4.PTA 220-Core Stability, Balance, and Gait

Question 1

Transverse Abdominus, Multifidus (transversospinalis group), Quadratus Lumborum

Central- located along the spine
Innermost- deepest layer of tissues
Essential- stabilizes individual spinal segments when external forces try to move them.

Answer 1

Deep core muscles

Question 2

Rectus Abdominus, Internal/External Obliques, Erector Spinae, Iliopsoas

Central- located along the spine/pelvis
Innermost- not so much. More superficial.
Essential- definitely. Provide global support with movement of trunk/spine.

Answer 2

Superficial core muscles

Question 3

Proximal stability to allow distal mobility.

-Many malfunctions in the extremities can be relieved by strengthening the core

Answer 3

Core Importance

Question 4

How do we stay aligned?

Answer 4

Maintain equality of strength and flexibility around the proximal and distal joints.

Question 5

Start at baseline
*Only progress if able to complete desired exercise while maintaining proper alignment and stability!
Don’t forget about patient education!!!

Answer 5

Core Ther Ex Progression

Question 6

How do you assess postural alignment in standing?

Answer 6

Anteroposterior Plumb Line Assessment
Passes Through:
Ankle: anterior to the lateral malleolus of the fibula
Knee: posterior to the patella
Hip: greater trochanter of the femur
Trunk: (shoudler)?- center of tip
Head: ear lobe

Question 7

Concepts That Affect Balance

Answer 7

Center of Mass (COM)

Center of Gravity (COG)

Base of Support (BOS)

Limits of Stability (LOS)

Question 8

What are motor strategies for balance control?

Answer 8

Ankle Strategy, Hip Strategy,Stepping Strategy

Question 9

ability to hold oneself in a posture without movement. Sitting or standing.

Answer 9

static balance

Question 10

ability to hold oneself in a posture of balance while manipulating an extremity or body

Answer 10

dynamic balance

Question 11

used to determine proprioceptive contributions to upright balance. The patient is instructed to stand with feet together, eyes open (EO) unaided for 20 to 30 seconds. If the patient falls with EO, the test is over. Then the patient is asked to stand with eyes closed (EC). In a negative test there is only minimal sway.

Answer 11

Romberg

Question 12

Developed to provide a quick screen of balance problems in older adults. It is the maximal distance on can reach forward beyond arm’s length while maintaining a fixed BOS in the standing position.

Answer 12

Functional Reach

Question 13

an objective measure of static and dynamic balance abilities. The scale consists of 14 functional tasks commonly performed in everyday life. Examples: sit-to-stand, stand-to-sit.

Answer 13

Berg Scale

Question 14

AKA performance-oriented mobility assessment (POMA). Provides a brief, and reliable measure of static and dynamic balance. Items are organized into 2 subtests of balance and gait.

Answer 14

Tinetti

Question 15

a quick measure of dynamic balance and mobility. The pt is seated comfortably in a firm chair with arms and back resting against the chair. The pt is then instructed to rise, stand momentarily, and then walk 3 m (10 ft) towards a wall at normal walking speed, turn without touching the wall, return to the chair, turn, and sit down.

Answer 15

Timed Up and Go

Question 16

Can be used to determine attentional demands. The therapist walks alongside the pt while walking and begins a conversation. Questions posed should require more than a yes or no answer. The test is positive if the patient has increased difficulty walking while talking. (slows down, staggers, or loses balance. Or if pt has to stop walking in order to talk).

Answer 16

Walkie-Talkie

Question 17

commonly used when disturbances are small and well within LOS. Involves shifting the COM forward and back by moving the body as a relatively fixed pendulum about the ankle joints. Muscles are activated in distance-to-proximal sequence.

Answer 17

Ankle Strategy

Question 18

involves shifts in the COM by flexing or extending at the hips. Typically recruited with larger and faster disturbances of the COM or when standing on a BOS that is narrower than the length of the feet.

Answer 18

Hip Strategy

Question 19

realigns the BOS under the COM by using rapid steps or hops in the direction of the displacing force. For example; forward or backward steps. In instances of lateral destabilization, the individual takes a side step or cross step to bring the BOS back under the COM.

Answer 19

Stepping Strategy

Question 20

The midpoint of the body; in the erect standing posture, the COM is located at the level of the second sacral segment.

Answer 20

COM- Center of Mass

Question 21

the point where the entire mass of the body is concentrated .It is 1cm posterior to the sacral promontory.

Answer 21

COG- Center of Gravity

Question 22

the area underneath and between both feet

Answer 22

BOS- Base of Support

Question 23

the maximum distance an individual is able or willing to lean in any direction without loss of balance or changing the BOS; the midpoint of limits of stability is centered alignment.

Answer 23

LOS- Limits of Stability

Question 24

O- inguinal ligament, iliac crest, thoracolumbar fascia, and last 6 ribs.
I- Abdominal aponeurosis and linea alba
A- Compression of abdomen
N- Seventh through 12th intercostal, iliohypogastric,and ilioinguinal nerves

deep core muscle

Answer 24

Transverse Abdominis OIAN

Question 25

``` O- transverse processes I- spinous processes of vertebrae above A- Bilaterally: extend Unilaterally: rotate to opposite side N-spinal nerves ``` *deep core muscle*

Answer 25

Transversospinalis Muscles OIAN

Question 26

O- iliac crest I- twelfth rib, transverse processes of all five lumbar vertebrae A- trunk lateral bending N- twelfth thoracic and first lumbar nerves *deep core muscle*

Answer 26

Quadratus Lumborum OIAN