The muscles of the legs are constantly in good shape. Violation of muscle tone

Muscle tone is essentially the degree of muscle elasticity and resistance that accompanies passive flexion or extension of the limbs. Muscle tone is due to various factors. First of all, it depends on the state of the muscles, peripheral nerve fibers and impulses. The ability of muscles to contract when overcoming a certain load is an important indicator of human health. It is absolutely normal that even in a relaxed state, the muscles are in some tension. As a result of disease and injury nervous system muscle tone may change. One or another type of violation leads to its decrease or increase. In accordance with this, hypo- and hypertonicity of the muscles are distinguished.

Increased muscle tone can be:

• spastic;
• rigid.

A distinctive feature of the spastic type is unevenness, selectivity. The cause of its occurrence are violations that affect the components of the pyramidal system. In this case, we are talking about a chain of neurons whose main task is to transmit motor commands addressed to skeletal muscles. Due to the fact that the central neuron in this system is damaged, spastic hypertonicity develops. Making movements of a passive nature occurs with difficulty, but this is characteristic of the very beginning of the action. In the future, these manipulations are performed quite easily. When making movements at a fast pace, such symptoms are more noticeable. Since there is damage in the motor center of the brain, the violation affects not one muscle, but their combination, for example, the flexor/extensor group of the feet. It is in this that the selective and uneven nature of this type of hypertonicity is manifested. Factors due to which it can occur are represented by strokes, brain injuries, various disorders of the nervous system, meningitis, sclerosis, hypoxia, phenylketonuria and other diseases.

Rigid increased muscle tone is also called plastic. It manifests itself if the extrapyramidal nervous system is affected. This system includes brain structures and nerve pathways that are directly involved in both the regulation and control of motor manipulations. As a result of this, a motor reaction is organized when laughing or crying, a certain posture in space is maintained, and so on. Distinctive feature The rigid variety is that the difficulty in performing passive motor manipulations is permanent, resulting in spasm of all muscles. The limbs freeze in the positions they were given. In some cases, a damaged pyramidal and extrapyramidal system can lead to a mixed type of hypertonicity. As a rule, the cause of this pathology are brain tumors.

Causes of increased muscle tone

Muscle hypertonicity in adults is not in all cases associated with pathology, a characteristic feature of which is the persistence of its increase. Sometimes it is associated with physiological causes:

1. Tired, tense muscles. Performing work for a long time period, the muscles lose energy, which leads to the freezing of the muscle fiber in a contracted state.
2. The duration of being in an uncomfortable or monotonous position. Since in such a situation the entire load is associated with a certain type of muscle, spasm occurs, as with overstrain. Very often the appearance of such a spasm in neck muscles observed in people who sit at the computer for a long time. Hypertonicity of the back muscles in adults is often found in those who work in the garden for a long time.
3. Protective response to pain. In this case, we are talking about the occurrence of pain syndrome, spastic hypertonicity as a kind of reaction, for example, damage to the spine leads to spasm of the corresponding muscles.
4. Bruises, back pain. In the presence of pathologies of the spinal column, there is an increase in pain.

Muscle hypertonicity syndrome accompanies many different diseases. For example, it can be observed when:

• acute circulatory disorders of the brain, which leads to ischemic and hemorrhagic stroke;
• tumors of both the spinal cord and the brain;
• craniocerebral injuries;
• spastic form of torticollis;
• bruxism;
• dystonic syndrome;
• hepatic encephalopathy;
• infections of the central nervous system;
• multiple sclerosis.

If such a condition for an adult is a deviation, then for a newborn it is within the normal range. It has to do with the position of the baby in the womb. Prolonged intrauterine stay in the fetal position is accompanied by close contact of the limbs, chin and torso, which leads to muscle tension in the fetus. clenched fists, bent legs, tilting the head - all these are signs of hypertonicity of a monthly baby.

Preservation of muscle tension at the age of six months is a serious reason for contacting a qualified specialist.

Symptoms and treatment

Like any disease, muscle hypertonicity has its own symptoms. Increased muscle tone in adults is characterized by:

• tension, immobility;
• discomfort during movement;
• muscular stiffness;
• spontaneous active movements;
• increased tendon reflexes;
• a slow process of relaxation of muscles that have undergone spasm.

