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Semester 5 FSNM Exam 3 > Balance > Flashcards

Balance Flashcards

1
Q

COM

A

the point that represents the average position of the body’s total mass; balancing point of the body

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2
Q

COM in quiet standing is where

A

20 mm anterior to L2

10 cm lower than navel

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3
Q

Is COM fixed?

A

NO! it moves depending on your position

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4
Q

Can COM be outside of the body

A

YES

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5
Q

Why do we care about COM

A

Researchers think that with gait in particular the brain is concerned about where the COM is in space relative to the support surface

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6
Q

Vertical projection of the COM is what

A

COG

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7
Q

BOS

A

Area of the body that is in contact with the support surface
Defined as the area within an outline of all ground contact points

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8
Q

LOS

A

The greatest distance in any direction a person can lean away from a midline vertical position without falling, stepping, or reaching for support
The range over which individuals can transfer their COG within the BOS

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9
Q

LOS - implies what

A

movement

Looking at how far they can move or lean within their BOS

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10
Q

balance is often interchanges with

A

equilibrium

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11
Q

Balance is the ability to

A

control the COM relative to the BOS or within the LOS

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12
Q

Balance is a process whereby

A

the body;s equilibrium is controlled for a given purpose

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13
Q

Functionally significant components of balance

A

1 maintenance of posture
2 post adjustments in anticipation of and during a self initiated movement (proactive, feedforward)
3 postural adjustments made in response to an external disturbance (reactive control)

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14
Q

3 components of the postural control system

A

Sensory
Integration
Execution

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15
Q

3 components of the postural control system - Sensory involves what

A

Sensory detection of body movements

Visual, Vestibular, Somatosensory inputs

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16
Q

3 components of the postural control system - Integration includes what

A

Integration of sensorimotor information within the CNS

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17
Q

3 components of the postural control system - Execution includes what

A

Execution of musculoskeletal responses

synergies

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18
Q

Synergies

A

functional coupling of muscles that work as a unit

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19
Q

Sensory input for reactive and anticipatory control includes what

A

Vision
Somatosensory
Vestibular

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20
Q

Sensory input for reactive and anticipatory control - Vision provides info about what

A

position and motion of the head with respect to surrounding objects

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21
Q

Sensory input for reactive and anticipatory control - Vision is a reference for

A

verticality

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22
Q

Sensory input for reactive and anticipatory control - Vision gives what type of information

A

anticipatory feedforward information

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23
Q

Sensory input for reactive and anticipatory control - Somatosensory provides info about what

A

position/motion of body with reference to support surface

Relationship of body segments to one another

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24
Q

Sensory input for reactive and anticipatory control - Vestibular provides info dealing with

A

gravitational, linear, and angular acceleration of the head with respect to inertial space

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25
Q

What is the problem with single leg balance

A

Bad when you stand directly in front of your patient because you are blocking their visual cues

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26
Q

Reactive postural control - happens when

A

when there are perturbations

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27
Q

Reactive postural control - what is happening

A

Feedback systems provide sensory inputs to initiate corrective responses to maintain/recover balance

28
Q

Proactice/Anticipatory Postural Control happens when

A

before voluntary movement (in anticipation of it)

29
Q

Proactice/Anticipatory Postural Control - what is happening

A

Feedforward - counteract internally generated destabilizing forces pretune or ready the system for upcoming movement

30
Q

A lot of problems with standing and walking are due to what

A

loss of APAs

31
Q

Reactive control - ankle strategy - muscle activity is __ to __ ms after perturbation in __

A

80 to 100ms after perturbation in gastroc/tib

32
Q

Reactive control - ankle strategy - muscle activity is ___, ___, ____

A

Gastroc/tib
Hamstrings/quads 20-30 sec later
Paraspinals/abdominals

33
Q

Reactive control with the ankle strategy is ___ to ___

A

distal to proximal

34
Q

When we use the ankle strategy the perturbation is __ and the surface is ___

A

Perturbation is small

Surface is firm

35
Q

Muscle synergy response adapts according to

A

stability needs

36
Q

Ankle strategy - when the force plate translates backwards (inducing a forward sway) what does the person do

A

compensates with a backward sway
extensors are contracting
gastroc, hams, paraspinals

37
Q

Ankle strategy - when the force plate translates forwards (inducing a backward sway) what does the person do

