Paratonia Definition, Symptoms, Causes, Treatment | Spasticity vs Rigidity vs Paratonia

What is Paratonia?

The lack of ability to relax muscles during a muscle tone examination is known as paratonia. Paratonia occurs in two types: Facilitatory and Oppositional. When subjects unintentionally oppose passive movements, this is known as oppositional paratonia (also written as "gegenhalten"), while when they unintentionally facilitate passive movements, this is known as facilitatory paratonia (also written as "mitgehen").

Both forms of paratonia are linked to cognitive impairments or mental disorders, specifically frontal lobe dysfunction. Paratonia is often seen in clinical practice.

    Rating scales are commonly used to evaluate paratonia in a clinical setting. The paratonia scale provides a semi-quantitative score for evaluating the degree of both oppositional and facilitatory paratonia. The Kral-modified approach provides a more objective and semi-quantitative rating of upper limb facilitatory paratonia that is conveniently used while patients are seated. The oppositional paratonia is also assessed using the Paratonia Assessment Instrument (PAI) in a physiotherapeutic environment.

    Paratonia Definition, Symptoms, Causes, Treatment  Spasticity vs Rigidity vs Paratonia

    Paratonia Definition

    The inability to relax muscles during an evaluation of muscle tone is characteristic of the condition known as paratonia. Paratonia can be either facilitatory or oppositional. Subjects who unintentionally oppose passive motions are said to be experiencing oppositional paratonia, whereas those who unintentionally facilitate passive movements are said to be experiencing facilitatory paratonia.

    Paratonia Symptoms

    One effect of paratonia is an increase in carer stress and load due to the patient's increasing difficulty in routine care tasks including bathing, dressing, and eating.

    The disorder known as paratonia is not well-known among physicians and researchers, even though it eventually affects nearly all dementia patients, possesses terrible health effects, and lowers the quality of life.

    Paratonia Causes

    Paratonia is a type of hypertonia characterized by varying involuntary resistance during passive movement. Early on in the course of degenerative dementias, paratonia is more prevalent than active resistance, and its nature varies as the dementing condition progresses. The level of resistance varies with the rate of movement (e.g., low resistance for slow movement and high resistance for fast movement). Additionally, there is no clasp-knife phenomenon and the resistance to passive movement must be sensed in two distinct directions.  With the progression of dementia, paratonia intensifies.

    Paratonia Treatment

    Paratonia is a form of hypertonia that causes people to lose their movement and develop contractures, especially in the later stages of dementia. The primary physiotherapeutic strategy used today is passive movement therapy (PMT). A randomized clinical trial (RCT) is required to examine the efficacy of PMT in reducing the severity of paratonia and enhancing daily care due to widespread skepticism regarding its efficacy.

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