Balance Flashcards
What are the sensory components to balance?
somatosensory, visual & vestibular
What are the motor components of balance?
muscle synergies
What are other components of balance?
cognition, attention, environment, confidence & fear
Postural control
AKA Balance
ability to achieve, maintain, & restore stability for different postures and movements
What is postural control dependent on?
task, individual, & environment
If the patient is at risk for a fall, what equipment should we utilize?
gait belt
When assessing and evaluating balance, what does our position need to be in relation to the patient?
posterior and to the side w/one hand at pelvis or belt
Where should we perform balance training?
near a support surface
If you feel uncomfortable performing a balance exercise with a patient, what should you do?
- ask another person to assist
- change the exercise
When choosing a balance test, what should you consider?
- patient
- available resources
- available evidence
What are common balance assessments?
- SLS
- modified clinical test of sensory interest on balance (mCTSIB)
- mini-BESTest
- ABC
What is considered a “good” range for a SLS test?
10 to 45 seconds
As an individual gets older, what is expected in their stance time?
decrease in stance time
Describe the four conditions of the mCTSIB.
condition 1: eyes open, stable surface
condition 2: eyes closed, stable surface
condition 3: eyes open, unstable surface
condition 4: eyes closed, unstable surface
What are the cons of using the SLS test?
- the test is measured in time, however we are probably more concerned with the quality of the movement
- affected by injury
What system is being tested during condition 1?
all systems (somatosensory, visual, vestibular)
What system is being tested during condition 2?
visual
What system is being tested during condition 3?
somatosensory
What system is being tested during condition 4?
vestibular
What is the mCTSIB designed for?
to differentiate between impairments of visual, vestibular, and/or somatosensory systems
On the mCTSIB, what score indicates impairment?
less than 30 seconds
What are the four balance domains of the mini-BESTest?
- anticipatory
- reactive
- sensory orientation
- dynamic gait
What are the tasks included in the anticipatory domain?
- sit to stand
- rise to toes
- SLS
What is the task in the reactive domain?
compensatory step strategy
- forward
- backward
- lateral
What are the tasks included in the sensory orientation domain?
- feet together, eyes open, solid surface
- feet together, eyes closed, unstable surface
- incline, eyes closed
What are tasks included in the dynamic gait domain?
- change in gait speed
- walk w/head turns
- walk w/pivot turns
- step over obstacles
- TUG with & w/o dual task
ABC
questionnaire regarding an individuals confidence w/balance in different activities
Never forget to measure the _______________ aspects of balance or injury.
psychosocial
What is the frequency of balance training?
2 to 5x a week
What should the intensity be for balance training?
difficult to measure
What is the type of balance training?
balance + resistance + functional activities
How much time should be set aside for balance training in a session?
15 to 30 mins
What is the progression recommendation for balance training?
increase difficulty to target individual needs & goals
What are the volume recommendations for balance training?
2 hours each week
What interventions can be used to challenge static balance?
- change posture
- change support surface
- add another task (cognitive or motor)
What interventions can be used to challenge dynamic balance?
- change to unstable support surface
- movement of the head, arms, trunk, or legs
- walking (backwards, to the side, w/eyes closed)
What interventions can be used to challenge anticipatory balance?
- reaching, catching, kicking
- lifting, navigation over/through obstacles
What interventions can be used to challenge reactive balance?
perturbations
What interventions can be used to challenge sensory organization balance?
reduce vision or somatosensory cues
What interventions can be used to challenge balance during ADL’s?
ADL’s
While there are many variables to consider when progressing a patient, what should be the main thing to consider?
end goal or functional activity/participation goal that the patient has
