Balance Flashcards
balance
Dynamic process by which the body’s position is maintained in equilibrium
COM - center of mass
Point that corresponds to the center of the total body mass
Point at which body is in perfect equilibrium
COG - center of gravity
Refers to the vertical projection of the COM to the ground
Typically located slightly anterior to 2nd sacral vertebra
BOS - base of support
The perimeter of contact area between the body and its support surface
Foot placement alters BOS & person’s postural stability
Body systems x3
neurological
musculoskeletal
cardiovascular
neurological
provides sensory processing, sensorimotor integration, and motor strategies
Musculoskeletal
contributes to postural alignment, flexibility/ROM, muscle performance, and sensation
cardiovascular
maintains adequate brain perfusion to prevent LOB due to orthostatic hypotension/altered consciousness
balance x 3
vision
sensation
vestibular
visual system
- info on position of head relative to environment
- orientation of head to **maintain level gaze
- direction & speed of head movements
- can improve stability through gaze fixation
vestibular
- info on position & movement of head w respect to gravity inertial forces
2 types: - vestibulospinal reflex:
- vestibulo-ocular reflex (VOR):
vestibulospinal reflex:
brings about postural changes to compensate for tilts/Movements of the body
vestibulo-ocular reflex
- stabilizes vision during head/body movements
- running, vision isn’t bouncing arounds its more so stable
somatosensory
- info on position/motion of body
- input from:
- mm proprioceptors (mm length/tension)
- joint receptors (joint position, movement, stress)
- skin mechanoreceptors (vibration, light touch, deep pressure, skin)
- anteroposterior plane
- quiet stance
- small perturbations
ankle postural response
- rapid/large perturbations
- COG near limits of stability
- hip flexion/extension
hip postural response
- larger forces
- displacement of COM beyond LOS
- forward/backward step
stepping postural response
- quickly lowering body COM
- flexing of knees, ankles, hips
- can combine w ankle/weight-shift
- surface moving underneath you
suspension postural response
is age a risk factor for falls in elders?
NOO!
static
- balance in place
- Romberg test
- sharpened (tandem) Romberg test
- single-leg stance test
interventions - vary postures
- sharpened (tandem) Romberg
types of postural control x4
steady-state control
reactive control
anticipatory control
adaptive control
sensory input impairments = poor balance
peripheral neuropathies
vision loss/low vision
vestibular damage
- TBI
- aging
- viral infection; ear infection
sensorimotor integration impairments
impaired processing of sensory information
damage to basal, ganglia, cerebellum, or supplementary motor area
- Parkinson’s Disease
- cerebellar CVA
biomechanical/motor output impairments
musculoskeletal/neuromuscular deficits
- posture
- ROM
- strength
- pain
- motor control
- tone
risk factors w aging x11
- hx of falls
- multiple medications
- gait, balance, & mobility defecates
- visual deficits
- other neuro impairments
- mm weakness
- HR/rhythm abnormalities
- postural hypotension
- foot/footwear problems
- environmental hazards
- Dx of depression
which (external/internal) is more effective for motor learning
external
The sway boundaries in which an individual can maintain equilibrium without changing BOS
Limits of Stability
“how far can we shift before changing BOS”
deficits for medications x5
Hypnotics
Sedatives
Tricyclic antidepressants
Tranquilizers
Antihypertensive drugs
- Hypotension
static balances test
romberg test
sharpened tandem romberg
single leg stance test
dynamic balance tests
five times sit to stand
anticipatory balance tests
functional reach test
multidirectional reach test
reactive balance test
pull test
push & release test
sensory organization tests
modified CTSIB
balance error scoring system (BESS)
functional activities tests
Berg Balance Scale (BBS)
Timed Up and Go Test (TUG)
Tinetti Performance-Oriented Mobility Assessment (POMA)
Balance Evaluation Systems Test (BESTest) or mini-BESTest
Four Square Step Test (FSST)
Functional Gait Assessment (FGA)
Safety During Gait, Locomotion, or Balance tests
Fear of Falling
- Falls Efficacy Scale (FES)
- Activities-Specific Balance Confidence Scale (ABC)
Home assessments
