Muscle tone. General characteristics. Causes and symptoms of muscle hypotension

Tone is the tension in the muscles that is necessary to maintain the posture of the body and ensure its movements. The right balance of tone various muscles This is the condition for proper economic movement.

Muscle tone of the newborn

Developing in the mother's abdomen, the child is in the fetal position: the legs are bent at the knees, slightly apart and pressed to the stomach, the arms are bent in elbow joints, pressed to the chest, fingers clenched into fists, thumbs pressed to the palm, the head is located in the midline, the position of the right and left sides is symmetrical. The muscles of the child are tense. After birth for a month, the child continues to maintain this posture. However, normally, the muscles should not be too tense - you can straighten your limbs, unclench your fists. Up to a year of life increase muscle tone physiological, that is, a variant of the norm, and in the flexor muscles the tone is higher, and in the extensors it is lower and tone must be symmetrical. With age, by about 6 months, the tone gradually evenly decreases. Define muscle tone as resistance to passive movements. In a normal newborn, held horizontally on the stomach (on the doctor's hand), the head, trunk and legs are extended (Landau reflex).

If the arms and legs of the baby are strongly pressed to the body, it is difficult to unbend them, while the baby cries, throws his head back, reacts irritably to light and sound - this is muscle hypertonicity - excessive muscle tension. Hypertonicity can be general, according to the hemitype - the arm, leg, only arms, only legs of the same name.

If the child is lethargic, the arms and legs lie sluggishly along the body, the baby moves a little, does not try to take a toy, roll over to hold his head - this is hypotonicity - reduced muscle tension.

Asymmetry in muscle tone a - on one half of the body the tone is greater than on the other. In this case, the head and pelvis of the child are turned in the direction of tense muscles, the body is bent in an arc, the child falls on its side.

Dystonia- uneven tone - a combination of hypertonicity and hypotonicity. Asymmetry of tone and dystonia at any age is NOT a variant of the norm.

Causes of impaired muscle tone

Muscle tone disorders are always problems in the work of the central nervous system- the brain or spinal cord. Change in muscle tone muscular dystonia It's not a disease, it's a symptom. The cause of the disorder may appear before or during birth. These are, for example, maternal illnesses during pregnancy, diabetes mellitus, alcohol and drug use, smoking, taking medications, stress, multiple pregnancies, rapid childbirth, benefits and stimulation of labor or hypoxia (lack of oxygen), asphyxia (suffocation). Violation of muscle tone in newborns and children of the first year of life is most often due to hypoxic-ischemic encephalopathy. This brain damage is the result of two causes: hypoxia and ischemia (impaired blood supply to tissues, leading in turn to hypoxia).

Diseases that may be accompanied by a violation of tone

Decreased muscle tone with nervous muscle diseases such as spinal muscular atrophy, poliomyelitis, neonatal myotonic dystrophy, congenital myopathies, Guillain-Bare syndrome, myasthenia gravis, botulism. Toxic disorders of neuromuscular transmission can cause hypotension in neonates. For example, if mothers used magnesium sulfate to treat preeclampsia, then hypermagnesemia can cause hypotension. Aminoglycosides may also cause neuromuscular conduction disorders.

Muscle tone increases in diseases of the brain - infections, injuries, vascular diseases, underdevelopment of the brain - cerebral palsy.

Dystonia - pathological postures resulting from simultaneous muscle contraction - twisting or bending of the body along the axis, speech impairment - dysarthria. Depending on the number of muscle groups involved, dystonia can be generalized (torsion dystonia) or focal (blepharospasm, spastic torticollis, writing spasm).

Dystonia

Identification of violations of muscle tone requires observation, comparison with the presence of other symptoms of developmental disorders. You should contact a neurologist who will examine the child, assess his condition, prescribe additional examination methods if necessary, and conduct a differential diagnosis with the listed and very serious diseases. Ultrasonic research methods are used - echo-electroencephalography, neurosonography; computer diagnostics - magnetic resonance imaging; examination of muscles and nerves - electroneurography. If you suspect myasthenia gravis, you will have to examine the thymus gland. In a number of diseases, molecular genetic methods can be used.

