Balance

Question 1

Cerebellar patients have a harder time with fast or slow movements?

Answer 1

fast

Question 2

Is there evidence that PT intervention works for cerebellar patients

Answer 2

no evidence

Question 3

do cerebellar patients often have weakness?

Answer 3

often no weakness

Question 4

What is movement decomposition

Answer 4

compensation for lack of fractionated movement

they move one joint at a time

Question 5

Why are ankle weights not effective for ataxia

Answer 5

It doesn’t stabilize the trunk and it doesn’t stabilize the leg in swing phase

Question 6

Why might adding weight to cerebellar patients help them move slower?

Answer 6

Added weight forces them to move slower

or

Added weight increases proximal stability

Question 7

What is the #1 priority to address with balance patients

Answer 7

risk of falling

Question 8

How do we treat balance at the impairment level?

Answer 8

Reduce or prevent impairments that are important to balance for that individual

Question 9

How do we treat balance at the strategy level

Answer 9

develop effective task specific strategy for balance

Question 10

how to we treat balance at the functional level

Answer 10

retrain functional tasks with varying postural control and demands under changing environmental context

Question 11

if we put foam under a patients feet what system are we taking away

what system are we emphasizing

Answer 11

taking away - proprioception

emphasizing - vestib and vision

Question 12

With increased severity of dementia, research shows theres reduced dependence on ___ input

Answer 12

visual

Question 13

Does resistance training help the following groups w/ balance?

Older adults:

MS:

CVA:

Answer 13

Older adults: Doesn’t always translate to better balance

MS: no effect

CVA: Small positive effect on balance

Question 14

retraining alignment: How can we enhance visual feedback for a patient

Answer 14

mirror or stripe to cue patient as to what is vertical or use flashlight on waist to aim at target on wall

Question 15

how can we use the somatosensory system to retrain alignment?

Answer 15

Have patient lean back onto yardstick that is vertically taped to wall

Question 16

T or F: CVA and MS patients have slower postural response reactions to help them recover from a fall

Answer 16

T

Question 17

How do we decrease coactivation and improve movement and balance in patients w/ parkinsons disease

Answer 17

Slip trainer

Question 18

What is impaired central set

Answer 18

inability to change movement strategies quickly to adapt to change in demands

Question 19

What kind of balance training is this:

External perturbations varying directions

slip training

Answer 19

reactive balance training

Question 20

Anticipatory postural response is heavily dependent on ______________–

Answer 20

previous experience and learning

note from this slide: CVA: Delay in activation of paretic hamstring mm in preparation for arm raise task

Question 21

How can we help a patient develop ankle strategy

Answer 21

self initiated sway in parallel bars, near walls

Question 22

how can we help a patient develop hip strategy

Answer 22

restrict ankle motion
stand on narrow beam
feet tandem
walk on heels/toes

Question 23

How can we help a patient develop step strategy

Answer 23

manual facilitation
step initiation during gait
perturbations

Question 24

pts with a CVA have an increased reliance on what balance system

Answer 24

Vision

CVA: Decreased stance time, increased sway

TBI, CVA: sensory selection problem

Question 25

How can we decrease a patient’s reliance on the visual system

Answer 25

blinders, frenzel goggles, inaccurate visual cues

Question 26

how do we emphasize training a patients vestibular system

Answer 26

reduce proprioception: Foam surface

and Visual inputs: eyes closed

Question 27

Balance treatment progression

Answer 27

Eye-Head coordination exercises
Orientation to midline/verticality
Sensory systems training
Sitting balance training
Sit to stand/transfer training
Standing balance training
Strategy training
Gait training
Patient education/Home program