STARRS

STARRS Characteristics One way to describe muscle function and movement Rating Scale from 0-4 with 0 indicating normal function 1 mild impairment ( ~25% or less impaired) 2 moderate ( ~50% or more is impaired ) 3 severe (~ 75% or more is impaired) 4 indicating profound deficits ( unable to perform)

Muscle Strength Descriptive terms: weakness, asymmetry, atrophy Potential causes- Bell’s Palsy, facial Palsy, lower motor neuron lesion, upper motor neuron lesion, tumor, TBI, Stroke CVA

Muscle Tone Look for Hypotonic Example- Tongue or lips may appear thickened and have litttle or no movement Common causes- Cerebral Palsy, Down Syndrome Hypertonic Increased activity and resistance Common causes Bells palsy, facial palsy symptoms

Accuracy of movement Descriptive terms: Uncoordinated or groping Potential causes :Apraxia- problem assembling the appropriate sequence of movements often results from unilateral left left hemisphere lesion ( Darley, Aronson, and Brown 1975, 1969)

Range of Movement Descriptive terms: reduced or decreased Hypokinesia- decreased body movement Excessive range is not common in neurological disease but decreased range is more common and may occur in the context of slow, normal or excessively rapid rate Example: Hypokinetic dysarthria- decreased range of motion and sometimes excessive rate ( Duffy 2005)

Speed of Movement Descriptive terms: Slow Bradykinesia- slowness of movement Potential causes; neuroanatomical area or system involvement ( upper motor neuron system, lower motor neuron system, cerebellum, extrapyramidal system or combination Dysarthria – a group of speech disorders resulting in weakness, slowness, incoordination due to damage central or peripheral nervous system or both Term dysarthria encompasses coexisting neurogenic disorders of several or all of the basic processes of speech: respiration, phonation, resonance, articulation and prosody ( Darley, 1969)

Steadiness of Movement Tremor- unintentional, rhythmic muscle movement involving to and fro movements Neurological causes include Multiple Sclerosis, stroke, traumatic brain injury, or some medications or alcohol use or withdrawal fasciculations- involuntary muscle contraction and relaxation which may be visible under the skin Causes -lower motor neuron lesions ALS- Spasms ( lingual dystonia) involuntary muscle contractions Possible causes Cerebral Palsy, MS, nerve damage from a stroke