If the cause of the violation of tone is not established, they speak of PEP (perinatal encephalopathy).

Treatment of violations of tone in a child

With the exclusion of serious diseases, early treatment leads to a complete recovery. Therefore, you should not postpone a visit to a pediatric neurologist. If untreated, violations of tone will lead to deformations of the skeleton, joints, impaired movement and general development.

Treatment should be comprehensive, prescribed by a pediatrician, orthopedist and neurologist:

kinesitherapy - movement treatment;
aqua gymnastics;
drug therapy.

Kinesiotherapy can be passive - different kinds massage and passive gymnastics and active - corrective physiotherapy and swimming. Can be used gymnastic ball- fitball.

To relieve hypertension a gentle massage is performed - relaxing and soothing. Stroking and rubbing with fingers and the whole brush, acupressure are used. Massage should not lead to crying of the child and hypothermia. This will increase muscle tension. There are many techniques for relaxing muscles - the fetal position, shaking according to Phelps, exercises on the ball, massage according to Semenova (effective even with cerebral palsy), convergence of muscle attachment points, massage of biologically active points.

In warm water, muscle tone decreases - you can use warm baths - coniferous, valerian, swimming in a circle, game moments in the bath. Such baths and activities in the water soothe the child well before daytime and nighttime sleep.

Exercises for hypertonicity of the limbs that parents can do with the child daily at home are different depending on which muscles are in good shape, but the principle is the same. 1. The child lies on his back, an adult strokes his arms and / or legs (with increased tone), respectively, from the shoulder to the fingers, from the hip to the fingers. 2. Extension of spasmodic limbs and fingers carefully, stroking movements from the palm to the fingertips, from the heel to the fingers. Circular movements with a brush or foot clockwise, counterclockwise. 3. Shaking the limbs, holding the child carefully by the fingers. Alternate with next exercise- 4. Embryo position, arms and legs pressed to the stomach. 5. Exercise on the ball, which helps to form a support on the foot - the child is placed on a rough surface with his legs, the tummy is placed on the ball (not very big size), an adult shakes the ball back and forth, left and right. Such exercises are recommended to be carried out with the child daily, be sure to follow the sequence. They greatly speed up the healing process.

A doctor with hypertonicity may prescribe treatment with paraffin wraps (moisten gauze in heated paraffin, roll up in 3 layers, shift with cellophane and another triple layer of gauze - make sure it is not hot, wrap and fix the limb in the most extended state, the duration of the course is at least 10 days 20 minutes a day), for babies - electrophoresis.

With low tone massage is done more intensively, stroking is deeper with pressure with a brush on the massaged areas of the muscles, rubbing with the second phalanges of the fingers with the brush clenched into a fist, tapping, pinching, tapping (with the tips of relaxed fingers and the side surface of the hand), exciting stimulating acupressure of biologically active points.

Drug treatment is prescribed by a neurologist, it is used, as a rule, for hypertonicity, dystonia, asymmetry (up to a year only for dystonia and asymmetry). It is possible to use neuroprotectors, antioxidants, muscle relaxants. Cerebrolysin, pantocalcin, semax, solcoseryl, mydocalm, baclofen, B vitamins can be used in the treatment of children.

What exactly your baby needs will be selected by a professional.

Prevention of muscle tone disorders

Prevention of dystonia is, first of all, healthy mothers, an exception bad habits, monitoring the course of pregnancy and fetal development, classes with a newborn, conducting health-improving massages and exercises with him, developing child care, comprehensive medical examinations for timely diagnosis and taking the necessary assistance measures.

Consultation of a doctor on the topic of violation of muscle tone in a child

Question: How early can a massage start?

Answer: massage in the form of stroking and rubbing starts from the first two weeks, later a more intense massage is done and special exercises are added.

Question: What kind of massage can mom do herself?

