Arm recoil
| Arm recoil | |
|---|---|
| Purpose | Determining muscle tone in newborns |
Arm recoil is a component of the neurological examination of neonates used to assess passive flexor tone of biceps(muscle tone). It is also one of the neuromuscular criteria used in the Ballard Assessment of gestational age.[1][2]
Procedure
The baby is placed supine, with forearm flexed at elbow. The elbow (forearm) is extended by pulling the hand; then released.[3]
The Arm should not be held in extended position for a prolonged period, as flexor fatigue can result in a falsely low recoil score.[4][5]
Observation
How quickly the forearm returns to flexed original position and the amount of flexion will designate a score.[1]
- Grade 0: Arms remain extended 180 degrees or abnormal movements begin
- Grade 1: Minimal flexion, 140-180 degrees
- Grade 2: Slight flexion, 110-140 degrees
- Grade 3: Moderate flexion, 90-110 degrees
- Grade 4: Quick return to full flexion, less than 90 degrees
Slow of incomplete arm recoil may indicate reduced muscle tone. Asymmetry in the response may also be observed with brachial plexus injury.[6][7]
Interpretation
The greater the tone development (flexor tone), the brisker the recoil will be.[1] This correlates to more advanced gestational age on the Ballard Scale.[8]
Note that for grade 4 score selection occurs when recoil brings the infant's fist into contact with the face; this is seen in term and post term infants.[4]
Leg recoil can be assessed following the same principle.[9]
References
- 1 2 3 Wilkins, Lippincott Williams & (2008). Straight A's in Maternal-neonatal Nursing. Lippincott Williams & Wilkins. p. 272. ISBN 9781582556932. Retrieved 8 November 2017.
- ↑ Murray, Sharon Smith; McKinney, Emily Slone (2014). Foundations of Maternal-Newborn and Women's Health Nursing - E-Book. Elsevier Health Sciences. p. 406. ISBN 9780323293846. Retrieved 8 November 2017.
- ↑ Kacmarek, Robert M.; Dimas, Steven; Mack, Craig W. (2005). The Essentials of Respiratory Care. Elsevier Health Sciences. p. 465. ISBN 9780323027007. Retrieved 8 November 2017.
- 1 2 "Ballard Score Training - 3. Arm Recoil - Ballard Score". www.ballardscore.com. Retrieved 2026-08-19.
- ↑ Gutman, Julie; Sangare, Laura (2009). "Newborn Examination: Training Manual (English)l" (PDF) (Training Manual). CDC Stacks. p. 34.
{{cite web}}: CS1 maint: url-status (link) - ↑ "Pediatric Neurologic Examination Videos & Descriptions: Newborn > Normal". neurologicexam.med.utah.edu. Retrieved 2026-08-19.
- ↑ Yozawitz, Elissa; Delfiner, Leslie; Moshé, Solomon L. (2018-08-01). "Neonatal Hypotonia". NeoReviews. 19 (8): e445–e455. doi:10.1542/neo.19-8-e445. ISSN 1526-9906.
- ↑ Ballard, JL; Khoury, JC; Wedig, K; Wang, L; Eilers-Walsman, BL; Lipp, R (September 1991). "New Ballard Score, expanded to include extremely premature infants". The Journal of Pediatrics. 119 (3): 417–23. doi:10.1016/s0022-3476(05)82056-6. PMID 1880657. Retrieved 13 August 2012.
- ↑ Ghosh, Sibarjun. bedside clinics in paediatrics. Academic Publishers. ISBN 9788189781859. Retrieved 8 November 2017.