The musculature has a basic tension, which is also called Ruhetonus. At rest, skeletal muscles are neither contracted nor fully relaxed. In a so-called rigor, the basic tension of the skeletal muscles is increased. The result is muscle stiffness or stiffness of the muscles. The rigor is based on a centrally controlled and simultaneous activation of the individual muscles and their antagonists.
As such, the opponents of individual skeletal muscles are called. The muscle activation in the rigor thus corresponds to an agonist-antagonist coactivation. In addition to a feeling of rigidity, patients with rigor often describe pulling sensations in the affected area. A special form of the Rigor is the so-called gear phenomenon, in which the musculature of a passively moved extremity yields jerkily. The gear phenomenon refers to disorders in the extrapyramidal system of the central nervous system.
The causes of all forms of rigors are to be found in the central nervous system. Muscles have a certain basic tension, which is regulated by different areas of the central nervous system. In addition to the pyramidal system, the extrapyramidal system is involved in this regulation.
All muscle information about the contraction of muscles and muscle groups migrates through the cerebral cortex-spinal cord to the target organs. These paths correspond to the pyramidal tracts, which are summarized in the pyramidal system. Movement information can also be extrapyramidally directed, reaching the spinal cord by other means. The pyramidal and extrapyramidal system interact with each other.
In most cases, a rigor is preceded by dysfunction in the extrapyramidal system. The cogging phenomenon, for example, is often based on dopamine deficiency and resulting disorders, such as Parkinson's syndrome.
Patients with a rigor suffer from the key symptom of muscle rigidity. In the gear phenomenon, this rigidity affects only passive movements. Other forms of rigors only affect active movements. The rigidity of the muscles ultimately leads to movement disorders and sometimes to coordination problems. One of the earliest signs of rigidity is the reduced moving of the arms while walking.
In some cases, in addition to rigidity, pain and discomfort may occur. The sensations are often due to the compression of sensory nerves in the musculature. The movement disorders can in individual cases favor a tendency to fall. In part, the patients develop a camptocormia during the rigor. Under this postural anomaly medicine understands an involuntary active bending movement of the trunk area forward.
The cause of this phenomenon is the dyston involuntary tension of the trunk flexor muscles. This contraction is particularly pronounced in upright posture, so that the Kamptokormie usually occurs when standing. All other symptoms depend on the particular cause of the rigor. For example, Parkinson's is one of the most relevant symptoms of resting tremor and akinesia.
The diagnosis for a rigor is made by measuring the resting tone. For example, an EMG can be used for the measurement, which makes the stress state objectifiable. In addition, a neurological examination takes place in the context of diagnostics. In this exam, the rigor is detected on a lying or sitting patient. This proof succeeds especially with the gear phenomenon.
The doctor moves the individual joints passively and asks the patient to relax the muscles. In a rigor or gear phenomenon, the doctor feels the waxy-looking rigidity of the muscles in the form of a uniformly tough resistance. Unlike spastic appearances, the resistance does not depend on the speed of movement.
As the patient actively moves the extremity of the other side, the resistance on the passively-moved side increases. In the gear phenomenon, the rigor is characterized by breaks in this investigation. In order to identify the primary cause of the rigor, the doctor subsequently initiates imaging procedures. The prognosis depends on the cause of the rigor.
A muscle stiffness or rigor arises mainly in the context of Parkinson's disease. Another possible complication in Parkinson's is the so-called freezing, in which the person in the middle of the movement freezes. On the contrary, it can also lead to overshooting, unwanted movements of the arms and legs or the trunk (hyperkinesia), whereby the risk of injury of the person affected and also the environment is increased.
Parkinson's Disease can also lead to disruption of the circulation, which can lead, for example, from lying down to standing up, to severe dizziness or loss of consciousness. In addition, the affected person may experience a weakness of the bladder or the rectum, so that it becomes incontinent and thus becomes in need of care.
In addition, Parkinson's can lead to depression due to impaired quality of life. This can lead to an increase in alcohol and drug use, also depressives tend to suicidal thoughts. A rare and dreaded complication of Parkinson's disease is the akinetic crisis.
