Spasticity vs. Rigidity: What’s the Difference?

A key element of the neurological assessment is the assessment of the patient’s muscle tone. Normal muscle tone maintains some residual tension during rest. This might be assessed by observing the muscle’s resistance to passive stretching. For example, hold the patient’s hand and support his or her elbow with the opposite hand. Flex and extend the patient’s fingers, wrist, and elbow and move the arm through a wide selection of motion. Notice the resistance (muscle tension) during these movements.
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Decreased resistance could also be an indication of the peripheral nervous system, cerebellar disease, or an acute stage of spinal cord injury. If you’re feeling less resistance, hold your forearm and shake the patient’s arm backwards and forwards. The patient’s arm should move backwards and forwards but mustn’t be completely limp. Significant laxity may indicate hypotonia or muscle laxity, normally brought on by a disorder of the peripheral motor system.
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If there may be increased resistance, assess changes as you progress the limb, note whether it stays the identical throughout the range of motion and whether it persists in each directions (i.e., each during flexion and extension). Move the limb at different speeds and feel the resistance jerks. Assess leg muscle tension, support the patient’s thigh with one hand, hold the foot with the opposite, and flex and extend the patient’s knee and ankle on either side. Assess the resistance of the moving limb.

Spasticity

Spasticity is a persistent increase in muscle tension when it’s passively lengthened or stretched. It is commonly speed dependent and becomes more severe at extreme ranges of motion. Spasticity may indicate central diseases of the corticospinal system.

Stiffness

Stiffness is increased muscle tension at rest that is still the identical throughout your complete range of motion, no matter speed. Stiffness may indicate a central disorder affecting the basal ganglia, resembling Parkinson’s disease.
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It could also be difficult to differentiate spasticity from stiffness at first, but as more patients are examined, these nuances will turn into easier to acknowledge over time.

Bickley, L. S., Szilagyi, P. G., Hoffman, R. M., & Soriano, R. P. (2021). Bate’s guide to physical examination and history taking (thirteenth ed.). Wolters Kluwer Health: Philadelphia.
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Hinkle, J. (2021). Brunner and Suddarth’s textbook of medical-surgical nursing (15^vol ed.). Wolters Kluwer Health. https://wolterskluwer.vitalsource.com/books/9781975161057

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