Answer: the massage begins with the toes of the foot, with the little fingers - we press, sort through, stroke, twist and pull. We pass to the foot - we press under the fingers - the fingers are compressed, we press on the heel - the fingers - are unclenched. We draw a figure eight on the foot of the baby. We make a notch on each foot in our direction. We draw from the heel to each finger. We wind the foot on the massage therapist's finger. We take the legs in our hands and imitate running - we stomp on the table, draw a figure eight with the heel. We stroke the legs from the foot up to the joints. We make kneading, light movements, circular motions around the knee and hip joint. We do breeding hip joints, fixing your knees with your hands - exercise "book". We pass to the tummy and make stroking movements clockwise, press our fingers around the navel and twist - a “bell” to strengthen the muscles of the abdominal wall. We take the fingers of the hand - stroke them, then stroke them up, around the shoulder.

Internal surfaces are not massaged. We stimulate the grasping reflex, lift the child. We turn over on the tummy and stroke the muscles of the back, along the spine, pinch and knead the ass. With an increased tone, tapping and patting cannot be done. We take the baby in our arms, press it against our back and imitate the simulator - we tilt the child forward - he tries to hold his back. You can even play with older ones - pick up a toy from the table.

Mom can learn this general massage and do it at home. But depending on the bag tone, special movements and techniques can be added. In order not to harm the child, you first need to show it to the doctor, visit a professional massage therapist, and repeat the necessary movements at home.

Question: can massage hurt?

Answer: maybe. With improper massage, you can further increase the tone of spasmodic muscles and relax so flaccid muscles, disrupt movement in the joints.

Question: what is the symptom of a "sluggish child"?

Answer: the term "sluggish child syndrome" combines cases of muscular hypotension in children of the first year of life - a violation of the fixation of the head (the head hangs down), the "frog" position in the supine position. Muscular hypotension can be caused by damage to the central and peripheral nervous system, including the brain and spinal cord, peripheral nerves, neuromuscular synapse, muscle pathology and systemic diseases - hypothyroidism, Down syndrome. Most often it is an atonic type of cerebral palsy. The "flaccid child" syndrome can be a manifestation of degenerative diseases, for example, Tay-Sachs disease, Krabbe disease, leukodystrophy. With a transverse presentation of the fetus, a transverse lesion of the spinal cord may occur. The newborn will initially have hypotension and weakness below the level of the lesion, and eventually turn into spastic tension. Another terrible option is poliomyelitis, a viral infection that affects the motor neurons of the spinal cord. Diagnosis of the disease is the business of a pediatric neurologist. Prevention - adherence to the vaccination schedule! Doing self-diagnosis and self-treatment is unacceptable.

Neurologist Kobzeva S.V.

Muscle tone is one of the physiological properties human body. The nature of this condition has not yet been established, but there are several theories that experts adhere to. Muscle tension at rest can change under the influence of external factors or diseases of the nervous system. There are two types of pathology: hypertonicity and hypotonicity. In the article we will consider in detail their symptoms and treatment.

The value of muscle tone

Tonic muscle tension is a normal physiological state of the human body, which is carried out at the reflex level. Without it, it would be impossible to perform many movements, as well as maintain the position of the body. Muscle tone keeps the body in readiness for active action. This is its main purpose.

What is the mechanism of muscle work with normal tone? If all the fibers of the tissue are involved in the movement, then at rest they replace each other. While some are tense, others are resting. Interestingly, the process is directly affected by the psycho-emotional state of a person. For example, a decrease in muscle tone leads to a decrease in performance and is observed mainly during sleep. The condition is accompanied by natural calmness: excessive excitement is significantly reduced.

The regulation of muscle tone is carried out with the help of alpha and gamma motor neurons, afferent fibers and spindles. The impulses come from the brain. The cerebellum, the midbrain (the red nucleus, the black substance, the quadrigemina) are responsible for maintaining muscle tone. When the neurons responsible for tonic tension are damaged, its disturbances occur: hypotension or hypertension of the muscles.