In this case, the symptoms worsen and the person suffering from a total muscle stiffness or extreme rigor. This can result in complete immobility, which can also affect the speech and respiratory muscles. This can also lead to overheating of the body.
To get a correct diagnosis, sufferers should contact a doctor for suspected rigors. Self-diagnosis using tests or checklists from the Internet is not enough. Usually, patients first turn to their family doctor. If necessary, the family doctor can then issue a referral to the specialist.
If the symptom recurs, patients suffering from Parkinson's should also inform their attending physician about the appearance of the rigor. This is usually a neurologist or psychiatrist.
In Germany, however, patients do not necessarily need a referral to see a neurologist. Depending on how well the medical supply situation is locally, the waiting times for an appointment can vary greatly. An appointment with the family doctor is often faster to implement and can in part already allow an initial assessment of the symptoms.
In some cities there are also special outpatient clinics that are often connected to a larger clinic. Some of these specialized treatment centers also provide diagnostic and treatment appointments for suspected Parkinson's disease.
Since the rigor is a core symptom of Parkinson's, a professional diagnosis by a doctor in any case makes sense.
Also the therapy of the Rigors is dependent on the primary cause of the disturbance. In any case, include physiotherapeutic steps and steps to therapy. A causal therapy can not take place. Each rigor has a CNS cause, and central nervous system damage is in most cases irreversible to a degree. Ergotherapy and physiotherapy are therefore not a causal, but a symptomatic treatment.
With forms of therapy aim to at least alleviate the rigor or to help the patient in dealing with the symptom. In occupational therapy, for example, the patient learns how to handle possible aids so that he can find his way through everyday life for as long as possible, even with strong rigors. Above all, everyday movements are trained as part of the therapy. Under certain circumstances, medical treatment steps are also possible, which move the central nervous system to a reduced toning.
In a rigor, the prognosis depends essentially on the cause of muscle stiffness. If the Rigor is based on Parkinson's disease, the symptoms can be alleviated by physiotherapeutic and ergotherapeutic measures, however already caused damage is in most cases irreversible. The prospect of a full recovery is therefore not given, but early action can at least alleviate further discomfort.
In the course of the disease, there are usually other symptoms such as a changed gait, a lack of eyelid or a decrease in the voice volume, which can worsen the prognosis accordingly. Corresponding symptoms develop with the course of the underlying Parkinson's disease on and on increase in intensity and spread, until it finally comes to severe paralysis and later death of the person affected.
The prospect of a cure is given at Rigor as a result of injury or accident. Surgery may then restore the original muscle performance without causing any sequelae. First signs of rigor should be clarified promptly by a doctor because of the severity of the course.
The rigor is the symptom of pyramidal or extrapyramidal damage to the central nervous system. Thus, the rigor can be prevented only to the extent that can prevent lesions in the central nervous system preventively. For example, there are no preventive measures against diseases such as multiple sclerosis. For this reason, the rigor should never be fully prevented.
With a rigor, it may be helpful to perform appropriate exercises outside of the physiotherapy units. The prerequisite for this, however, is that the exercises are carried out cleanly and that a consultation with the treating therapist takes place beforehand. Otherwise, exacerbations of symptoms or overloading may occur. Only properly performed exercises are able to improve the daily lives of those affected.
Nonetheless, the opportunities to get involved with a rigor yourself are quite limited. It is only possible to supplement or support existing treatment approaches. Since a rigor is often accompanied by irreversible damage to the central nervous system, the affected must align their everyday life after the disease. This is to be accepted. Everyday movements should be done despite the limitations. If aids should be used, they must be controlled.
In addition, psychological aspects must be taken into account in the everyday life of those affected. Finally, the diagnosis Rigor brings with it many changes. Since these are mostly irreversible, the path of acceptance is usually the simplest. It is therefore advisable to mentally reconcile with the new life circumstances. Consultation with a psychologist or psychiatrist may help.Tags: