STARRS STARRS Characteristics One way to describe muscle

STARRS

STARRS Characteristics • One way to describe muscle function and movement • Rating Scale from 0 -4 with • • • 0 indicating normal function 1 mild impairment ( ~25% or less impaired) 2 moderate ( ~50% or more is impaired ) 3 severe (~ 75% or more is impaired) 4 indicating profound deficits ( unable to perform)

Muscle Strength • Descriptive terms: weakness, asymmetry, atrophy • Potential causes- Bell’s Palsy, facial Palsy, lower motor neuron lesion, upper motor neuron lesion, tumor, TBI, Stroke CVA

Muscle Tone • Look for Hypotonic • Example- Tongue or lips may appear thickened and have litttle or no movement • Common causes- Cerebral Palsy, Down Syndrome • Hypertonic • Increased activity and resistance • Common causes Bells palsy, facial palsy symptoms

Accuracy of movement • Descriptive terms: Uncoordinated or groping • Potential causes : Apraxia- problem assembling the appropriate sequence of movements often results from unilateral left hemisphere lesion ( Darley, Aronson, and Brown 1975, 1969)

Range of Movement • Descriptive terms: reduced or decreased • Hypokinesia- decreased body movement Excessive range is not common in neurological disease but decreased range is more common and may occur in the context of slow, normal or excessively rapid rate • Example: Hypokinetic dysarthria- decreased range of motion and sometimes excessive rate ( Duffy 2005)

Speed of Movement • Descriptive terms: Slow • Bradykinesia- slowness of movement • Potential causes; neuroanatomical area or system involvement ( upper motor neuron system, lower motor neuron system, cerebellum, extrapyramidal system or combination • Dysarthria – a group of speech disorders resulting in weakness, slowness, incoordination due to damage central or peripheral nervous system or both • Term dysarthria encompasses coexisting neurogenic disorders of several or all of the basic processes of speech: respiration, phonation, resonance, articulation and prosody ( Darley, 1969)

Steadiness of Movement • Tremor- unintentional, rhythmic muscle movement involving to and fro movements • Neurological causes include Multiple Sclerosis, stroke, traumatic brain injury, or some medications or alcohol use or withdrawal • fasciculations- involuntary muscle contraction and relaxation which may be visible under the skin • Causes -lower motor neuron lesions • ALS- • Spasms ( lingual dystonia) involuntary muscle contractions • Possible causes Cerebral Palsy, MS, nerve damage from a stroke