LOW MUS­CLE TONE EX­PLAINED

If your lit­tle one has been de­scribed as “floppy’”or has a weak suck­ing re­flex, he may have low mus­cle tone. Here’s what you need to know.

Living and Loving - - CONTENTS -

If your child seems to trip over his own feet, slouches, leans or lies down while play­ing, he may have low mus­cle tone, also known as hy­po­to­nia. More se­vere cases are usu­ally picked up by a pae­di­a­tri­cian, if your child is not meet­ing cer­tain mile­stones like sit­ting, crawl­ing and walk­ing, but less se­vere cases can go un­no­ticed and un­treated.This can lead to dis­com­fort and frus­tra­tion for the child – es­pe­cially when he strug­gles to sit at school for longer pe­ri­ods.

Hy­po­to­nia de­fined

“Mus­cle tone is the readi­ness of a mus­cle to move,” ex­plains Liz Se­nior, oc­cu­pa­tional ther­a­pist and founder of Clam­ber Club.“It is ge­netic and can’t be changed, so the mus­cle tone you are born with is what you will have for the rest of your life,” she ex­plains. “Mus­cle tone can be de­fined as the amount of con­tin­u­ous con­trac­tion of a mus­cle at rest,” ex­plains Claire Malone, a phys­io­ther­a­pist working in the UK. “Mus­cles re­quire a cer­tain amount of con­trac­tion at all times in or­der to main­tain struc­ture and func­tion. If there wasn’t a de­gree of con­trac­tion, our bod­ies would be­come floppy and dis­torted when we slept, due to grav­ity.” She says it’s also im­por­tant for par­ents to know there is a dif­fer­ence be­tween mus­cle tone and strength. “Al­though the two are re­lated, tone re­lates to re­sis­tance to pas­sive move­ments and strength re­lates to the abil­ity to per­form ac­tive move­ments.”

Un­der­stand­ing a di­ag­no­sis

In a paper pub­lished in African Jour­nal of Dis­abil­ity, the au­thor states:“Clin­i­cal as­sess­ment of hy­po­to­nia is chal­leng­ing due to the sub­jec­tive na­ture of the ini­tial clin­i­cal eval­u­a­tion,” and that “the pre­sen­ta­tion of hy­po­to­nia can be ei­ther a non-threat­en­ing or malev­o­lent sign.” “Hy­po­to­nia it­self is an eas­ily recog­nis­able con­di­tion, but de­ter­min­ing the disor­der caus­ing the low tone is of­ten dif­fi­cult,” ex­plains Claire. Low tone can’t be viewed in iso­la­tion as it is al­ways caused by an un­der­ly­ing con­di­tion, which could range from hy­per­mo­bil­ity of the joint and treated through strength and sta­bil­ity ex­er­cises to more se­ri­ous con­gen­i­tal and ge­netic dis­or­ders that will re­quire med­i­cal in­ter­ven­tion, such as cere­bral palsy, menin­gi­tis, mus­cu­lar dys­tro­phy or spina bi­fida.A Fe­bru­ary 2012 memo from Johns Hop­kins Med­i­cal Cen­ter urged pae­di­a­tri­cians to screen all ba­bies for vi­ta­min D and cal­cium de­fi­cien­cies and stated that this rel­a­tively easy is­sue to cor­rect could be an un­der­ly­ing cause for the num­ber of chil­dren pre­sent­ing with low mus­cle tone, as vi­ta­min D is in­volved in the ab­sorp­tion of cal­cium.“Much of our life­long health is pre-pro­grammed in child­hood, and many adult dis­eases are rooted in ex­po­sures, lifestyle and diet dur­ing the first decade of life, ex­perts say.Vi­ta­min D, or lack of it, is a clas­sic ex­am­ple,” wrote the au­thors. “For dif­fer­en­tial di­ag­no­sis, your doc­tor may re­quest fur­ther in­ves­ti­ga­tions such as an MRI, a CT scan, blood tests or ge­netic test­ing,” ex­plains Claire.

Spot­ting the signs

“When my son was two years old, his nurs­ery school teacher men­tioned in our first par­ent/teacher con­fer­ence that he has low tone. I was shocked by the sug­ges­tion, be­cause our pae­di­a­tri­cian and doc­tor hadn’t men­tioned any­thing,” says Re­becca Todes, mom of Blaine (2). “I was wor­ried about what this meant for my child and had lit­tle un­der­stand­ing of the im­pli­ca­tions,” says Re­becca. Blaine’s teacher was the first to pick up his low mus­cle tone, be­cause he strug­gled to sit still dur­ing

morn­ing ring and of­ten ended up slouch­ing or ly­ing down by the end of it. His speech was also slightly be­hind that of his peers and he would run in an awk­ward way – of­ten from his hips – if he was overly ex­cited. “Once I started re­search­ing, things be­gan to fall into place. Blaine did drool ex­ces­sively when he was a baby and crawled slightly late at 10 months.We didn’t think any­thing of it be­cause he started walk­ing soon af­ter at around 12 months.” Liz says the im­pli­ca­tions of low tone can in­clude your child avoid­ing so­cial­is­ing and play­ground ac­tiv­i­ties that re­quire phys­i­cal strength, fear­ing he won’t be able to keep up. “Al­ter­na­tively, a child may com­pletely dom­i­nate sit­u­a­tions in or­der to con­trol them,” she says. Claire ex­plains that hy­po­to­nia ranges from mild to se­vere, so it’s im­por­tant for par­ents not to panic if their child presents with a few of the symp­toms, but to be vig­i­lant as early di­ag­no­sis can go a long way in as­sist­ing the child. “The un­der­ly­ing con­di­tion has not yet been found, but Blaine’s symp­toms have im­proved through en­cour­ag­ing cer­tain play ac­tiv­i­ties, par­tic­u­larly jump­ing on a tram­po­line, ”says Re­becca.

Bounc­ing your baby on your lap is a great way to en­cour­age weight bear­ing.

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