4.19 Balance Flashcards
Morbid statistic about over 70 y/o and falling with a hip fx
70% chance of dying within the year
What is balance?
maintaining COM over BOS
COM locations: men/women
men: umbilicus
women: 2-3 in. lower (ASIS level)
What does COM change with?
- height
- girth
- posture
- morphology
- weight distribution
- carrying a child or backpack
posture issues that change COM
- FHP
- kyphosis
morphology that may impact COM
- endomorph
- mesomorph
- ectomorph
weight distribution and COM
- Sir Mix-a-lot
- Dolly parton
- Dunlap
- amputees
base of support: things to consider
- foot position
- look at shoes, wear patterns
What is the cone of stability?
can go forward, back, side⬌side without falling over in standing
What is the cone of stability for most people?
12 in. A⬌P
16-18 in. laterally
*bigger in sitting than standing
Why assess cone of stability?
can help determine how well they can sit and support themselves
3 strategies for catching ourselves to regain balance
- ankle strategy
- hip strategy
- step strategy
ankle strategy
DF/PF
hip strategy
sticking out the butt
step strategy
take a step forward
Why are the catching strategies so important for stroke pts?
stroke pt may not be able to take a step, may not be able to dorsiflex
basic idea of balance training
almost getting them to fall but they don’t
- can do a lot with BOS
- trying to get them strong in single leg stance, narrow stance, eyes closed, etc
*getting rid of the fear of those feelings of “falling”
What 3 systems feed into the CNS for balance?
- vestibular
- visual
- somatosensory
How to work on vestibular with pts?
can push someone and get their brain to better understand or habituate
How does a pt habituate to PT that targets vestibular?
- keep putting them into the position until their body gets used to the signal (turns down the input in the processing area)
- tune it down like Bringman tunes out his wife and kids
addressing visual issues
- glasses
- light
somatosensory issues: what is the problem?
- not getting as much input
- pts either do too much or too little
What is done for somatosensory issues (PT)?
Do the activity over and over again to get the signals stronger and better
Why is HEP for balance difficult? What sorts of things might you incorporate?
you can’t be there with them
- close their eyes brushing their teeth
- simple things they can be safe with
