Muscle Tone Diagnostic Algorithm


    This article is a continuation of my previous one about muscle tone disorders in a baby. And today I’m describing an easy diagnostic algorithm with the help of which parents can determine disorders in time and to see a doctor. Generally, five age intervals are highlighted within the first year of baby’s life and the baby should master certain skills within each age period, and when there are aberrations from the norm – it’s better to consult a neurologist.

    0-1 month

    When lying in a supine position, the baby should lie in a “fetal position” with the arm bent and pressed to his chest, hands are clenched into fists, the thumbs are covered by the rest of fingers. The knees are bent and the legs are spread apart; the left and right halves of the body are symmetrical; the head is straight, not bending to a side.

    If you place the baby on his stomach, he will turn his head to a side having placed the hands under his chest and flexed his legs and imitating the crawling movements. By the end of the month of age the baby tries to lift and hold the head for a few seconds placing it in parallel to the spine.

    1-3 months

    In the supine position the arms are bent less than in the first period, but they still are. The baby can push them forward and to the sides, can bring them to his eyes or mouth. At about three months of age he tries to reach for a toy, and when it is placed in his hand, he holds it tight. The baby tries to lift and hold the head, turning it toward the source of a sound or light. When pulled by hands, he tries to catch up to the hands of the adult, holds his head, especially confident by the end of the third month of age. When catching up, the baby flexes his legs.

    When placed on his stomach, the baby lifts his head holding it in this position for a longer time, and turns it actively in different directions. When lifting the head, he rests on his forearms while elbows are slightly unbent. The baby performs crawling movements with the legs by bending the hips and knees.

    3-6 months

    When lying on the back, the baby opens his palms, hands and legs are half bent. The baby can put the hands together like for clapping movement, can bring them to his mouth; can touch the nappy, a toy, the parents; he moves his fingers, purposefully reaches for a toy and grabs it. If at the beginning of this period, the baby can grasp the objects in front of his chest, so by the end of the period he can grasp them from different directions. The baby groups his limbs, making the first attempts to sit up. When being pulled by the hands at the fifth month of age, the baby holds his head and body in the same plane, slightly bending the legs. By six months of age the chin bends to his chest and the legs are bent and pressed against the stomach.

    When lying in a prone position, the baby confidently holds his head exactly along the spine, rests confidently on the forearms and the palms are open. By the half of the first year of age, the baby leans on his hands when rising leaning on his extended arms, the legs are straightened, the back is flat. At about four months of age the child attempts to roll from the back to a side, and by the end of the stage he freely rolls over from the stomach to the back and backward.

    6-9 months

    Being in a supine position the child actively moves by changing positions, rolling over on his stomach or to the back, sits up by himself, and learns to maintain balance when sitting by supporting the body with the hands. When being pulled by the hands, the baby groups his limbs, and by the end of 8-9 months of age, gets up on his feet. He crawls sideways or on the tummy pushing off with the elbows and leaning on the floor, gets up on all fours. Shifts the emphasis from hand to hand when reaching for a toy, and stands up holding a support by the end of the period.

    9-12 months

    At nine months of age the baby crawls confidently on all fours, gets up and walks by holding a support, he can squat and stand up to reach the toys holding the support, then he learns to stand without a support. By the end of the period the child walks on his own, grabs objects with two fingers. Points to the toys with a hand, takes them.

    Treatment methods

    The complex of treatment is assigned by a neurologist. Muscle tone is regulated and normalized with a comprehensive treatment. It includes various types of massage and gymnastics, as well as therapeutic swimming.

    Physiotherapy is recommended additionally for many children – thermotherapy, treatment with water and mud, electrophoresis with various medications, magnetic therapy, and ultrasound.

    In the most complicated cases, treatment with medications is added – medications for ICP (intracranial pressure)correction, for spasm relief and expansion of blood vessels, B vitamins. Herbal baths are recommended, as well as visits to a homeopath and osteopath.

    Elimination of excessive muscular hypertonicity is the basis of treatment, and relaxing baths with massage complex are the best ways of treatment in this case. Massage can be performed either in the hospital or at home, the parents having learned the basic techniques. Usually these are stroking movements on the arms, legs, back. You can alternate grasping stroking the limbs with the palm stroking the back and tummy. You can perform light rubbing as well; swinging in arms or on a gym ball relax the baby greatly.

    When the baby is hypertonic, chopping and slapping movements are unacceptable – they will increase the tension. Baby walkers and jumpers are prohibited, as the spine gets an excessive load and muscle tension is distributed unevenly.

    If the baby is hypotonic stimulating massage is being performed that activates the muscles. Chopping and slapping movements, rolling knuckles are perfect in this case – they tone muscles.

    Swimming and ball massage tone muscles greatly as well. They normalize and equal the tone level in different muscle groups.

    If physiotherapy treatment is ineffective, the doctor can assign medications additionally.

    In the most cases, muscle tone disorders are corrected quickly and disappear without any effects. If you have found unusual tension in the individual muscle groups in your baby or he develops with some delay, do not hesitate to consult your doctor.

    At what age period have you notice some muscular tension disorders in your baby? What techniques and medications did you use to cope with them? Share your story and tips with other parents!


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