Hypertonia

In this video, the examiner is testing the tone of the lower limbs. After ensuring that the patient is fully relaxed, he first of all rolls each leg using both hands – one placed above the knee and another below the knee. Then, the examiner lifts up each leg at the level of the popliteal fossa. Besides feeling for the tone, which is defined as the resistance to passive movement when voluntary contraction is absent, there are a number of features of hypertonia which can be observed in the video. First of all, when the examiner rolls the leg, there is a reduced swinging of the foot compared to patients with normal tone. Secondly, when the examiner lifts up the leg at the level of the popliteal fossa, the heel of the foot can be seen to be elevated from the surface of the bed, again indicating an increased tone. This patient had a history of transverse myelitis, and one can appreciate that the tone is increased over both legs.

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