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Muscle Tone Management

What is Muscle Tone?

Muscle tone is the amount of tension in a muscle when it is not moving. It can be high, low or normal and affects how we move

Altered muscle tone is common in people with neurological conditions.

Uncontrolled movements are common too and can be known as Dystonia.

Why Does it Matter?

Good muscle tone helps to:

• Reduce pain
• Improves your posture
• Helps activities of daily living

See the dropdowns below for ideas to manage muscle tone problems.

Postural Care

What it is?

Postural care aims to improve your body’s position when you are sitting, lying down or standing. It is important that you think of your postural care throughout the day and night; this is also known as 24-hour postural care.

Poor positioning and posture can lead to muscle and joint problems such as:

• Increased muscle tone (a ‘tight’ feeling in your muscle)
• Reduced muscle strength (your muscles feeling weak)
• Reduced voluntary movement (a ‘stiff’ feeling)
• Not being able to change positions easily

Postural care can be broken up into lying, sitting and standing postural care.

Why Does Postural Care Matter?

There are several benefits that you will get from having good postural care:

• Relief/prevention of pain
• Reduced risk of scoliosis 
• Improved circulation
• Prevention/reduction of pressure sores:
  • Can take part in activity more easily
  • Pamis postural care video

Types of Movement

What are they and how do they help?

Passive Movements these are exercises and movements that someone else will do on your muscles and joints if you are unable to move yourself.

• Passive movements can help you to maintain movement and reduce joint stiffness
• Passive movements help reduce any discomfort or pain you might have

Active-assisted Movements these are exercises and movements that you do yourself with some help from another person or a mechanical aid such as a weight or band.

• These may be a progression towards active movements or where greater user participation is possible.

Active Movements are carried out by yourself

• Active movements help keep your muscles strong and maintain movement.

Short Instructional Videos

Please read the list of safety precautions before continuing with these activities.

Passive Movement videos and booklet:

• Full Video
• Upper Limb Video
• Lower Limb Video
• Positive approach booklet for paper/pdf format

Safety Precautions

Precautions before starting:

1. Wear loose clothing that does not restrict movement.
2. Don’t let your helper force any part of your body. If pain occurs, stop. Check with your physiotherapist before trying that movement again. The shoulder joint can be particularly prone to trauma if not moved correctly. If any discomfort occurs, ask to go back to a movement that’s easier.
3. It’s important to distinguish between pain and the feeling of stretch. Talk to your helper when they are moving your limbs. A feeling like stretching a tight elastic band is okay; pain is not.
4. Remember to breathe evenly and relax throughout each movement. There can be a tendency to hold the breath during movement.
5.  Experiment with times of day. Some people find morning best; some find it helpful to break exercise sessions into two parts: one in the morning and the other in the afternoon or evening.

Some safety instructions for the helper:

1.  If the person you are helping is in an electric or hospital bed, raise the height of the bed to a comfortable level so that you are not putting strain on your back.
2.   If the person is in a normal bed, sit or kneel in a comfortable position.
3. Don’t try to “fight” a spasm or tight muscle. This could result in injury to both of you. Move slowly, to allow tight muscles to relax and spasms to reduce. Sometimes holding a position will allow the spasms to pass. Moving quickly can increase stiffness. (For more information on this, see page 14)
4. You may be able to incorporate some of these movements if you are washing or dressing the person.
5.  Keep communication open – look at and listen to the person you are helping.
6. Hold each stretch for several seconds. Then gently return to the starting position. Repeat each exercise 2-3 times.

Moving Functionally (Moving Around)

“Functional Moving” is simply moving safely and independently. For people with neurological conditions, moving functionally can be difficult due to the changes in their muscle tone, strength and coordination. Moving around improves your well-being and can reduce your risk of falls through developing better balance.

Who can help you to live and move functionally?

Physiotherapists
Can assess and suggest ways to carry out your tasks and activities, which can help you to improve your muscle use.

Occupational therapists
Can also assess your ability and suggest activities or equipment that will help you to maximise your ability to carry out activities of daily living. Activities of daily living include tasks like feeding ourselves, bathing and showering, going to the toilet, dressing, working, and doing housework.

Yourself
You can try to stay active with different activities which will help your movement and functional ability.

Achievement Chart

Achievement charts are a great way for you to keep track of your daily achievements. These can be as small as holding level eye contact for longer than 10seconds or something bigger as being able to achieve sitting balance for longer than 3minutes, depending on what you want to work on to achieve your goals. A simple way to keeping track would be to measure each activity with time or increasing the repetitions. Here is an example below:

Selected Neurological Conditions

• Multiple Sclerosis (MS)
  • MS Society
  • MS Trust
  • NHS Inform
• Parkinson’s Disease (PD)
  • Parkinson’s Scotland
  • NHS Inform
• Rett’s Syndrome
  • Rett UK
• Stroke
  • Chest, Heart and Stroke Scotland
  • Stroke UK
  • NHS Inform