MCML Assessment and Treatment of Abnormal Muscle Tone Practice Test

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• Which term refers to the natural resting tension of a muscle, influenced by environment and neurological status?
• In the Tardieu assessment, what does a large R2−R1 difference indicate?
• Which inhibition technique decreases spasticity and tactile defensiveness and improves symmetry, tone, ROM, ambulation, alertness, and bowel movements?
• Hypotonia may present with which joint position at the elbows and knees?
• Which of the following is NOT listed as a Tone Inhibition technique in the material?
• How can clinicians maximize functional gains after reducing tone with BoNT-A?
• Facilitating normal posture through sensory-motor experiences aims to help the patient learn what?
• What is the role of the gamma motor system in tone regulation?
• NDT therapy aims to align body segments and promote what?
• In pediatrics, which splint category is typically used for nighttime stretching and can be serial?
• Which is a prematurity-associated diagnosis?
• In therapy for hypertonic children, positioning aims to break up tone patterns. Which action is described as reducing upper-extremity tone?
• Hypertonia may affect which functional area in infants?
• Remember to promote what and protect what?
• Excessive lower-extremity adduction is often described as which term?
• Which technique uses a device to provide pulsating or alternating hand flexion and extension to stimulate muscle and motor learning?
• Ankle-Foot Orthoses (AFOs) are used to provide what benefits for low-tone children and can enable what?
• Which term best describes decreased muscle tone with reduced resistance to passive stretch, as described in the material?
• Which splint category includes Dynasplints and is used to progressively adjust stretch?
• Which tool can be used to measure tone?
• Flexor posturing is most closely associated with damage to which regions?
• When using dantrolene for spasticity, what monitoring is critical due to potential hepatotoxicity?
• Which infection is included under hypertonicity?
• Which facilitation technique involves a light manual force applied over a tendon or muscle belly to facilitate a voluntary contraction, typically 3 to 5 over the muscle belly?
• Sustained or repetitive muscle contractions result in repetitive movements, twisting or abnormal fixed postures describes which condition?
• When setting goals for pediatric tone management, what should be considered?
• What signs suggest development of antibodies to BoNT-A?
• What is a primary goal of normalizing tone?
• What safety considerations are essential when performing serial casting?
• In ICU or acute rehab settings, what coordination is important for timing BoNT-A injections?
• Spasticity is most commonly associated with which type of lesion?
• Among oral antispastic medications, which is a central GABA-A agonist?
• Name common upper-limb spasticity patterns after stroke and the primary muscle groups involved.
• Neutral warmth as a tone inhibition technique is described as providing what?
• Which condition is characterized by decreased resistance to passive movement?
• In the progression from Supine, which sequence correctly lists the steps from rolling to side through standing?
• Treatment inhibition technique may reduce contracture in the lower extremities when using which intervention?
• An objective of NDT therapy is to increase reciprocal muscle function for what?
• Hypertonia can contribute to which joint-related issue as described?
• Unintegrated Moro reflex affects which functional areas?
• Hypertonicity or hypotonicity caused by interruption of motor neurons reflects which component?
• Which of the following is a neuromuscular disease included in the hypertonicity category?
• An unintegrated ATNR (Asymmetrical Tonic Neck Reflex) affects which motor skill?
• In NDT, what sequence is emphasized for motor facilitation?
• Which facilitation technique can increase core stability in children with hypotonia?
• Which tone facilitation modality includes fast movements as an option?
• Which technique within tone facilitation includes fast brushing/stroking as one of its modalities?
• Which neuromuscular disease is listed under hypertonicity?
• Hard Splints are used to hold the foot in which degrees of dorsiflexion?
• To promote maximum function, combine what?
• What is the rationale for combining pharmacologic therapy with therapy and activity-based interventions in spasticity management?
• Which domains are affected by an Unintegrated TLR?
• What is the typical presentation of mixed tone?
• Which procedure involves cutting some sensory nerve fibers entering the spinal cord to reduce spasticity?
• If a patient shows shorter duration of BoNT-A effect and reduced response, what is an appropriate next step?
• Dystonia is typically described as what?
