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Muscle Tone
My daughter has mild CP and low muscle tone. I have heard that the low tone can turn to spasticity, is this true, and if so, is it in all cases? I have been so worried about my little girl, she is 18 months, I posted about it a week or 2 ago. My major concern is her little fingers. Her fingers now seem to be the most affected and lagging. Her ring fingers, and pinky's tend to curl under and don;t have much strength at all, they just get in the way really, and she favours her index and thumb. Is that maybe a sign that they will not improve? Over the last week I have been noticing that her little hands sometimes bend at the wrists, and she gets all twisted and tangled up when trying to do things. Is it just a wait and see thing? THe physio told me the hands work from the thumb out, but i don;t think her little ones will ever be strong, or will they just get stiff??
Thankyou for all your info. I am awaiting, gosh in this day and age, for a paediatrician appointment as I have changed, so that is not for another month or 2, and only he can refer me back to the neuro.
Her fingers curling appears to be from low muscle tone, although sometimes she can straighten them, they seem to sit curled, like she just does not have the strength needed to straighten them. Her fingers are unlike most baby's, they are not chubby and straight, they each have their own strength, and depending on her tiredness depends on how they will sit and affect her ability to use them. Her pinky's though, they just seem very limp, like the joint between the middle and the end, doesn't work very well at all. Do muscles die off over time if they are not used? The OT said massage and play that uses those 2 fingers, but it is very difficult to single out the pinky's. I don't know, I just worry for her and how she will be, although she is very beautiful. When tired, she still seems to hold one hand fisted, like newborns do.
Her fingers curling appears to be from low muscle tone, although sometimes she can straighten them, they seem to sit curled, like she just does not have the strength needed to straighten them. Her fingers are unlike most baby's, they are not chubby and straight, they each have their own strength, and depending on her tiredness depends on how they will sit and affect her ability to use them. Her pinky's though, they just seem very limp, like the joint between the middle and the end, doesn't work very well at all. Do muscles die off over time if they are not used? The OT said massage and play that uses those 2 fingers, but it is very difficult to single out the pinky's. I don't know, I just worry for her and how she will be, although she is very beautiful. When tired, she still seems to hold one hand fisted, like newborns do.
Hi, good to see you back, but not with such worries. No, low tone does not always lead to spasticity. But when the low tone is not equal in all the opposing muscle groups, it can become spastic.
An example of "opposing muscle goups" might be the muscles the open the hands and stretch out the fingers (these are the extensor muscles on the back of the hand and forearm) VS. the muscles that curl the fingers in a fist. (These are the flexor muscles in the palm of the hand and the underside of the forearm.
At rest, all the muscles have some tone (resting tone). For example, in normal movement, when you want to stretch all the fingers straight and out your brain sends signals to the extensor group to raise their tone and do this action. But it ALSO has to send corresonding INHIBITORY signals to the opposing group so that they relax and allow the hand and fingers to open and straigthen.
If there is brain or spinal cord damage a couple things may happen. The pathways that signals for extension might not work well and the fingers can't open very well or some of them can and some can't. That means when the brain tells the hand to "do it's thing" the only muscles which work well are the flexor and the hand or fingers will flex instead of extend.
The other possibility is that the pathway for the inhibitory signal is damaged. In this case the hand has to work very hand to extend out, because the tone in the flexing muscles never gets the signal to relax. Then, at rest, the extensor muscles (that straighten the fingers) relax normally, but the opposing flexing muscles keep their higher tone even at rest. That's when we begin to see the curling under of fingers or wrist when the body is relaxed. This is spasticity.
I live with this phenomenon in my right hip. I have constant higher tone (spacticity) in the muscles that pull my hip/femur down and back. When I try to walk and stride forward with my right leg, it is pulled back against my effort and I end up dragging the leg forward with each step. What should have been natural is now a real effort.
And you are doing what you need to watch for when the limbs seem to do something unnatural when she is at rest or seem to do the opposite of what she wants or is trying to do. If you are already seeing some of these signs, you need a recheck with her neuro! Spasticity can be treated with meds that specifically relax high tone and it is important that all joints be stretched out and straightened very frequently so they don't bend, get stiff and lock into a bent position. If her little wrists want to curl under when she is using her hands she may need wrist splints to help her. I can't tell from what you are describing, if her movements are just weak and from low tone or if they are from spasticity opposing what she is trying to do.
Let me know what the doc says.
Quix
An example of "opposing muscle goups" might be the muscles the open the hands and stretch out the fingers (these are the extensor muscles on the back of the hand and forearm) VS. the muscles that curl the fingers in a fist. (These are the flexor muscles in the palm of the hand and the underside of the forearm.
At rest, all the muscles have some tone (resting tone). For example, in normal movement, when you want to stretch all the fingers straight and out your brain sends signals to the extensor group to raise their tone and do this action. But it ALSO has to send corresonding INHIBITORY signals to the opposing group so that they relax and allow the hand and fingers to open and straigthen.
If there is brain or spinal cord damage a couple things may happen. The pathways that signals for extension might not work well and the fingers can't open very well or some of them can and some can't. That means when the brain tells the hand to "do it's thing" the only muscles which work well are the flexor and the hand or fingers will flex instead of extend.
The other possibility is that the pathway for the inhibitory signal is damaged. In this case the hand has to work very hand to extend out, because the tone in the flexing muscles never gets the signal to relax. Then, at rest, the extensor muscles (that straighten the fingers) relax normally, but the opposing flexing muscles keep their higher tone even at rest. That's when we begin to see the curling under of fingers or wrist when the body is relaxed. This is spasticity.
I live with this phenomenon in my right hip. I have constant higher tone (spacticity) in the muscles that pull my hip/femur down and back. When I try to walk and stride forward with my right leg, it is pulled back against my effort and I end up dragging the leg forward with each step. What should have been natural is now a real effort.
And you are doing what you need to watch for when the limbs seem to do something unnatural when she is at rest or seem to do the opposite of what she wants or is trying to do. If you are already seeing some of these signs, you need a recheck with her neuro! Spasticity can be treated with meds that specifically relax high tone and it is important that all joints be stretched out and straightened very frequently so they don't bend, get stiff and lock into a bent position. If her little wrists want to curl under when she is using her hands she may need wrist splints to help her. I can't tell from what you are describing, if her movements are just weak and from low tone or if they are from spasticity opposing what she is trying to do.
Let me know what the doc says.
Quix
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