Modality Assessment Inspection Visual assessment of the patient's posture, gait, coordination, voluntary and involuntary movements whilst the patient is unaware of being observed Palpation Manual assessment of individual and muscle groups for indications of hypertonia (high resistance to movement followed by a sudden 'give', often indicative of an UMN lesion) or hypotonia (flaccidity, often indicative of LMN and cerebellar lesion) Power Assessment of resisted movement (using the MRC grading - see Table 3) Reflexes Patellar (knee jerk) tendon stretch reflex (quadriceps muscle stretch) and the Achilles (ankle) tendon stretch reflex (gastrocnemius muscle stretch), reinforced as necessary by Jendrassik's manoeuvre. Muscle stretch reflexes are noted as brisk (indicative of an UMN lesion), normal, normal/slow (indicative of underactive thyroid), reduced or absent (indicative of an LMN lesion) Babinski's reflex (extensor plantar response) is indicative of an UMN lesion Coordination • Heel-shin test (left heel to slide down right shin and vice versa) • Fingertip test: where the patient places the index finger on the examiner's finger as this moves apparently at random in front of the patient Failure to perform in these tests indicates a cerebellar lesion Movement Active dorsiflexion and plantarflexion, inversion and eversion, and adduction and eversion of the foot against resistance imposed by the examiner: • Lead pipe rigidity indicates a basal ganglia disorder • Clasp knife rigidity indicates an extrapyramidal disorder • Clonus indicates an UMN lesion
During Phase 1, your #ULTRAFIT Challenge trainers, Team Nutrex's Gerardo & Sammy, will take you through the first steps of the challenge. The directions are simple: you will be challenged to complete as many rounds as possible (AMRAP) of a series of exercises. You will have 30 minutes to finish the workout. While you would typically have rest time in between sets, this AMRAP is non-stop and should be completed in circuit-style fashion. Phase 1 will test your limits. Each week, you will blow yourself away with how much further you can push your body. The time component takes up the intensity and the variety of exercises will increase your strength and stamina every time. You will need equipment, including a medicine ball, kettlebell and dumbbells. Don't forget about your warmup! Effective warm-ups are vital to any training session to avoid injury. Get the warmup HERE. Get comfortable with warming up as part of the training program, as it will be consistent throughout all four phases.