Balance Flashcards
Cerebellar patients have a harder time with fast or slow movements?
fast
Is there evidence that PT intervention works for cerebellar patients
no evidence
do cerebellar patients often have weakness?
often no weakness
What is movement decomposition
compensation for lack of fractionated movement
they move one joint at a time
Why are ankle weights not effective for ataxia
It doesn’t stabilize the trunk and it doesn’t stabilize the leg in swing phase
Why might adding weight to cerebellar patients help them move slower?
Added weight forces them to move slower
or
Added weight increases proximal stability
What is the #1 priority to address with balance patients
risk of falling
How do we treat balance at the impairment level?
Reduce or prevent impairments that are important to balance for that individual
How do we treat balance at the strategy level
develop effective task specific strategy for balance
how to we treat balance at the functional level
retrain functional tasks with varying postural control and demands under changing environmental context
if we put foam under a patients feet what system are we taking away
what system are we emphasizing
taking away - proprioception
emphasizing - vestib and vision
With increased severity of dementia, research shows theres reduced dependence on ___ input
visual
Does resistance training help the following groups w/ balance?
Older adults:
MS:
CVA:
Older adults: Doesn’t always translate to better balance
MS: no effect
CVA: Small positive effect on balance
retraining alignment: How can we enhance visual feedback for a patient
mirror or stripe to cue patient as to what is vertical or use flashlight on waist to aim at target on wall
how can we use the somatosensory system to retrain alignment?
Have patient lean back onto yardstick that is vertically taped to wall
T or F: CVA and MS patients have slower postural response reactions to help them recover from a fall
T
How do we decrease coactivation and improve movement and balance in patients w/ parkinsons disease
Slip trainer
What is impaired central set
inability to change movement strategies quickly to adapt to change in demands
What kind of balance training is this:
External perturbations varying directions
slip training
reactive balance training
Anticipatory postural response is heavily dependent on ______________–
previous experience and learning
note from this slide: CVA: Delay in activation of paretic hamstring mm in preparation for arm raise task
How can we help a patient develop ankle strategy
self initiated sway in parallel bars, near walls
how can we help a patient develop hip strategy
restrict ankle motion
stand on narrow beam
feet tandem
walk on heels/toes
How can we help a patient develop step strategy
manual facilitation
step initiation during gait
perturbations
pts with a CVA have an increased reliance on what balance system
Vision
CVA: Decreased stance time, increased sway
TBI, CVA: sensory selection problem
How can we decrease a patient’s reliance on the visual system
blinders, frenzel goggles, inaccurate visual cues
how do we emphasize training a patients vestibular system
reduce proprioception: Foam surface
and Visual inputs: eyes closed
Balance treatment progression
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