Diagnosis in adults

A change in tone can occur for various reasons. Most often, these are diseases of the nervous system or a complex psycho-emotional state. A neuropathologist or orthopedist deals with the problem of muscle tone disorders. To correctly diagnose, conduct an examination. Muscle tension is assessed in a relaxed state and during passive movements using special tests: head drop, supination-pronation, leg swing, shaking by the shoulders, and others.

Examination is quite difficult: not every patient can completely relax. At the same time, the qualification of the doctor is also important - the speed of passive movements affects the assessment of the condition. External factors can also distort the results: muscle tone changes under the influence of temperature and mental state. The most difficult situations require re-examination.

Tonus in children up to a year

In the womb, the fetus is located very closely, so all the muscles are in constant tension. After birth, the baby has physiological hypertonicity. In this case, the head is thrown back, and the legs and arms are brought to the body.

Which muscles are tense is affected by the position of the baby in the womb and in the birth process. For example, with facial presentation, there is an increased tone of the neck (the newborn throws his head back). In the “forward buttocks” position, the child’s legs are spread apart, forming an angle of 90 ° between them. Lying on the bed, the baby tries to take the usual fetal position.

Diagnosis of tone in babies

When conducting an examination, a pediatrician or neuropathologist assesses the state of the child's muscle tone according to the following signs:

At 1 month, the baby, lying on his stomach, tries to raise his head and holds it for a few seconds. Legs make bending movements, as if crawling. If you put your hand under your feet, he will push off from it.
By 3 months, the child holds his head confidently. If you raise it in a vertical position, the legs will make movements, as when walking. The child can lean on the foot. If you put him on his back and pull the handles, he will be pulled up by his own strength.
Up to 6 months, the baby rolls over from his stomach to his back, tries to get on all fours, holds small objects in his hands.
By the age of one, the child sits confidently, tries to walk with support, and develops on his own.

If the baby cannot perform one of the listed actions due to excessive tension or, conversely, muscle weakness, they speak of pathology. Additionally, the doctor evaluates the symmetry of the tone. To do this, alternately bend and unbend the arms and legs of the child. They also observe active movements in different positions of the body. A deviation from the norm is hypotonicity, hypertonicity, which persists even during sleep, and muscle dystonia.

Types of hypertonicity and the causes of its development

Increased muscle tone can manifest itself in different ways. Experts distinguish:

Spasticity - develops due to craniocerebral and spinal injuries, meningitis, encephalopathy, cerebral palsy, multiple sclerosis, stroke. It is characterized by uneven distribution of hypertonicity, when only certain muscle groups are subjected to spasm.
Rigidity is a sharp increase in the tone of skeletal muscles, which occurs as a result of diseases of the nervous system, the poisoning effect of certain poisons.
Gegenhalten - a sharply increasing muscle resistance during passive movements of any type. It occurs in connection with the defeat of the mixed or corticospinal tracts in the frontal regions of the brain.
Myotonia - characterized by slow relaxation of tense muscles after active movements.
Psychogenic hypertension - during a seizure, a "hysterical arc" is formed.

In children, the cause of the development of hypertonicity is birth trauma, hypoxia in childbirth, damage to the nervous system and brain, meningitis, excessive excitability or hyperactivity.

Symptoms of hypertonicity

Hypertension of the muscles is expressed in their excessive tension in a relaxed state. The disease can be identified by the following signs:

decline motor functions, stiffness in the muscles;
seals;
feeling of constant tension;
soreness;
spasms;
significant muscle resistance during passive movements;
in children, tearfulness, increased nervous excitability, increased muscle resistance when repeating flexion-extensor movements;
in a vertical position with support on the legs, the baby presses the feet, standing on tiptoe;
slowdown motor development child (does not sit down, does not crawl, does not walk at the right age).

It is not difficult to notice hypertonicity in an adult or a child, especially in the middle and severe stages. The gait changes, actions are carried out stiffly, with great difficulty. At the same time, babies are clamped and tense, often scream and sleep poorly, react painfully to any, even minor, noise. After eating, profuse regurgitation occurs.

