5. HOFFMANN’S SIGN STIMULUS : flicking down on the nail of the 3rd or 4th finger RESPONSE: involuntary flexion of the distal phalanx of the thumb or index finger
- 7. • Involuntary limb movements in the affected limb as reaction to voluntary, forceful movements in the uninvolved side. - Brunnstrom • These reactions come to a halt when muscle tension or the stimulus ceases.
- 8. HUNTINGTON’S PHENOMENON • YAWN -is usually present in patients with spasticity. Reaction: increase of flexor synergy ff’by the limb reaching forward et the hand opens - “Morning stretch” • COUGHING ET SNEEZING - evokes sudden muscular contraction of short duration.
- 9. HOMOLATERAL LIMB SYNKINESIS • There is mutual dependency that exists between the synergies of the AFFECTED upper and lower extremities.
- 10. RAIMISTE’S PHENOMENA • Resisted abduction or adduction in the sound side causes abduction or adduction of the affected side • Adduction is easier elicited.
- 11. HAND REACTIONS
- 12. TRUE GRASP REFLEX STIMULUS: distally moving deep pressure over certain areas of the palmar surface RESPONSE: flexion or grasping of the fingers over the direction of the stimulus REFLEXOGENIC ZONE- most of palmar surface excluding the ulnar side. It is weakest over the thumb.
- 13. SOUQUE’S FINGER PHENOMENON STIMULUS: elevation of the affected limb at 90° RESPONSE: extension of the fingers
- 15. UE • SCAPULAR PROTRACTION • SHOULDER IN NEUTRAL OR FLEXION @ 90°, PLACING ARM ANTERIORLY • ELBOW EXT. OR SLIGHTLY FLEXED (10-15°) • WRIST ET FINGERS EXTENDED OR SLIGHTLY FLEXED • HIP IN NEUTRAL OR SLIGHTLY ABDUCTED • KNEE EXTENDED • ANKLE NEUTRAL • TOES EXTENDED LE POSITIONS TO FACILITATE:
- 16. UE • SCAPULAR RETRACTION ET ELEVATION • SHOULDER ABDUCTION, EXTERNAL ROTATION • > 90° • FA SUPINATION • WRIST ET FINGER FLEXION • PELVIC TILT • HIP EXT., ADDUCTION ET INTERNAL ROTATION • KNEE EXTENSION • ANKLE PF ET INVERSION • TOE PLANTAR FLEXION LE POSITIONS TO AVOID
- 17. SUPINE POSITION • PILLOW UNDER PT’S HEAD, BED ELEVATED (25-30°) • SUPPORT UNDER THE AFFECTED ARM • PILLOW UNDER BOTH KNEES
- 18. SIDE-LYING ON AFFECTED SIDE • UE SHOULDER IN NEUTRAL POSITION SCAPULAR PROTACTED ELBOW SLIGHTLY BENT ET SUPPORTED ON A PILLOW WRIST ET FINGERS EXTENDED • LE AFFECTED HIP NEUTRAL ET KNEE EXTENDED ANKLE NEUTRAL OR SLIGHTLY DORSIFLEXED
- 19. SIDE LYING ON UNAFFECTED SIDE • PILLOW UNDER PT’S HEAD, BED ELEVATED (25-30°) • SHOULDER ET SCAPULA PROTRACTED ET SUPPOTED WITH A PILLOW • ELBOW, WRIST ET FINGERS OF AFFECTED SDE IN EXTENSION • UNAFFECTED EXTREMITY ON A PILLOW WITH SHOULDER AROUND 90° ABDUCTED • ELBOW SLIGHTLY FLEXED !! AFFECTED UE IS PLACED INFRONT OF THE BODY TO IMPROVE AWARENESS
- 20. SITTING POSITION • IN BED SAME AS SUPINE POSITION BUT THE HEAD OF THE BED IS ELEVATED UPTO 80-90° • IN CHAIR SUPPORT THE AFFECTED ARM WITH AN ARM TRSY OR BEDSIDE TABLE. OR ADD EXTRA CUSHION USING PILLOWS TO POSITION SHOULDER IN NEUTRAL POSITION.