• Spasticity occurs from damage to which pathways?
• Which statement best describes a management approach to baclofen withdrawal?
• In NDT practice, what does the phrase 'Less is more' emphasize?
• What is a common use of neoprene splints for thumb abduction in pediatric splinting?
• Which facilitation method includes NMES (Bioness) as a tone facilitation technique?
• What biomechanical effect do hard splints provide beyond dorsiflexion positioning?
• Which facilitation technique utilizes cold therapy to facilitate muscle response?
• Lack of voluntary coordination of muscle movements with jerky, unsteady trunk motion describes which condition?
• What is intrathecal baclofen therapy and when is it considered?
• Which progression step comes directly after 'Side lying' in the progression from Supine?
• Which of the following is a known limitation of the Modified Ashworth Scale?
• What is the role of reflexes such as Babinski and hyperreflexia in assessing tone?
• What are common adverse effects or risks of BoNT-A injections?
• Unintegrated palmar grasp primarily affects which motor domains?
• How do stretching and range-of-motion exercises contribute to tone management?
• Which upper-limb muscle groups are commonly targeted with BoNT-A for post-stroke spasticity?
• Which statement describes a typical presentation in a hypertonic child?
• Which term describes the ability to recruit muscle fibers to meet the demands of a task?
• An unintegrated STNR (Symmetrical Tonic Neck Reflex) affects which motor behavior?
• In the listed order for medical management of high tone, which treatment is listed first?
• Spasticity can be advantageous in which way?
• Which term describes a ratchety resistance to passive movement seen with rigidity?
• Which statement best describes rigidity?
• Which scale is used to assess the velocity-dependent component of spasticity along with the Modified Ashworth Scale?
• Which facilitation technique uses bioness pulsating or alternating settings of hand flexion and extension to stimulate muscle and motor learning?
• Which outcome measures are commonly used to monitor spasticity and function after BoNT-A?
• Hypertonicity can lead to which of the following complications?
• Dantrolene is best described as which type of agent?
• What is serial casting and how does it help with tone?
• What safety considerations and monitoring are required for an intrathecal baclofen pump?
• Unintegrated Head Righting affects which domains?
• Which facilitation technique uses a battery-operated brush on the skin overlying the muscle to facilitate movement responses and static holding?
• Which of the following is a typical effect of BoNT-A on injected muscles?
• What is the role of constraint-induced movement therapy (CIMT) in a patient with focal spasticity?
• Which facilitation technique includes rolling patterns, rocking on elbows, crawling; spinning; and is not widely used?
• Which therapy gradually lengthens a muscle-tendon unit to increase ROM?
• How can aquatic therapy influence tone management?
• Which progression step comes directly after 'Side sitting' in the progression list?
• How can you distinguish spasticity from a fixed contracture during exam?
• Unintegrated Landau reflex is associated with deficits in which areas?
• A positive Babinski sign in adults indicates what?
• Which term describes distal writhing or contorting movements?
• How would you structure a management plan for a patient with focal elbow flexor spasticity after stroke?
• What is a major risk associated with long-term use of tizanidine?
• Which category includes a range of modalities such as joint approximation, fast movements, and cold used to facilitate tone?
• Hard Splints hold the foot in dorsiflexion to break up extensor synergy. Which option lists the correct category?
• What is a key limitation of using diazepam for tone management?
• Which tool is used to assess muscle tone?
• Which treatment is described as Deep Brain Stimulation for Dystonia?
• Which facilitation technique uses joint approximation and small repetitive compressions to provide proprioceptive input and may enhance motor control?
• In pediatric tone assessment, why is dynamic tone considered?
• What is a common use of Dynasplints in pediatric tone management?
• Unintegrated Plantar reflex influences which aspects of mobility?
• Which statement best describes the extensor synergy pattern for the upper extremity?
• Which pelvic tilt is commonly associated with hypotonia?
• Biomechanical properties of muscles, joints, and soft tissue affected or altered due to weakness or spasticity are part of which muscle-tone component?
• Which category includes wrist cock-up splints among its typical examples?
• Extreme hypertonicity is referred to as which term?
