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30 second outpatient lower limb muscle testing. Abnormalities in gross movements that utilise multiple muscles should prompt a detailed Neurological or orthopaedic examination

14,957 Aufrufe • vor 2 Jahren •via X (Twitter)

7 Kommentare

Profilbild von Neurophilia
Neurophiliavor 2 Jahren

Any suggestions, modifications pr recommendations are welcome

Profilbild von Naveen Sankar S
Naveen Sankar Svor 1 Jahr

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Profilbild von Ashwin Rajenesh MD
Ashwin Rajenesh MDvor 2 Jahren

Very useful for OP screening. One suggestion if I may - the tandem walk may be performed after demonstrating ability to toe-walk/heel-walk; as the integrity of small muscles of the foot are an pre-requisite to being able to perform the tandem walk.

Profilbild von Neurophilia
Neurophiliavor 2 Jahren

I agree

Profilbild von Richa Tiwari
Richa Tiwarivor 2 Jahren

Small addition of jumping on low objects and hopping on one leg to detect subtle weakness can be used if above normal. I commonly use these in children beyond 4 year age

Profilbild von Subhan | سُبحان
Subhan | سُبحانvor 2 Jahren

Cerebellar lesion??

Profilbild von Neurophilia
Neurophiliavor 2 Jahren

Tandem walking will be abnormal

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Ryan Aguirre, CSCS

79,627 Aufrufe • vor 3 Jahren

Do you know how to perform the “whack-a-mole” or WAM sign on your neurological examination? Just like the arcade or fair game; reemergence of involuntary movement in different body part after suppression of movement by examiner. Original name Japan: mole buster or mole smash. Key points: - It is specific but not very sensitive for functional movement disorders. - Diagnosis of a functional movement disorder ideally supported by demonstrating positive signs during neurological examination. - Development and evaluation of new positive signs is an important to improving diagnostic certainty. - WAM sign was a highly specific (78%) and moderately sensitive (52%) test for the diagnosis of FMD. Tested across a variety of functional hyperkinetic movements. - Since stress or being under pressure may worsen abnormal movements during suppression of another body part and this makes it tough to be completely sensitive or specific. - Marked difference in the inter-observer agreement values for the WAM sign between FMD and organic movement disorder patients (0.77 vs. 0.28). - Greater than a third of persons tested, intra-person variability of the WAM sign. Translation: the test result depended on which part of the body was suppressed. - History lesson: Whac-A-Mole arcade game created in 1975 by the amusements manufacturer TOGO in Japan. - Original name Mogura Taiji モグラ退治, Mole Buster or Mogura Tataki モグラたたき, Mole Smash. - Criticized for teaching children to be cruel towards animals. - Used in rehabilitation to teaching auditory processing and attention. My take is that you should never diagnose a functional movement disorder based on one examination maneuver or one visit in the clinic or hospital setting.

Michael Okun

23,006 Aufrufe • vor 2 Jahren