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Lauren > 13. Balance and Gait > Flashcards

13. Balance and Gait Flashcards

1
Q

Upper extremity tests in standing

A

bilateral shoulder flexion
apley scratch test

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2
Q

lower extremity standing tests

A

bilateral 1/4 squat
half squat
full squat
single leg stance
toe walking/heel walking

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3
Q

what are the three balance systems

A

neurosensory
central processing
musculoskeletal

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4
Q

to acquire information about where the body is relative to the BOS- includes visual, somatosensory, and vestibular

A

neurosensory

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5
Q

to determine in advance an effective response

A

central processing

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6
Q

effector components, resources to carry our the needed movement for response (strength, core, ROM)

A

musculoskeletal

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7
Q

body balance is controlled by which 3 sensory systems?

A

vestibular, visual, proprioceptive

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8
Q

important components of visual

A

acuity
contrast sensitivity
peripheral vision
depth perception

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9
Q

which cranial nerve is in charge of visual

A

optic, CN 2

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10
Q

what sensory components provides information about the environment

A

visual

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11
Q

which sensory component provides info about the relative location of body parts in space

A

somatosensory

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12
Q

components of somatosensory

A

tactile- touch/pressure receptors
joint, tendon, muscle proprioceptors

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13
Q

which sensory components helps posture and balance control

A

vestibular

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14
Q

what are the anatomical components of the vestibular system

A

semicircular canals
otolith organs- utricle and saccule
vestibular n- CN 8
vestibular nuclei in brainstem

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15
Q

integration and processing of sensory info in order to generate a motor response

A

central processing

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16
Q

time required to complete central processing

A

latency

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17
Q

T or F: central processing important for resolving sensory conflict

A

T

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18
Q

time required to generate a central processing response

A

reaction time

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19
Q

2 types of postural responses

A

automatic (feedback)
anticipatory (feed forward)

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20
Q

automatic postural motor strategies progression

A

ankle strategy
hip strategy
stepping strategy
reaching strategy

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21
Q

ankle strategy:
used when disturbances are _____. ______ common strategy used. small adjustments _______ to ______. muscle activation is from _______ to ________

A

used when disturbances are small. most common strategy used. small adjustments anterior to posterior. muscle activation is from distal to proximal

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22
Q

hip strategy:
used when disturbances are larger and ______, when the support surface is ______ or ______ in size. muscle activation is from _____ to ______.

A

used when disturbances are larger and faster, when the support surface is compliant or reduced in size. muscle activation is from proximal to distal

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23
Q

stepping strategies:
occur when the COM is displaced ______ the limits of the ____.

A

occur when the COM is displaced beyond the limits of the BOS

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24
Q

T or F: if stepping strategy is not an option or failing, a reaching strategy can be used when a nearby object is there

