Aging and Postural Control

Question 1

What two factors contribute to aging?

Answer 1

genetic 20%
environmental 80%

Question 2

what are the primary factors for age-related decline?

Answer 2

consequence of lifestyle - physical activity

Question 3

what are other secondary factors that contribute to age-related decline

Answer 3

inadequate nutrient intake
excess body weight
smoking
excessive alcohol intake

Question 4

Is there a clear definition of old age? Is there a clear line between healthy/non-healthy aging?

Answer 4

nope

Question 5

what is the continuum of physical function among older adults from least to most active?
(Definitely don’t fuck in flippers, ew)

Answer 5

disability
physically dependent
physically frail
physical independent
physically fit
physically elite

Question 6

at what point on the continuum of physical function among older adults are your patients likely to be in?

Answer 6

physically dependent
physically frail

Question 7

we use the ___________ tract to execute movement

Answer 7

corticospinal

Question 8

where does our free will to decide movements come from?

Answer 8

we don’t know for sure but we think its the limbic system (emotion/memory)

Question 9

what are the four main categories of motor system changes in postural control

Answer 9

MSK
change in steady-state balance
changes in reflexive postural control
changes in anticipatory postural control

Question 10

what are the 2 main categories of sensory/perceptual changes in postural control with aging

Answer 10

changes in individual sensory systems
adapting senses for postural control

Question 11

What are some changes with MSK?

Answer 11

• loss of muscle strength (and power)
• loss of ROM
• muscle power is more highly correlated with physical function than strength

Question 12

what are some changes to steady state balance?

Answer 12

• increase sway in quiet stance
• increase in functional stability limits

Question 13

changes in reactive balance control with aging

Answer 13

• use hip strategies rather than ankle
• longer latency to fire muscle

Question 14

changes in adaptation

Answer 14

• increase muscle response amplitudes during large perturbation in old/unstable adults
• more oscillations
• increase time to stabilization

Question 15

why is it bad there is an increased muscle response amplitude during large perturbations in older and unstable older adults compared to young adults

Answer 15

because muscle strength and power decrease with age so then they fall

Question 16

what are the 4 compensatory stepping change in base of support strategies

Answer 16

• ankle strategy
• Hip strategy
• Stepping
• Reaching

Question 17

what is the only stepping strategy that does not increase fall risk

Answer 17

side-step sequence

Question 18

In anticipatory postural control, the ________ activates before the ___________

Answer 18

postural response muscle
prime mover

Question 19

medium old and very old adults show ________ in both postural and prime mover muscle response onsets

Answer 19

significant slowing

Question 20

what are some age related changes in somatosensory components

Answer 20

loss of vibration sense
loss of proprioception
decreased sensation

Question 21

what are some age related changes in vision

Answer 21

loss of acuity
loss of depth perception
loss of contrast sensitivity

Question 22

what are some age related changes in the vestibular system

Answer 22

20-40% loss of hair cells after 70
loss of neurons in vestibular nuclei

Question 23

somatosensory: delay activation of muscle and increase muscle onset latency in people with__________

Answer 23

neuropathy

Question 24

do older adults have more postural sway with eyes open or closed

Answer 24

closed

Question 25

when is the vestibular system most important for balance control?

Answer 25

when the visual and somatosensory systems give conflicting information

Question 26

why is attention limited?

Answer 26

think bottle neck theory

Question 27

what are the two main theories of duel-task interference

Answer 27

• perceptual processing (physiological) limitation i.e. bottleneck
• central processing (neural/machinery) limitations

Question 28

______ response to a secondary cognitive task is fast than _______

Answer 28

young adults
old adults

Question 29

if sensory information is decreased, reaction times become significantly longer for?

Answer 29

both young and older adults but more so older adults

Question 30

sway was _______ in the older faller compared to the nonfaller

Answer 30

larger

Question 31

older faller ___________ postural sway compared to older nonfaller during dual-task performance

Answer 31

significantly increased

Question 32

___________ took a longer time to regain stable posture in the duel-task condition than in the single postural task alone

Answer 32

balance impaired older adults

Question 33

def of fall

Answer 33

• an unintentional loss of balance that leads to failure of postural stability
  or
• sudden and unexpected change in position which usually results in landing on the floor

Question 34

def of recurrent faller

Answer 34

those who have fallen two or more times in either 6 or 12 months

Question 35

should a fall without injury still be considered a fall?

Answer 35

duh, yes

Question 36

T or F: all studies looking at fall incident data have an operational definition of falling

Answer 36

apparently not. stupid. false

Question 37

what are the top three causes of falls in elderly adults

Answer 37

1 - accident/environment related
2 - gait/balance disorders or weakness
3 - dizziness/vertigo

Question 38

what are the top 3 individual risk factors for falls

Answer 38

1 - weakness
2 - balance deficit
3 - gait deficit

Question 39

T or F: PTs alone should be responsible for falls prevention

Answer 39

false, fall prevention is a multidiscipline teamwork issue