In addition, hypertonicity of the calf muscles in adults is manifested by walking on "toes". This indicates the advanced nature of the disease with childhood. The occurrence of seizures is directly related to the tension of any muscle. With any mechanical impact, a person experiences severe pain. Hypertonicity of the muscles of the legs in adults as a result of prolonged stress leads to impaired blood circulation, the formation of painful seals.

Hypertonicity in newborns is characterized by:

• restless, short sleep;
• pretension of the upper and lower extremities;
• tilted back position of the head;
• resistance that accompanies attempts to spread the upper, lower limbs baby;
• painful response to various stimuli, such as light;
• frequent spitting up.

In the presence of the described signs of increased muscle tone, you should consult a doctor: a therapist or a neurologist. The rapid achievement of positive results of treatment is ensured by the timeliness of contacting a specialist. At the first stage of treatment, the underlying disease that provoked an increase in muscle tone is overcome. The second stage is corrective and aimed at facilitating therapy.

Muscle hypertonicity can be treated with:

1. relaxing massage;
2. physiotherapy exercises;
3. electrophoresis;
4. paraffin applications;
5. swimming;
6. medical treatment.

The main purpose of drug treatment is to minimize pain, normalize the functioning of the central nervous system. In each case, drug therapy may be associated with:

• relief of symptoms;
• reduction of spasmodic phenomena;
• facilitation of movement.

Similar goals are achieved with the use of muscle relaxants, neuroleptics.

Timely diagnosis of muscle hypertonicity, compliance with the treatment prescribed by the doctor, regular physical exercise will allow to overcome the disease in a short time and reduce the risk of possible complications.

Muscle tone - involuntary, constantly changing in intensity muscle tension, not accompanied by a motor effect. Muscle tone creates preparation for movement, provides resistance and elasticity of muscles. Maintain balance and posture. Muscle tone has 2 components - plastic and reflex. Plastic tone is muscle tension, its turgor, which is preserved under conditions of denervation. This term defines the tone of individual muscle cells, depending on the characteristics of their structure, the exchange of in-in, blood and lymph circulation, the content of comp. fabrics.

Reflex tone - reflex muscle tension caused by its stretching, i.e. stimulation of proprioceptors. Muscle tone is influenced by the spinal reflex apparatus, afferent innervation, reticular formation, vestibular centers, cerebellum, red nucleus system, basal nuclei, etc. To judge the state of muscle tone, direct palpation of the muscles of segmental areas of the body is performed. However, the determining factor is the study of muscle tone through passive movements in the flexors and extensors, adductors and abductors. Hypotension and muscle atony occurs with peripheral paralysis or paresis (violation of the efferent section of the reflex arc when the nerve, root, cells of the anterior horn are damaged spinal cord), lesions of the cerebellum, brain stem, corpus striatum and posterior funiculi of the spinal cord. Distinguish between spastic and plastic hypertension. Spast-th - increase. muscle tone in the flexors and pronators of the arm and in the extensor and adductors of the leg (with damage to the pyramidal tract). With spastic hypertension, during repeated movements of the limb, muscle tone does not change, and sometimes decreases, with plastic hypertension, muscle tone increases. In spastic hypertension, there is a symptom of a "penknife" (an obstacle to passive movement in initial phase research), with plastic hypertension - a symptom of "gear wheel" (feeling of tremors during the study of muscle tone in the limbs). Plastic hypertension is an increase in muscle tone, uniform in both flexors and extensors, in pronators and supinators.

2.7.Peripheral paralysis.

In periphral paralysis (PP), damage can involve the anterior horns, several anterior roots, and peripheral nerves. PP is characterized by: 1) hypotension and muscle atony. 2) hypo- and areflexia. 3) hypo- and muscle atrophy. 4) neurogenic muscular degeneration with the reaction of degeneration.

When the anterior horns are affected, the muscles innervated from this segment suffer. Often in atrophying muscles, rapid contractions of individual muscle fibers and their bundles - fibrillar and fascicular twitches, due to irritation by the pathological process on dead neurons.