A

T

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25
what make up the effector components, in order to execute a response?
lower extremity ROM, muscle strength, endurance, power, coordination
26
in older adults, ________ and _______ are reduced by aging or disease
redundancy and reserves
27
T or F: aging is a diagnosis
F
28
risk factors for fear or falling
at least one fall female older
29
consequences for fear of falling
decline in physical and mental increased risk of fall progressive loss of health related quality of life
30
components of the balance assessment
1. assessment of **movement strategy** for postural response 2. exam of sensory organization 3. tests to quantify balance
31
what is the type of assessment you should use to look at older patients and their function?
biopsychosocial model
32
4 conditions of the mCTSIB (modified Clinical Test of Sensory Interaction in Balance)
eyes open firm surface eyes closed firm surface eyes open, compliant surface eyes closed, compliant surface
33
tests to quantify balance- which tests functional balance?
static balance dynamic balance psychological aspects dynamic balance!
34
tests of static balance
mCTSIB romberg test semi-tandem sharpened romberg single leg stance ALL timed tetsts
35
Single leg stance high fall risk cut off time
5 seconds
36
types of functional balance tests
active standing reactive balance anticipatory balance dynamic balance
37
functional balance: active standing tests
functional reach berg balance scale step test
38
functional balance: reactive balance test
nudge/push test
39
functional balance: anticipatory balance test
catching test
40
functional balance: dynamic balance test
4 square step test DGI (dynamic gait index) TUG tinetti balance and gait physical performance test
41
geriatic society rec for balance and gait
**TUG**- with cognitive effort **berg balance** **tinetti** performance- oriented mobility assessment
42
self report questionnaires
**MFES**: Modified Falls efficacy scale **ABCs**: activity balance confidence scale fear of falling avoidance behavior questionnaire
43
downfall of BERG balance screen
does not effective capture gait issues, especially important in stroke populations
44
gait performance measures
functional gait assessment dynamic gait index
45
what populations would you use sitting balance scale for?
Spinal cord pts
46
self report questionnaires tests for what?
the psychological aspects of balance
47
review the gait cycle
48
stance portion in what percent of the gait cycle
60%
49
phases of the stance portion of the cycle
initial contact loading response midstance terminal stance preswing
50
foot contacts the ground/heel strike
initial contact
51
weight shift occurs: from initial contact to other foot lights off the ground
loading response
52
both ankles aligned in frontal place; from other foot off ground to midswing
midstance
53
from ankle alignment to just prior of IC of swing leg
terminal stance
54
from initial contact of swing leg to just prior to lift off of stance leg
preswing
55
swing portion of cycle is what percent of the cycle?
40%
56
progression of swing phase
initial swing mid swing terminal swing
57
lift off of stance leg from ground to max knee flexion
initial swing
58
from max knee flexion to vertical tibia position
mid swing
59
from vertical tibia to just prior of initial contact
terminal swing
60
double limb support is ___% of the gait cycle
20
61
double limb support happens when
at beginning and end of stance phased
62
single limb support happens ___% of gait cycle
80
63
this happens when the opposite foot is in swing, and increases with increased speed
single limb support
64
arm swing: the arm _______ the leg in ____ should move _____ to offset spinal rotation; arm swing ______ with increased gait speed and step length
the arm **opposite** the leg in **swing** should move **forward** to offset spinal rotation; arm swing **increases** with increased gait speed and step length
65
assistive device is ______ the affected side
opposite
66
assistive device is _______ the affected side, if the patient has neuro deficits and cannot hold it on opposite side
same side
67
maximal hip flexion needed for any of the stances of gait
25
68
maximal hip extension need for any of the stances of gait
20
69
where does a DF limitation show
midstance
70
how would a patient with limited dorsiflexion compensate in midstance?
increased knee flexion
71
in terminal stance, if iliopsoas is tight, what motion will the pelvis do?
rotation backwards
72
largest amount of knee flexion needed for gait
60
73
largest amount of ankle plantarflexion needed for gait
15
74
largest amount of dorsiflexion needed for gait
10 degrees of dorsi
75
which muscles bring the leg forward
iliopsoas, rectus femoris, adductor magnus muscles in the front!
76
anterior view- what can you see during gait
knee valgus/varus hip drop/hike ankle supination/pronation pelvis movement
77
distance the foot advances in relation to the other
step
78
horizontal distance between heels
step width
79
distance from one foot to the same foot
stride length
80
number of steps taken per minute
cadence
81
the speed that one ambulates
velocity
82
what gait is this? what happens?
circumduction gait trunk and pelvis rotate anteriorly circumducting the leg out to the side of the body
83
what gait is this? what happens?
foot drop toes drag against the ground during swing phase loss of dorsiflexion
84
which gait is common after a stroke or TBI?
foot drop
85
what gait is this?
trendelenburg gait pelvis drops excessively on contralateral leg side with each step
86
compensated trendelenburg
pt leans towards stance side to stop pelvic drop
87
what gait is this? what happens?
hemiplegic gait paralysis or weakness of entire side of body
88
antalgic gait
ambulating against or to avoid pain
89
ataxic gait
range of motion/strength are not compromised, just a lack of coordination
90
what gait is this? what is happening
scissor gait- narrowing or even crossing over of the legs as they walk tightness of hip adductors
91
what ortho issue can cause foot drop
fibular issues- fracture, etc
92
what is scissor gait associated with
cerebral palsy or other neuro
93
what gait is this? what is happening?
parkinsonian gait/ festinating gait shuffling the feet with flexion of the trunk, weight of body on balls of feet
94
hip hiking is
elevation of ipsilateral pelvis during swing
95
what is knee hyperextension in relation of gait
rapidly thrust knee into hyperextension after limb contacts the floor
96
what is steppage gait
excessive hip and knee flexion to clear swing limb
97
what is vaulting gait
rapid ankle PF during stance to clear opposite limb

Lauren (90 decks)

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