Causes and symptoms of muscle hypotension

Weak muscle tone is characterized by low tissue tension in a relaxed state, which makes it difficult to actuate them. This happens mainly due to damage or disease of the spinal cord, cerebellum or extrapyramidal disorders and cerebellar damage. There are also attacks, during which the muscle tone temporarily decreases. This occurs in the acute phase of a stroke or in a midbrain tumor.

Weak muscle tone in children is less common than hypertension. Its appearance can be triggered by prematurity, slow brain development, damage to peripheral nerves during the birth process, congenital malformations, Down syndrome, rickets.

Symptoms of muscle hypotonia in babies are:

lethargy, overly relaxed state;
respiratory failure, inability to swallow, suck;
weak motor activity;
excessive sleepiness, poor weight gain.

Violation of muscle tone in the direction of its decrease can be observed in adulthood. This usually leads to various diseases: muscle dystrophy, sepsis, rickets, meningitis, Sandifer's syndrome. The condition is accompanied by physical weakness, reduced resistance to passive movements. When flexed, the joints unbend on their own, the muscles feel soft to the touch.

Muscular dystonia in adults and children

With muscle dystonia, uneven tone is observed. At the same time, there are signs of both hypotension and hypertension. The main symptoms of dystonia in children and adults are:

excessive tension of certain muscles and relaxation of others;
spastic contractions;
legs or arms;
fast or slow movements of certain parts of the body.

A condition develops in connection with genetic, infectious diseases, birth injuries, severe intoxications.

Treatment

Muscle tone is important to normalize in time, especially in childhood. The progression of symptoms leads to impaired movement, scoliosis, cerebral palsy, and delayed development. There are several treatment methods:

massage for muscle tone good results, for this, the muscles are stroked, kneaded, stretched, their strength is trained, making physiological movements (flexion-extension);
therapeutic gymnastics, including in water;
physiotherapy: electrophoresis, ultrasound, treatment with heat, water and mud;
in difficult cases, medications are used, among which vitamins of group B, dibazol, mydocalm can be prescribed.

With hypertonicity, the muscles try to relax with the help of stroking, healing injuries, light massage, stretching. With hypotension, on the contrary, they stimulate motor movements by performing muscle tone exercises. significantly improves the patient's condition.

Violation of muscle tone is a common problem in children of the first year of life and adults with diseases of the nervous system. It is quite easy to treat with the help of massages, less often - medicines. Mobility returns to normal, and there is no trace of the problem. The main thing is to start treatment on time, preventing serious violations and deviations in the development of the skeleton and muscles.

The causes of hypertonicity are a group of factors that provoke excessive tension in any muscle groups, which persists at the time of their relaxation. With increased tone, human muscles are dense, constrained, voluntary movements are difficult, sometimes painful.

Increased muscle tone is one of the main syndromes of neurological diseases and disorders of the nervous system. Brain signals are incorrectly transmitted along the nerve fibers, are falsely interpreted or do not reach their destination, which is the reason for the incorrect, slow response of the muscles. Conventionally, three types of hypertonicity can be distinguished, depending on the group of people in which it is observed:

Hypertonicity of the uterus of pregnant women;
Hypertonicity in children (babies);
Hypertonicity in adults.

These three types of tone are characterized by different signs, have a number of different causes and effects, and require different kinds of treatment.

Hypertonicity is not a disease, but only its manifestation, a syndrome. Thus, treatment provides initially correctly diagnosed.

Increased uterine tone in pregnant women

Many pregnant women face the problem of uterine hypertonicity, which is muscular organ. Excessive tension of the uterus of a pregnant woman can be dangerous for the unborn child and cause abortion, especially in the early stages, when the embryo is not yet well attached to its walls. The body perceives the embryo as a foreign object and tries to get rid of it, push it out of the uterus through its contractions. Sometimes a woman may not feel the tone at all, but most often its signs are:

pulling pains in the lower abdomen or lower back;
"petrification" of the abdomen, it becomes hard, changes shape;
uncharacteristic discharge, sometimes bloody.

Since a miscarriage can become a consequence of the tone of the uterus, at the first sign you should consult a doctor. According to the results of the examination, tests, ultrasound, the doctor determines the cause of this pathological condition and prescribes the necessary treatment.

