Balance

Question 1

Postural control

Answer 1

control the bodys position in space for stability and orientation between body segments and the environment, appropriate for a task

Question 2

Postural stability

Answer 2

maintenance of COM within BOS

Question 3

Postural orientation

Answer 3

Ability to maintain relationship between body segments and between body and environment for a task

Question 4

Aging and postural control

Answer 4

MSK: Decreased ROM in LE, loss of spinal flexion flexibility leads to flexed posture
NM: Decreases in vision, somatosensory, vestibular functions, multisensory deficits

Question 5

Peripheral vestibular structures

Answer 5

Vistibular end organ
CN VIII
Basilar artery
Anterior inferior cerebellar artery

Question 6

Otoliths

Answer 6

Utricle- horizontal
Saccule- vertical
detects linear motion, tonic discharge, push/pull relationship

Question 7

Semicircular canals

Answer 7

Anterior, posterior, and lateral
perpendicular relationship
angular motion detection
tonic discharge
push/pull relationship

Question 8

Vertebrobasilar system (blood supply)

Answer 8

PICA supplies the inferior vestibular nuclei and inferior portion of the cerebellum
Basilar artery supplies pons and superior vestibular nuclei

Question 9

Vestibular Ocular Reflex

Answer 9

stabilize gaze during movemebt
VOR gain normal is 1:1 head:eye movement
VOR is intact and mature by 1 year of age

Question 10

Vestibulo-Spinal Reflexes

Answer 10

Coordinated head and body movements to maintain head in upright position
Lateral VSR: adjusts limb movement for balance
Medial VSR: cervical connections, branches to extraocular muscles

Question 11

Central processing

Answer 11

Adaptive strategies change with demands of task and environment
Anticipatory strategies pretune sensory and motor systems based on prior learning

Question 12

Postural control strategies

Answer 12

Ankle: driven by somatosensory system
Hip: driven by vestibular system
Stepping: driven by vestibular system

Question 13

Purpose for testing balance

Answer 13

Screen for fall risk
Basic screen of large populations
Compare to normative data for large populations
provide an individualized training program for improvement and fall risk reduction

Question 14

Activities of balance confidence- ABC scale

Answer 14

out of 16
100% confident in all
50-80% somewhat impaired
<50% likely homebound

Question 15

Falls efficacy scale FES

Answer 15

Score 10-100
>70 fear of falling
>80 increased risk of falling

Question 16

Timed up and go TUG

Answer 16

< 20s independently mobile
>30s needs assistance for mobility
>12s fall risk

Question 17

BERG Balance scale

Answer 17

0-56
age 60-69: 55
age 70-70: 53-54
age 80-90: 50-53

Question 18

POMA

Answer 18

Balance and gait, out of 28
<19 high fall risk
19-24 medium fall risk
25-28 low fall risk

Question 19

Intervention Vertically (pusher syndrome)

Answer 19

Orient to perturbed position, use intact senses to re-calibrate missing or dysfunctional senses

Question 20

steady state and stability interventions

Answer 20

vertical position feedback, reaching activities, head righting skills

Question 21

Anticipatory balance control intervention

Answer 21

repeated sit to stand
walking on toes
lateral weight shifts

Question 22

Reactive postural control

Answer 22

reflexes
ankle/hip strategies
stepping strategies

Question 23

Cephalocaudal progression of control

Answer 23

birth: lacking head control
3 months: emerging anticipatory and reactive postural response in neck muscles
6-8 months: steady state control for independent sitting
10 months: postural response in standing
15 months: postural response in walking
3 years: visual –> somatosensory control of balance
10-12 years: mature postural control

Question 24

Postural control in children with CP

Answer 24

increased excursion and velocity of postural sway
difference in balance strategies

Question 25

Kids best test

Answer 25

Ages 7-18
27 tasks
all domains

Question 26

Pediatric balance scale

Answer 26

Ages 2.5-13.5
14 items
all domains except reactive

Question 27

Early clinical assessment of balance

Answer 27

Children with CP ages 1.5-12
13 items
all domains except sensory/orientation

Question 28

Segmental assessment of trunk control

Answer 28

children and adults with CP 3+ months
static, active, and reactive control across 7 segemtenal areas
only steady state and postural domains