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In medicine, obligatory synergies occur when spasticity appears, such as following a stroke. It manifests in abnormal and stereotypical patterns across multiple joints called obligatory synergies. [1] They are described as either a flexion synergy or an extension synergy and affect both the upper and lower extremity (see below). [1]
Spasticity and the influence of synergy begins to decline and the patient is able to move with less restrictions. The ease of these movements progresses from difficult to easy within this stage. 5: Spasticity continues to decline, and there is a greater ability for the patient to move freely from the synergy pattern.
The Bobath Concepts' theoretical underpinning and practice is clearly documented in a contemporary book published by Wiley Blackman in 2009: Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation' written by the British Bobath Tutors Association (BBTA) and edited by Raine, Meadows, and Lynch-Ellerington.
Spasticity (from Greek spasmos- 'drawing, pulling') is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.
Clasp-knife response refers to a Golgi tendon reflex with a rapid decrease in resistance when attempting to flex a joint, usually during a neurological examination.It is one of the characteristic responses of an upper motor neuron lesion.
1: Slight increase in muscle tone, manifested by a catch and release or by minimal resistance at the end of the range of motion when the affected part(s) is moved in flexion or extension; 1+: Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM
Both facilitatory and oppositional paratonia increase during continuous flexion and extension movements, moreover, oppositional paratonia increases with movement velocity. [13] Spasticity also is velocity-dependent, [14] but, differently from oppositional paratonia, if repeatedly elicited decreases instead of increasing. [15]
People with cerebral palsy often suffer from spasticity due to hyperreflexia. [13] A common clinical test of spasticity is the pendulum test, in which the subject remains seated and the relaxed leg is dropped from horizontal. In individuals with spasticity, the leg comes to rest much more quickly due to increased reflexive muscle contraction.