Aculady - I think that gets to the problem with using the terms low tone or hypotonia - they are way too vague and can be used to describe kids with minor impairments and kids who are lucky to ever learn to walk. Lots of OTs seem to use that pretty freely to describe kids with a very minor degree of lack of strength. I'm thinking more of kids who are actually really floppy - kids like Lori's son who have trouble with even walking into an event from the parking lot. It is hard to have the energy to be bouncy when you are totally floppy.
Wow, OT's are diagnosing kids with low tone on the basis of a lack of strength? That's really odd, and very troubling.
Poor muscle tone and poor muscle strength are completely separate issues, even though there are certainly conditions where both are present. Tone relates more to the ability to sustain muscle contraction appropriately, to resist passive stretching to an appropriate degree, and to rapidly respond to proprioceptive input regarding changes in muscle length so that muscular co-contraction can be modulated appropriately for proper movement and postural control. Strength relates more to the degree of maximum contraction or force that can be generated by a given muscle.
You can be very strong but with muscles that fatigue quickly during activity, and that fail to contract in response to passive stretching, and that do not react quickly and smoothly to modulate movement from having a nervous system that fails to signal the muscles to respond appropriately to sensory input. You can also lack strength but have perfectly normal or even excessive tone.
Treatment strategies for hypotonia with muscular weakness, which include techniques and exercises aimed at increasing muscle strength in addition to regulating the responsiveness of the muscles, differ significantly from those for hypotonia without accompanying muscular weakness, which primarily target trying to improve the responsiveness of the nervous system to proprioceptive inputs. Strategies for muscle weakness without hypotonia are another animal entirely.
