Balance Flashcards
Postural control
Controlling body position for stability and orientation
Postural orientation
Maintain relationship between segment and body and
Environment
Posture stability (balance)
Control COM in relationship to BOS with balanced forces
Center of mass
Center of the body mass, average of body segments
Center of mass on Adults
S2
Center of gravity
Vertical projection of COM, changes with environment
Center of pressure
Center distribution of total force, sum of all forces on the floor
Base of support
Body part in contact with support surface, usually feet
Vertical line of body alignment: Standing
Mastoid process, anterior to shoulders, hip joints, anterior to knee joints, anterior to ankle joints
Muscle tone
Force to which a muscle resists being lengthened
Postural tone
Increase in activity of postural muscles, requires sensory input from multiple systems
-gastroc, tib ant, glut med, tfl, ilipsoas, errectors
Balance Considerations
Vision, vestibular, and proprioception
3 Types of Postural Control
Automatic (Steady state), reactive, proactive/anticipatory
Ankle strategy
Small perturbation, reactive balance training
-rotation around ankle joint
Post Displacement:
-dorsiflexors, quads, abs
Ant Displacement:
-plantarflexors, gastroc, hamstring, errectors
Hip Strategy
Larger, faster perturbation, ankle motion limited
Post Displacement:
-quads, abs
Ant Displacement:
-hamstring, errectors
Stepping Strategy
Largest, fastest
Reach strategy
Arms engage, similar to stepping strategy
Normal Postural Sway
Ant/Pst: 12deg
Lateral: 16deg
MSK Components of Balance
-joint ROM, spine flexibility, muscle tone, segmental mmt
Neuro Components of Balance
-sensory processes
-hihger level integration
-Neuromuscular
Vertical line of body alignment: Sitting
-head balanced on level shoulders
-upper body erect
-shoulders over hips
-deett and knees apart
Semicircular Canals
-angular acceleration
-sensitive to fast movements
-slips, falls, trips, gait
Otolith Organs
-linear position and acceleration
-head in space
-respond to slow head movements
Causes of Balance Impairments
-injury to inner ear, SC, peripheral receptors, cerebellum, basal ganglia, proprioceptors, MSK
-lesions to neuro
Spatiotemporal Compensations
Change BOS:
-widen, shuffling feet, shifting onto stronger leg
Restriction of mmt:
-stiffening, moving slowly
-Standing Reaching forward: flx hips instead of DF ankles
-Standing Reaching sideways:
flex trunk instead of lat moving hips
-Sitting Reaching Sideways: flexing forward and not to side
-In standing: not ttaking step when needed
Using hands for support
-holding onto things
Balance Guidelines
-cannot be trained in isolation
-stand/sitt, static/dynamic
-double/single limb
-postural adjustments are action specific
-should progress
-include external cues that require stepping
Safety:
-gait belt
-stand behind and to the side
-near railing, no sharp edges
-check equipment
-clean floor
Balance Training: Mode
-weight shift w/ increasing sway
-speed
-surface challenges
-weight distribution on chairs (balls and leaning)
Balance Training: Postural Training
-awareness of posture
-modified position
-increase varietty of BOS and arm positions
-unstable sessions
-visual cues and mirros
-static and dynamic posture
-Change environment
Balance Training: Movements
-movment patterns (PNF)
-trunk rotations
-head movements
-stepping
Balance Training: Progression
-BOS: wide to narrow
-Posture: stable to unstable
-Visual: closing
-COG: distrupitions
-Unable surfaces
-environments
-REPETITION
Balance PNF Techniques
Stability:
-rhythmic stabilization
-alternating isometrics
Enhance Dynamic Balance:
-Isotonic contractions
-Slow and quick reversals