• Which lower-limb muscles are commonly targeted with BoNT-A for post-stroke spasticity?
• Which condition is commonly associated with hypertonicity?
• How can proper positioning and postural alignment influence tone?
• Postural deformities in upper motor neuron syndromes may include which of the following?
• Assessing tone is best done with which type of stretch?
• Which foot structure is commonly observed in hypotonic children?
• Which position is used to observe tone according to standard practice?
• What is a primary goal of BoNT-A injections in focal spasticity management?
• Which of the following is a known risk of BoNT-A cumulative dosing over time?
• Which term describes decreased tension in muscles and laxity with movement?
• Which of the following describes the flexor synergy pattern for the lower extremity?
• Clonus is tested clinically by which maneuver?
• What is spasticity defined as?
• Diagnoses associated with dystonia include which of the following?
• Which facilitation technique produces a short-lived contraction of the agonist muscle and a short-lived inhibition of the antagonist to facilitate a muscle contraction and stimulates the muscle spindle reflexively?
• When is BoNT-A indicated for tone management?
• Which tools support planning Botulinum toxin A injections for focal spasticity?
• Which term best describes a syndrome of involuntary muscle contractions that cause twisting or abnormal postures?
• Which of the following is a sign of baclofen withdrawal?
• Which statement best reflects the range of diagnoses associated with prematurity?
• Which functional limitation is typically observed in a hypertonic child?
• Normal muscle tone may range from which to which?
• An unintegrated spinal Galant reflex affects which of the following?
• What is the typical onset and duration of BoNT-A effects?
• NOT listed as a prematurity-associated diagnosis?
• Which considerations are especially important for spasticity management in ICU or acute rehab settings?
• Which of the following is listed as a prematurity-associated diagnosis?
• What is the role of intrathecal baclofen therapy in spasticity management?
• Which description characterizes decerebrate posturing?
• Which are common contraindications or precautions for BoNT-A injections?
• Dystonia affects what on the body?
• Which inhibition technique uses slow, rhythmic movements such as slow rocking or movement on a ball to provide proprioceptive input?
• Which condition is commonly associated with hypertonicity that involves a brain injury?
• Which of the following is a hypertonicity diagnosis?
• Which inhibition technique can increase range of motion and tone with participation and improve functional motor performance in CP?
• Which shoulder girdle posture is often observed with upper limb hypertonicity?
• Standing frames are used to provide what outcome?
• Which term is typically used to describe the outcome of severe brain injury?
• Spasticity cannot be what?
• Prolonged stretch as an inhibition technique is described as providing what?
• What is Botulinum toxin A and how does it reduce spasticity?
• Why is caregiver education essential in tone management?
• What are the two components of muscle tone?
• Which technique is listed as a tone facilitation method involving Cold as an option?
• Which areas are considered key points of control in NDT therapy?
• Which term describes a combination of low proximal tone and high distal tone?
• Therapists control certain variables through positioning to influence movement. Which set of elements is controlled?
• Heavy compression, greater than body weight, is thought to facilitate what at the joint under compression?
• What practice supports safe home exercises for tone management?
• Which data can further refine target muscle identification when planning BoNT-A injections, if available?
• Which facilitation technique involves rhythmic, repetitive movement of the horse to normalize tone?
• Hypertonicity may present with which resting posture of the limbs?
• Which pattern describes the flexor synergy pattern for the upper extremity?
• Which statement describes the extensor synergy pattern for the lower extremity?
• Which term is defined as the resistance of a muscle to active or passive stretch, reflecting tone?
• Which posture is typically seen in a hypertonic child?
• In the NDT approach, tone is defined as which of the following?
• A common functional consequence of hypertonia on activities of daily living is?
• How do you decide between BoNT-A injections and intrathecal baclofen for a patient with spasticity?
• Which of the following is a typical presentation of a hypotonic child?
• How can pain influence tone assessment and management?
• Unintegrated Babinski reflex is associated with difficulties in which areas?
• How do you perform a Tardieu assessment for elbow flexors?
• Serial casting is used to achieve which primary effect?
