What is Dysdiadochokinesia? Its Treatment & Exercises

Dysdiadochokinesia (DDK) is a combination of Greek letter diadochos “succeeding” and kinesis “movement”, it is basically caused due to heavy disturbance in cerebellar dysfunction (blockage of posterior lobe that is directed towards brain), means fail to respond against quick moves, in other words, become totally paralyze to all alternating actions; in case if a person unconsciously put his hand on a stove, he pulls it back due to involuntary action, but in this state he fail to response against this he remains to stick with it (sensory neurons are unable to transport signals to interneurons via motor neurons respectively).

Causes of Dysdiadochokinesia:

Cerebellum a part of the brain that controls both voluntary and involuntary actions. Dysdiadochokinesia is caused due to blockage of posterior lobe or front lobe that link with this part of the brain, that become insufficient to further transfer the signal via motor neurons towards acceptor. That is why some doctors prescribed it a second stage of paralyze.

Dysdiadochokinesia test:

Doctors before the treatment check the patients by passing them through a series of test, in order to determine that how much percent do it is affected by the disease.

Rapidly Alternating Movement Evaluation:

First, tell the patient put the dorsum of one hand against their thigh or another hand. Then to move his hand back to palm side up and finally, continuously perform the hand flipping as quickly as possible.

what is Dysdiadochokinesia

Point-to-Point Movement Evaluation:

In this test ask the patient to move their forefinger in order to touch the nose and after that touch the analyst’s outstretched finger with the same finger. Tell the patient to perform it instantly, until the doctor examines it perfectly.

Gait Test:

In this test, doctors tell the patients to walk simply and walk heel to toe across to the room, in order to check whether his foot are performing well or not.

Rhomberg Test:

Rhomberg test is performed to check the patient’s balance, by telling them to stand still with their heels together.

Babinski test:

Babinski test or plantar reflex is a very crucial test in which patient is pricked with a pointed pin, in order to check its involuntary action.

Clonus test:

It is tested to give a knee-jerk or up and downside movement of the leg, in order to determine the reflex action cases.

Rinne test:

Rinne test is basically performed to check Rinne positive and negative state, by simply sounding the tuning fork near the ear.

Heel shin test:

In this test doctors ask the patients to put one leg over his second leg to read his brain coordination system.

Coordination test neurology:

Patients are inquired some easy questions by the doctor.

Achilles reflex:

Achilles reflex is a kind of reflex that is directed to the spinal cord, in this whole test patient’s foot is touched with a cold body.

Treatment to handle Dysdiadochokinesia:

If you are afflicted with dysdiadochokinesia, your doctor begins by working with primary condition first. For instance, dysdiadochokinesia a result of a metabolic illness may be dealt with medications along with a good diet plan. Dysdiadochokinesia is also linked to a vitamin insufficiency which can be handled providing adequate amount of vitamins. There are several drugs and therapies in the industry to help in gait and swallowing disorders.

Common Exercises for Dysdiadochokinesia:

1. Warm up: 5 minutes:

A five minutes of a continuous activity such as jogging, riding a bike, arm bike, treadmill, rowing machine, etc. The five-minute activity will:

  • Increase muscle and body temperature
  • Dilate blood vessels
  • Increase range of motion
  • Providing mental co-ordination

2. Balance training: 20 minutes:

Modified Lee Silverman LVST – This is a protocol that came out about five years ago. It is a program that was developed for individuals with Parkinson’s disease. Some of these forms of exercise are used for people with ataxia because it involves moving your arms and legs in very coordinated movements. They are done while sitting and standing, and they challenge your balance in a safe way. Romberg – Patient stands with feet together, semi-tandem, and tandem, with eyes open for 10 seconds then closed for 10 seconds in each position. Unilateral stance – The standard for adults is to stand on one leg for 30 seconds. That can be your goal. If you do it over, and over and over again, you should see improvement. There are so many ways for you to work on and challenge your balance, so when you are doing this be sure to target neuromuscular systems that control balance through various levels of challenges such as: Control centre of gravity (COG) over the base of support (BOS). Increase challenge by engaging visual, vestibular, somatosensory and cognitive systems. Elicit postural reactions and balance strategies by altering stimuli, surfaces, etc., standing with your feet together, standing with your feet apart, standing on one leg, etc. Weighted vests.

3. Strengthening: 20 minutes:

Evidence-based research suggests: Muscle strength decreases with age, Weakness is a risk factor for falls, High-intensity strength training programs can significantly increase lower extremity strength and significantly increase functional balance ability.

The recommended amount of repetitions is 12-25 at 30-60% of a maximal contraction. Perform each exercise with full ROM and at a slow pace. Research has shown that maintaining a muscle contraction throughout the full ROM will release dystrophin, which will aid in building muscle strength.

4. Strengthening Exercises:

  1. Target pelvic muscles.
  2. Straight leg raise, knee to chest, hip abduction, hip adduction, bridging, long arc quad, hamstrings curls, squats.
  3. If you have access to a facility that has strength building machines, here are the most beneficial strengthening activities. Try for three sets of eight repetitions each, as you are able.
    1. Leg Press
    2. Hip Abduction/Adduction
    3. Calf Press
    4. Seated Row
    5. Plank
  4. Upper extremity weakness or core – there are hundreds of different exercises that can be done. Ask your therapist to teach you how to activate your core. It is called abdominal bracing, where you are squeezing your abdominal and back muscles and activating the core while you are exercising. It is a learning process.
  5. Proximal weakness in the upper extremities, in particular, the shoulders, which seem to be a little bit weaker than the hands or the elbows for those with ataxia. Focus on the working those muscles. It is also suggested that you do not exercise in the same position. Often when you go to therapy, the therapist will tell you to, “Lay on the mat, we are going to do the leg exercises.” That is great, but it is important to exercise in additional postures such as sitting and standing. If you can’t stand independently, maybe standing in the “standing-frame” and doing exercises with your arms so you are activating different muscles. Even laying on your stomach and doing different exercises is a great way to activate some of those back core muscles. If you sit in a wheelchair or scooter, even asking to just sit in a different chair. If you change the surface that you are sitting on, that also can activate different muscles as you are working on the upper extremities.

Hi, This is Hamza Khan from Peshawar, Pakistan. I am a 2nd prof MBBS Student at Bannu Medical College and a hobby Blogger. The Purpose of this site is to share my knowledge and Guide new Medical Students.

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