4.PTA 220-Core Stability, Balance, and Gait Flashcards
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.
Deep core muscles
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.
Superficial core muscles
Proximal stability to allow distal mobility.
-Many malfunctions in the extremities can be relieved by strengthening the core
Core Importance
How do we stay aligned?
Maintain equality of strength and flexibility around the proximal and distal joints.
Start at baseline
*Only progress if able to complete desired exercise while maintaining proper alignment and stability!
Don’t forget about patient education!!!
Core Ther Ex Progression
How do you assess postural alignment in standing?
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
Concepts That Affect Balance
Center of Mass (COM)
Center of Gravity (COG)
Base of Support (BOS)
Limits of Stability (LOS)
What are motor strategies for balance control?
Ankle Strategy, Hip Strategy,Stepping Strategy
ability to hold oneself in a posture without movement. Sitting or standing.
static balance
ability to hold oneself in a posture of balance while manipulating an extremity or body
dynamic balance
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.
Romberg
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.
Functional Reach
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.
Berg Scale
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.
Tinetti
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.
Timed Up and Go