Welcome To Spence Rehabilation Center



	ANKLE PAIN

	CARPAL TUNNEL SYNDROME
	CARPAL TUNNEL SYNDROME

	CHRONIC PAIN

	ELBOW PAIN

	HIP PAIN

	IMPAIRMENT & DISABILITY
	IMPAIRMENT & DISABILITY

	KNEE PAIN

	MUSCLE WEAKNESS

	MYOFASCIAL PAIN

	NECK & LOW BACK PAIN

	NUMBNESS

	SHOULDER PAIN

	WRIST PAIN


Spence Rehabilitation Center
9305 Calumet Ave. Suite C-1
Munster, IN 46321
Phone	: (219) 513-2267
Fax	: (219) 836-1276

What Are Some Potential Causes of Muscle

Weakness?

1.	Disorders of the brain:
	Stroke, brain tumors, meningitis, multiple scleroisis, etc.

2.	Disorders of the spinal cord:
	Myelopathy, spinal cord metastasis from cancer,
	arteriovenous malformations, abscess from infection.

3.	Radiculopathies:
	Pinched nerves can be caused by disc herniations or
	spinal stenosis.

4.	Compression Mononeuropathies:
	pinched nerves elsewhere in the body such as at
	the arms or legs. Some examples are carpal tunnel
	syndrome which is compression of the median nerve
	at the wrist.

5.	Peripheral Polyneuropathies:
	Many of the nerves in the body are affected particularly
	in the arms and legs. Common causes include diabetes,
	alcohol use, toxins. Etc.

6.	Neuromuscular Junction disorders:
	A disorder involving where the nerve and muscle
	communicates. The disorder can be due to broken
	neurotransmitters, improperly working receptors
	at the muscle, etc. One example is Myesthenia
	Gravis.

6.	Myopathy:
	A disorder of the muscle. The muscle can be inflamed
	also known as myositis or have a structural problem
	which is known as muscular dystrophy.

7.	Dislocated kneecap (patella):
	Caused by direct trauma or forceful straightening of the
	leg. If present, you will notice the patella being out of
	place and may have difficulty flexing or extending your
	knee.

What are some Important things to consider in the

patient history?

1.	Family History:
	Hereditary disorders include Duchennes Muscular
	Distrophy.

2.	Recent viral infections:
	Can hint at West Nile Virus or Guillain Barre.

3.	Recent exposure to toxins:
	Such as alcohol, lead.

4.	Other Medical Problems:
	Diabetes and thyroid problems can result in neuropathies.

What are some symptoms that can accompany

muscle weakness?

1.	Choking or difficulties swallowing

2.	Shortness of breath

3.	Slurred speech or difficulties talking

4.	Poor exercise tolerance

5.	Numbness and tingling

6.	Spasticity

7.	Joint pain

8.	Fatigue

9.	Difficulty climbing stairs, combing hair, or rising from
	a chair

What are important factors to consider on

physical exam?

1.	Inspection:
	For muscle atrophy which is muscle wasting.

2.	Muscle tenderness:
	Could mean inflammation of the muscle also known
	as myositis.

3.	Muscle strength:
	Which muscles are weak? Is the weakness symmetric
	or asymmetric?

4.	Reflexes:
	If they are absent it can mean a problem with the
	peripheral nerve or muscle while brisk reflexes can
	mean there are brain and spinal cord problems.

What laboratory studies are important when

evaluating for Muscle weakness?

Elevation of plasma muscle enzymes:

(creatine kinase, aldolase, lactate dehydrogenase, and

the aminotransferases) are highly suggestive of muscle

diseases.

Urinalysis:

A positive test for urine blood, in the absence of red

blood cells in the sediment, is suggestive of

myoglobinuria.

Labs to evaluate for Inflammatory diseases:

Antinuclear antibodies, antibodies against extractable

nuclear antigens (anti-Ro/SSA, anti-La/SSB, anti-Sm,

and anti-RNP)

Labs to check for Myositis anti-histidyl-t-RNA synthase

[anti-Jo-1]

Labs to check for vasculitis Anti-neutrophil cytoplasmic

antibody (ANCA) titers, hepatitis B and C serologies

Genetic Testing:

If there is a family history of muscle weakness

Electrolytes:

Metabolic abnormalities particularly calcium and

magnesium are associated with weakness

What tests can be used to evaluate for Muscle

weakness?

1.	X-rays of the spine

2.	CT or MRI of the Brain and Spinal Cord

3.	Bone Scan

4.	EMG and Nerve Conduction Studies:
	Can look for abnormalities of the peripheral nerve,
	the neuromuscular junction that attaches the muscle
	and nerve, and the muscle itself.

5.	Muscle Biopsy:
	A small sample of the muscle is taken and sent to a
	pathologist to look for abnormalities.

Treatment of Muscle Weakness:

Treatment options will vary depending on the diagnosis,

medical comorbidities, and disease severity.


	Physical Therapy

1.	Moderate Resistance Strengthening Exercises:
	Performed two to three times a week for eight to twelve
	weeks can be helpful.

	a.	It is important not to over exercise particularly in
		patients with certain nerve and muscle disorders
		such as Muscular Dystrophy and Amyotrophic
		Lateral Sclerosis.

	b.	Also, isometric exercises are less likely to cause
		muscle injury while eccentric exercises should be
		avoided (for examples of isometric and eccentric
		exercises, please refer to the physical therapy link).

	c.	Patients that develop severe muscle cramping or
		muscle heaviness should inform their doctor.

2.	Submaximal, Low impact Aerobic Exercises:
	Such as walking, swimming, and using the stationary
	bicycle can help minimize fatigue and improve heart
	fitness.

3.	Range-of-Motion and Stretching exercises:
	Should be performed daily to keep the joints moving
	properly and minimizes the likelihood of joint stiffness
	which is also known as contracture. If a contracture
	does develop, splinting can help to regain the joints
	range of movement.

4.	Gait training:
	A term used by doctors and therapists when they want
	you to practice walking and provide you with safe
	walking practices. The therapist can help you work on
	visual cues and balance techniques

5.	Transfer training:
	Strategies to safely move from your bed to your
	wheelchair, etc.

6.	Bracing:
	Can help to support the weak extremity and allow you
	to perform activities that would be difficult without its
	use. One example is an ankle-foot-orthosis which can
	be used for a person with foot drop to support a weak
	ankle and allow them to walk.

7.	Assistive Devices:
	Are used to improve mobility in a person with .
	weakness. Examples of assistive devices include
	canes, walkers, and wheelchairs. A doctor and
	qualified physical therapist are well trained to
	determine which device is most appropriate for
	your situation.

Occupational Therapy

1.	Energy Conservation techniques

2.	Adaptive Equipment Evaluation:
	certain devices can be attached to your wheelchair
	or arm and used to perform daily activities. For
	example, a universal cuff is commonly prescribed
	for patients with poor grasp to hold a spoon or fork.
	Another example is a balanced forearm orthosis
	which is sometimes used for upper arm weakness. It
	is attached to the wheelchair to support the arm and
	helps eliminate the effects of gravity.

Disclaimer

"Nothing contained on this website should be interpreted to be medical advice. This website is for general information only.
Please consult a physician for medical advice regarding any medical condition."