- Alignment of limbs and trunk: Finally, the effects of a neuromuscular disability on the body's alignment should be assessed. Misaligned limbs will complicate laying in bed, sitting in a chair and any attempt at using the limb functionally. A maligned trunk will result in the body's center of gravity being displaced with a resulting imbalanced and difficulty with movement.
- Joint motion: The mobility of the limbs' joints should be assessed since loss of mobility is a common problem seen in individuals with chronic neuromuscular disabilities. Commonly this is due to muscle contraction as mentioned above but done deformities and weakness can also contribute.
When assessing he neuromuscular system for a disability several of its attributes must be examined to appreciate the impact of the disability:
- Muscle tone: Muscle tone refers to the amount of stiffness or resistance to movement in a muscle. It is important to quantify any abnormality in muscle tone since an elevation in tone can result in blockage of limb function, abnormal stresses on bone leading to deformities and poor stretching of the muscle leading to muscle contracture or inability to lengthen to accommodate movement with an associated loss in a limb's mobility.
- Muscle strength: When a muscle does not have a normal connection to the nervous system it weakens or fails to develop normal strength. This in turn will impair its functional ability and, in young children, can result in impaired bone growth owing to the lack of stimulation of the bone by the normal pull of the muscle. An understanding of a muscle's strength will lead to an appreciation for the level of risk for these problems occurring
Examination of the Neuromuscular System