The defeat of the anterior roots gives the same picture. Damage to the plexus har-Xia periph with paralysis of one limb in combination with pain and anesthesia, as well as autonomic disorders in this limb. In case of damage to the periphery of the nerve, paralysis of the muscles of the inner nerves by this nerve is observed, in combination with sensory disturbances. Damage to many peripheral nerves leads to widespread sensory, motor and vegetative disorders, most often bilateral, mainly in the distal segments of the extremities. Patients complain of paresthesia and pain. Disturbances in the type of "socks" or "gloves", flaccid paralysis of muscles with atrophy, trophic disorders on the skin are revealed.

Content

Parents may sometimes notice that their children have physical development slightly behind the norm, there is a weak muscle tone. These symptoms cannot be ignored, because they indicate health problems that need to be treated in time. As a rule, with such manifestations, SMD is diagnosed - muscular dystonia.

What is muscular dystonia

The word "dystonia" is of Latin origin. It translates as "violation of tone." Doctors under the term "muscular dystonia" understand a disease that affects the muscles of the baby or an adult. Deviations can be observed not only in the direction of a decrease (hypotonicity), but also an increase (hypertonicity). Muscles can be affected on one side or symmetrically on both sides. As a rule, the lower extremities are more prone to hypertonicity, and the arms are more likely to suffer from hypotonicity. The disease according to the ICD has the code G24.

Causes

Muscular dystonia syndrome is more common in infants, develops in most cases due to perinatal encephalopathy or standard brain damage during childbirth. Only in some cases does this occur even during fetal development. The baby can get such damage for the following reasons:

• detachment of the placenta;
• prolonged toxicosis of a pregnant woman;
• polyhydramnios during pregnancy;
• chronic fetal hypoxia;
• the threat of miscarriage of any nature;
• alcohol, nicotine intoxication during gestation;
• long waterless period;
• impact on future mother harmful factors;
• too rapid / protracted childbirth;
• caesarean section under general anesthesia;
• profuse blood loss during childbirth;
• entanglement of the umbilical cord inside the womb of the baby.

At the baby

In very young children, dystonic syndrome has pronounced symptoms from the very first days of life. Reduced muscle tone is easier for the baby and parents to tolerate: the child sleeps more, rarely cries. However, the baby noticeably later masters holding the head, turning over and other motor skills. The disease is accompanied by hypertonicity with the following symptoms:

• trembling of the chin;
• frequent crying;
• sleep disturbance;
• frequent regurgitation;
• anxiety.

In children and adolescents

The presence of muscular dystonia syndrome in older children (over 2 years old) indicates disorders in the functioning of the nervous system. This reason becomes a provoking factor, affects the functioning, muscle tone. With the timely detection of the disease, the prescribed treatment will be more effective. Muscle dystonia must be diagnosed by a pediatrician and a neurologist.

In adults

A decrease in muscle tone in adults occurs due to a malfunction in the functioning of neural connections within the basal ganglia. They are located deep in the brain, are responsible for controlling any movement, maintaining correct posture. An acquired increase or decrease in muscle tone in an adult can manifest itself for the following reasons:

• brain tumor;
• stroke;
• cerebral paralysis;
• brain injury;
• infection;
• chorea of ​​Huntington;
• lead poisoning;
• oxygen starvation;
• Wilson-Konovalov disease;
• drug treatment;
• encephalitis.

Primary (idiopathic) dystonia in most cases is transmitted from parents. The manifestations of the disease can vary widely among members of the same family. The disorder can manifest itself when performing some specific tasks, for example, writing by hand. Deterioration of the condition can occur when taking medications from certain groups of drugs. Doctors say that this disease does not affect cognitive abilities (communication skills, memory).

Types of disease and their symptoms

As the main diagnosis, hypertension or hypotonia of the muscles can be made in infancy. In adults, it manifests itself more often at the age of 40-60 years. Adolescents are much less likely to experience such a disease. Doctors divide this disease into two types:

1. Primary - manifests itself against the background of a genetic predisposition. It is diagnosed when other diseases, neurological damage are not capable of causing this syndrome.
2. Secondary SMD - a disorder occurs against the background of the underlying condition. In most cases, it is caused by neurological injuries, genetic damage that affects the nervous system.

The syndrome can have different degrees of manifestation. Specialists, based on the severity of symptoms, distinguish several stages of the condition in dystonic syndrome:

1. The first stage - it is characterized by a slight tension in the muscles, but the tone relatively quickly returns to normal.
2. The second is that the signs are more noticeable during movement, after some time and during rest.
3. The third is clearly visible physical disorders that occur due to prolonged muscle spasms(the foot, spine, cerebral palsy, torticollis are bent).

Muscle hypertonicity

Increased tone in this syndrome is characterized by excessive tension of the extensor, flexor muscles. Signs can be mild or pronounced, for example, the child only resists a little while changing clothes or does not give the opportunity to control his body at all. The main manifestations of hypertension in a child include:

• disturbing dream;
• tightly pressed legs, arms to the body;
• causeless crying;
• the head is thrown back;
• babies who have begun to walk move on their toes;
• disturbing dream;
• legs are strongly separated to the sides;
• movement resistance;
• attempts to roll over always only on one side;
• frequent vomiting.

Doctors say that there is no reason to panic when diagnosing muscle hypertension in infants. By six months, the syndrome, as a rule, disappears without a trace, the development of the child continues in the usual direction. Nevertheless, if you suspect muscular dystonia, you should definitely conduct an examination and seek advice from your doctor. You may need to undergo treatment.

Muscle hypotension

The reverse state of the above syndrome - muscular hypotension. Instead of increased activity, the child has lethargy, weakness on the part of this system. Often parents are glad that their baby is very calm, but it should be remembered that this may be a sign of dystonia that has begun. The main symptoms include:

• the baby does not hold his head well;
• lack of desire to move;
• sleeping too much;
• little crying, almost always calm;
• unable to hold anything in his hands.

How to treat impaired muscle tone

Treatment of SMD, as a rule, includes several directions at once and is complex. In infants, they first try to get by with only common therapeutic massage so as not to load a weak body with medicines. If the desired effect in eradicating the syndrome cannot be achieved, then the doctor's recommendations should not be abandoned. It is necessary to use all methods of treating this disease, which include:

• gymnastics;
• physiotherapy;
• baths;
• taking medications;
• special massage.

This syndrome is not a sentence, it responds well to treatment, especially in the early stages. If the course is successful, it is necessary to continue to be observed by a specialist for a long time in order to respond in time with the development of a relapse, the possible negative consequences of the disease. The main task of parents is to carefully monitor the behavior and condition of their child and contact a specialist in time if they suspect the development of muscular dystonia.

Video

Hardest to define muscular dystonia in young children who are not yet able to say anything. An important factor in the successful treatment of this syndrome is timely access to a specialist, so it is important to understand how the disease manifests itself. The video below details the signs of SMD, methods of its treatment, gives the opinion of the famous pediatrician Komarovsky and an example of a simple massage for the disease.

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Muscle tone disorders are one of the manifestations of various diseases of the nervous system. The most common problem is hypertension.

Muscle tone is the residual tension of the muscles during their relaxation, or resistance to passive movements during voluntary muscle relaxation. In other words, this is the minimum muscle tension that is maintained in a state of relaxation and rest.

Changes in muscle tone can be caused by diseases and injuries at different levels of the nervous system. Depending on the type of disorder, muscle tone may increase or decrease. As a rule, doctors in clinical practice are faced with the problem of increasing muscle tone - hypertonicity.

Causes of increased muscle tone

Common causes of increased hypertension are the following types of diseases and disorders:
- vascular diseases of the brain or spinal cord with damage to the central nervous system (stroke);
-diseases of the central nervous system in children (cerebral palsy);
- demyelinating diseases (multiple sclerosis);
-Injury to the spinal cord or brain.

To a lesser extent, muscle tone is affected by the mental and emotional state, ambient temperature (cold increases, and heat reduces muscle tone), the speed of passive movements. The state of muscle tone is assessed by the doctor in the study of passive movements.

Signs of muscle hypertonicity

General signs of muscles with increased tone: tension, compaction, decrease in range of motion. In mild cases, hypertonicity causes some discomfort, a feeling of tension and muscle tightness. In these cases, the patient's condition improves after mechanical action (rubbing, massage). With moderate hypertonicity, muscle spasms are observed, which cause sharp pain. In the most severe cases of hypertonicity, the muscles become very dense, painfully react to mechanical stress.

The main types of muscle hypertonicity are spasticity and rigidity.

With spasticity, the muscles are constrained, which interferes with normal movements, is reflected in gait, speech. Spasticity can be accompanied by pain, involuntary crossing of the legs, deformity of muscles and joints, muscle fatigue, slowing down of muscle growth. The most common causes of spasticity are stroke, traumatic brain injury, spinal cord injury, cerebral palsy, multiple sclerosis, encephalopathy, and meningitis.

Spastic hypertonicity is characterized by uneven distribution, for example, only flexor muscles spasm.

With rigidity, the tone rises sharply skeletal muscle and their resistance to deformation forces. Muscle rigidity in diseases of the nervous system, poisoning with certain poisons, under the influence of hypnosis is manifested by a state of plastic tone - the muscles become waxy, and the limbs can be given any position. Rigidity, unlike spasticity, usually covers all muscles evenly.

For the treatment of muscle hypertonicity in adult patients, muscle relaxants (mydocalm, etc.) are most often used in combination with physiotherapy. In the treatment of local muscle spasms, botulinum toxin can be used in certain cases. Drugs that affect dopamine receptors are used to treat some forms of hypertonicity (such as muscle stiffness in Parkinson's disease).

Muscle tone study carried out in conditions of complete relaxation of the muscles, preferably in horizontal position examined, laid on a hard couch. The tone of the back muscles is determined in the position of the patient on the stomach.

To assess muscle tone a method is used to determine the transverse hardness (resistance) of the muscle and the depth of immersion (indentation) of the doctor's fingers into the muscle. The method is indicative, does not have clear criteria and is practiced empirically on a healthy person.

At research transverse hardness of the muscle, the doctor grabs the relaxed muscle with the thumb and forefinger and gently squeezes it, assessing the resistance to compression and the depth of immersion of the fingers. In places where the capture of the muscle is impossible, the muscle is pressed against the bone with a finger, while both resistance and the depth of immersion of the finger into the muscle are also evaluated.

In a healthy person engaged in moderate physical labor, the muscles are normotonic. Muscles with high resistance are defined as hypertonic, they are dense, tense. Muscles with low resistance are assessed as hypotonic, they are flabby, lethargic to the touch. Muscles that have lost resistance are atonic. Deviation from normal tone can be generalized and local.

Another method research muscle tone aims to determine the contractile tone (tonic resistance), that is, to assess the reflex tension of the muscle caused by its stretching during passive movements in the limbs, trunk, neck.

At study of contractile tone the doctor takes the distal part of the limb, which is in complete relaxation, and performs passive flexion and extension, while assessing the resistance of the flexor and extensor muscles functionally associated with this joint. The degree of muscle tonic resistance is also estimated approximately on the basis of clinical experience and skill, as well as a comparison of the muscle tone of the symmetrical parts of the limbs. A decrease or loss of muscle tone occurs due to a violation of the integrity of the reflex arc when a peripheral motor neuron is damaged.

Muscular hypotension leads to an increase in the volume of passive movements in the joints, a decrease in muscle resistance, and stretching. With muscle atony, these signs are pronounced up to the complete looseness of the joint. Generalized muscular hypotonia is observed with progressive atrophic lesions muscular system- starvation, dehydration, severe debilitating diseases, generalized form of myopathy, myasthenia gravis. Limited muscle hypotonia (atony) is more often detected on the limbs, in the muscles of the shoulder and pelvic girdle. Causes can be diseases of the central and peripheral nervous system, as well as long-term dysfunction of the joint.

Increased muscle tone observed in cases of damage to the pyramidal and extrapyramidal systems. Muscle hypertonicity is one of the leading symptoms of central paralysis.