• Which principle does NDT therapy rely on to support recovery?
• Which statement best reflects pediatric assessment of hypertonia compared to adult assessment?
• How does ultrasound or EMG guidance improve BoNT-A injections?
• Which is a functional limitation commonly observed in hypotonic children?
• Which diagnosis is listed under prematurity along with PVL?
• Extreme decreases in muscle tone are described as what term?
• Which description corresponds to decorticate posturing?
• Which gait pattern is commonly associated with gastrocnemius tightness?
• What feature best distinguishes rigidity from spasticity?
• Which intervention lasts 3-6 months and targets specific muscle groups?
• Unintegrated trunk righting affects which aspects of movement?
• Which inhibition technique should be used with caution and may fatigue muscle if prolonged, but may enhance strength, sensory awareness, and coordination?
• Which statement best describes the presentation of hypertonicity?
• Which term denotes a combination of hypo and hypertonicity?
• Which feature is most characteristic of spasticity?
• Which inhibition technique involves applying vibration directly to the chosen muscle or tendon at low or high frequency, with questionable sustained effects?
• In aquatic therapy, why is plan-based progression important?
• What is the potential role of NMES in spasticity management?
• What is a primary initial goal of NDT therapy?
• What is a key difference between the Tardieu Scale and the Modified Ashworth Scale?
• Why is differential diagnosis important when evaluating abnormal muscle tone?
• During gait analysis, which finding most directly guides decisions about which muscles to treat and where to place orthotics?
• Light compression, applied as normal body weight along the long axis of the bone, is thought to do what to muscle spasticity?
• Which therapy involves a programmable pump delivering baclofen with a battery lasting several years?
• Which statement is true about assessment scales for pediatric hypertonia?
• Which term denotes increased resistance to passive movement?
• Which statement best describes a functional limitation in hypotonic children?
• Which medication is a central GABA-B agonist used for spasticity as an oral antispastic?
• Which of the following is listed under hypertonicity as a cerebrovascular event?
• Hypertonicity may cause pain and difficulty with caregiving. Which option best reflects this impact?
• Which term refers to brief, rapid, unsustained irregular movements?
• Hypotonicity is common with which type of neurological lesion?
• Which term refers to the resistance of a muscle to active or passive stretch?
• When is BoNT-A used in the management of spasticity?
• How do orthotics contribute to tone management and functional improvement?
• Which technique is included in the Tone Inhibition techniques?
• Which facilitation technique is used to block/inhibit functional hand to promote use of the affected upper extremity?
• Which of the following is true about selecting muscles for BoNT-A injections?
• On the Modified Ashworth Scale, which description best matches a score of 1+?
• Which of the following is not a tool used to assess muscle tone?
• Dystonia affects what in the brain?
• Dynasplints exemplify which splinting category?
• Decorticate posturing indicates damage to which region?
• Which term describes the natural tension of a muscle at rest, influenced by environmental factors and neurological damage?
• What information can gait analysis provide for tone management decisions?
• What do wheelchair components provide in tone management?
• Which term describes increased tension of a muscle with increased resistance to passive movement?
• Which Tx Inhibition Technique uses the dissociation of the upper and lower trunk with trunk rotation and pelvic positioning to lengthen a shortened muscle?
• Constraint Induced Therapy is a technique used to improve functional use of the affected limb; under which category is this listed?
• Which components comprise clinical management and treatment of tone in this material?
• What are key dosing considerations when planning BoNT-A injections?
• Which statement best differentiates spasticity from dystonia?
• Name common lower-limb spasticity patterns after stroke and the primary muscle groups involved.
• What mechanism does NMES have in spasticity management to support motor relearning?
• Which posturing indicates damage to deeper brain structures and is more common after traumatic brain injury?
• Dantrolene is best described as which type of agent?
• Inhibition techniques should be painful to be effective.
• Rigidity is commonly associated with which diagnosis?
• Which option describes orthopedic surgery as listed here?
• Which of the following is a technique used for tone inhibition in NDT?
• Which infection is listed under hypertonicity?
• Which is included in hypotonicity as a developmental milestone concern?