Causes of uterine hypertension during pregnancy:

physical exercise;
overwork;
stress, nervous state of the pregnant woman;
diseases of the female reproductive organs such as: fibroids, endometriosis, inflammation;
infectious disease of a pregnant woman;
hormonal disorders, for example, the level of the male hormone is higher than the female one.

When eliminating the tone of the uterus in pregnant women, the doctor needs to find the cause of this phenomenon. Basically, women require inpatient treatment, complete rest, a minimum of movements and physical activity, emotional balance. A pregnant woman should understand that she is responsible not only for her life, but also for the life of her unborn child, so you should not self-medicate, and seek medical help at the first suspicion.

Hypertonicity in infants

In 90 cases out of 100, children in the first months of life have an increased muscle tone. There are two main causes of this condition in infants:

physiological features;
disturbances in the work of the central nervous system.

In the first case, the baby’s muscle tone is explained by the fact that during the period of intrauterine life, the child was in a limited, small space of the mother’s uterus and his posture was forcedly constrained, the so-called fetal position. The arms and legs of the fetus are pressed to the body, and the chin to the chest. After birth, for the baby, this position is the most familiar and safe, the baby needs to get used to the new world around him, usually by the 3rd month the muscles gradually relax, and the increased tone goes away by itself, I do not need treatment. However, if hypertonicity persists after 3 months, this may indicate that the baby's nervous system has suffered. The main causes of hypertonicity in children older than 3 months lie in the impact of negative factors during the period of intrauterine development of the fetus, diseases, birth injuries. It could be:

bad habits of the expectant mother: smoking, alcohol, drugs;
infectious diseases suffered by the mother during pregnancy, or her chronic diseases;
early or late toxicosis of the pregnant woman, uterine tone, the threat of miscarriage;
Rhesus conflict between mother and fetus;
perinatal encephalopathy;
rapid or prolonged labor;
fetal hypoxia in utero or during childbirth;
various birth traumas.

Usually, neurologists prescribe procedures for children with increased muscle tone, which can only relieve the main symptoms, but they do not find the causes of violations, do not solve problems. For example:

physiotherapy;
physiotherapy;
aromatherapy;
massotherapy;
medical treatment.

Most effective method treatment of hypertension in young children - osteopathic. An osteopathic doctor considers the human body as a whole, and sees all its systems and organs as interconnected. Osteopaths can treat one organ while influencing another, identifying the cause of the pathology and fighting its consequences. Osteopathic treatment is based on a special massage. The doctor's fingers are extremely sensitive and receptive, and the movements and manipulations are very gentle and gentle. That is why the impact of osteopathic techniques on babies is safe, painless and effective. An osteopath can easily help a baby's unfinished nervous system to function fully.

Increased muscle tone in an adult

In an adult, muscle tone is observed as a result of a malfunction of the nervous system, this is one of the indicators of the presence of neurological diseases. There are 2 types of increased tone: spastic (localized) and rigid (applies to all muscles at the same time). The cause of hypertension can be:

demyelinating neurological diseases such as multiple sclerosis;
pathological processes in the vessels of the brain and spinal cord (stroke);
various injuries of the brain or spinal cord;
dysfunction of nerve impulses.

With a spastic form of tone, there is a disruption in the functioning of the nerve centers and pathways, and with a rigid form, pathologies of the brain or spinal cord are observed.

Hypertonicity in adults is a sign of a serious neurological disorder that has arisen due to the presence of severe diseases of the nervous system. In this case, it is most rational to use complex therapy. Along with traditional medicine, osteopathy can come to the rescue, which greatly alleviates the patient's condition. Ostepathic techniques are very gentle, they bring the patient a feeling of relaxation, peace, warmth. With the hands of an osteopathic doctor, he can improve muscle function, blood flow, affect bones and joints, while he fights not with the clinical manifestations of the disease, but with its cause. The osteopath launches the necessary mechanisms, which, like a clockwork, normalize the work of the whole organism as a whole.