- ensure the patient is relaxed.
- for assessment in the upper extremities, the patient
may be lying or sitting. In the lower extremities,
tone is best assessed with the patient lying down.
- explain the examination technique to the patient
- spasticity (clasp knife) is velocity dependent and
should be assessed by a quick flexion/extension of
the knee or the elbow or quick supination/pronation
of the arm.
- rigidity (lead pipe) is continuous and not velocity
dependent and the movement should be performed slowly.
- "activated" rigidity; minor degrees of
rigidity may be enhanced by having the patient activate
the opposite limb.
- rigidity in the neck can be assessed by slow flexion,
extension and rotation movements
- normally minimal, if any resistance to passive movement
- spasticity is a feature of an upper motor neuron
lesion and maybe minor such as a spastic catch or
a very stiff limb that cannot be moved passively.
Accompanying features may include spasms, clonus,
increased deep tendon reflexes and an extensor plantar
- rigidity is a continuous resistance to passive movement
and is seen in extrapyramidal disorders such as Parkinsons
- rigidity may be continuous or ratchety (cogwheeling).
Cogwheeling is typically seen at the wrists.
- hypotonia (flaccidity) or decreased tone is more
difficult to appreciate but is seen with lower motor
neuron or cerebellar lesions