Voluntary movement is best defined as:
A. Passive elongation of muscle fibres
B. Reflexive muscle activation
C. Continuous background muscle activity
D. Active contraction of muscle
D
Muscle tone refers to:
A. Velocity-dependent resistance to stretch
B. Continuous partial muscle activation needed for postural control
C. Rhythmic contractions following sustained stretch
D. Permanent loss of passive range of motion
B
Which feature best distinguishes spasticity from rigidity?
A. Presence of clonus
B. Uniform resistance across movement
C. Velocity-dependent increase in resistance
D. Equal involvement of flexors and extensors
C
Clonus is characterised by:
A. Sustained muscle shortening
B. Repetitive rhythmic contractions following sustained stretch
C. Uniform resistance not dependent on velocity
D. Permanent structural muscle changes
B
Rigidity differs from spasticity because it is:
A. Dominated by neural factors and not velocity dependent
B. Caused primarily by contracture
C. Associated with exaggerated tendon jerks
D. Limited to upper motor neuron lesions
A
Spasticity is best described as:
A. A release phenomenon occurring immediately after injury
B. A motor disorder characterised by velocity-dependent tonic stretch reflexes
C. Permanent intrinsic muscle shortening
D. Loss of voluntary motor control only
B
Upper motor neuron syndrome:
A. Is an immediate consequence of pyramidal tract injury
B. Consists only of positive symptoms
C. Develops over time and includes both positive and negative features
D. Does not include changes in muscle tone
C
Which of the following is considered a positive feature of UMN syndrome?
A. Weakness
B. Fatigue
C. Loss of dexterity
D. Clonus
D
Negative features of UMN syndrome are best described as:
A. Involuntary muscle overactivity
B. Heightened and unpredictable symptoms
C. Absence of normal motor function
D. Exaggerated reflex responses
C
The pooled incidence of spasticity following stroke is approximately:
A. 10%
B. 25%
C. 45%
D. 60%
B
In multiple sclerosis, spasticity severe enough to modify or prevent ADLs occurs in approximately:
A. 5%
B. 10%
C. 17%
D. 40%
C
Loss of descending inhibitory input contributes to spasticity primarily by:
A. Increasing peripheral muscle stiffness only
B. Enhancing inhibitory spinal reflexes
C. Reducing alpha motor neuron excitability
D. Allowing relative over-excitation of alpha motor neurons
D
Which pathway is particularly important for descending inhibitory control of alpha motor neurons?
A. Corticospinal pathway
B. Vestibulospinal pathway
C. Dorsal reticulospinal pathway
D. Rubrospinal pathway
C
Which change occurs over time in spasticity?
A. Complete loss of stretch reflexes
B. Development of abnormally long plateau potentials in motor neurons
C. Restoration of post-activation depression
D. Reduction in axonal sprouting
B
Which of the following is a non-neural contributor to muscle stiffness in spasticity?
A. Disinhibited primitive reflexes
B. Reduced inhibitory control
C. Exaggerated stretch reflexes
D. Increased collagen and altered muscle fibre composition
D
Thixotropy refers to:
A. Reduced sarcomere number
B. Increased excitability of stretch reflexes
C. Resistance due to actin–myosin cross-linkages
D. Conversion of slow to fast muscle fibres
C
Which factor can increase spasticity through heightened afferent input?
A. Reduced sensory input
B. Blocked catheter or UTI
C. Use of assistive standing
D. Passive stretching
B
Spasticity is best understood clinically as:
A. Always disabling
B. Occurring in isolation
C. Independent of weakness or sensory loss
D. One component of a broader pattern of impairment
D
Which outcome measure best helps distinguish spasticity from passive stiffness?
A. Modified Ashworth Scale
B. Visual Analogue Scale
C. Spasm Frequency Scale
D. Tardieu Scale
D
The Spasm Frequency Scale is most appropriate for measuring:
A. Resistance to passive stretch
B. Muscle strength
C. Random or intermittent muscle spasms
D. Joint range of motion
C
A key disadvantage of the Modified Ashworth Scale is that it:
A. Is expensive
B. Lacks face validity
C. Has low inter-rater reliability due to examiner judgement
D. Cannot be used clinically
C
MDT management of spasticity is preferred because it:
A. Reduces the need for outcome measures
B. Allows complementary interventions to work together
C. Eliminates need for community liaison
D. Prevents need for orthotics
B
Effective management of spasticity should be:
A. Medication-based only
B. Short-term and intensive
C. Therapist-led without carer involvement
D. Multimodal and individualised
D
Which statement best reflects good clinical decision-making in spasticity management?
A. All spasticity should be treated
B. Spasticity is always the main cause of disability
C. Intervention depends on functional impact and secondary risks
D. Severity alone determines treatment
C