A

compensates with a forward sway
flexors are contracting
tib, quads, abdominals

38
Q

Reactvie control - hip strategy - muscle activity is __ to ___ ms after perturbation to what

A

90-100ms after perturbation in abdominals/paraspinals

39
Q

Reactive control - hip strategy - muscle activity is ___, ___, ___

A

Abdominals/paraspinals

Quads/hamstrings

40
Q

Reactive control - hip strategy - is __ to __

A

proximal to distal

41
Q

Reactive control - hip strategy is for what type of perturbations and what support surface

A

larger/faster perturbation

support surface is compliant or smaller

42
Q

Reactive control - stepping strategies - involves a change in what

A

change in support strategy - movement of the limbs to make a new contact with the support surface

43
Q

Reactive control - stepping strategies - realigns what ___ within ___ by using what

A

COM within BOS by using rapid steps in the direction of the displacing force

44
Q

Reactive control - stepping strategies is typically recruited in response to what type of perturbations

A

fast, large perturbations where the ankle and hip strategies are not adequate

45
Q

Stepping strategies can also be what (in the UE)

A

Reaching strategies

46
Q

Reactive control - stepping strategies are NOT always a last resort - who is common to use it first and why

A

people with balance deficits because it is the bigger thing to go for that they know is the safest

47
Q

Can we train compensatory stepping?

A

YES

Takes a lot of repetition

48
Q

Who would step training be beneficial for

A

step training can be beneficial for older adults but additional multidirectional training may be necessary to facilitate generalization of postural stepping responses for any direction of a slip or trip

49
Q

Do we use ankle.hip strategies as discrete synergies

A

NO! They blend together
Study showed that as velocity of the translation increased there was a blend - the ankles turned on and then the hips were added, but the ankle strategy was still on

50
Q

Anticipatory postural control is what

A

activating postural muscles in advance of a skilled movement

51
Q

Anticipatory postural control is feed___

A

FEEDFORWARD

52
Q

Study with pulling on fixed handle - what did they do

A

They cued the subjects with what percent of their max force that they wanted them to pull the handle with

53
Q

Study with pulling on fixed handle - what did they find

A

As the pulling force requested increased, the postural component increased in amplitude as well

54
Q

Study with pulling on fixed handle - the larger the pulling force, what happened with ankle strategy

A

The larger and earlier the ankle force came on

55
Q

Study with pulling on fixed handle - what happened when they were cued to pull with 95% of max force

A

the gastroc came on in anticipation of (before the voluntary movement) to stabilize the body

56
Q

Study with pulling on fixed handle - What was the order of the muscle activation

A

gastroc and hams before the onset of when the person pulled the handle, and the biceps came on as they pulled the handle

57
Q

Study with pulling on fixed handle - what happened when the person was given a brace

A

the system knew that they were not going to fall forward, so the APA did not even turn on - you only see the activation of the biceps at the time of pull

58
Q

Study with pulling on fixed handle - clinical implications of the study

A

Even if you are just touching your patient, there is a change in the system to reduce sway - so you cannot say that someone has normal balance when you test them if you have even a single finger on them

59
Q

Spinocerebellum is important for what

A

adapting postural responses based on experience

60
Q

With a spinocerebellum deficit - the participants could

A

use immediate sensory input but not experience to adjust automatic postural responses

61
Q

What happened with study that involved healthy and non healthy spinocerebellum participants

A

Healthy - learned and adapted through experience to adjust their responses
Deficit - did not change with exposure - they always had a large activation

62
Q

In the study where the platform was translated backwards in healthy controls and those with ant lobe of cerebellum damage - what were the findings

A

Control - small gastroc activation
Deficit - Large gastroc and tib firing - coactivation - overall response where system isn’t sure how to respond so just gives larger response than necessary

63
Q

Postural responses are

A

task specific

we can adapt them as needed

64
Q

What were the findings of the study that went from stand to sit in healthy controls compared to individuals with PD

A

Control - standing show typical ankle strategy as going to sit - gastroc - ham - PSP and then when they sat only the PSP stayed firing because we do not need LE firing with sitting - task specific
PD - A lot of co contraction with standing and sitting - LE stayed activated with sitting - so they show postural inflexibility - they employ the same strategy with standing and sitting

65
Q

Cbm and BG are important in adaptation of posture! They are not necessary for…

A

triggering or constructing the basic postural pattern - but they play a role in adapting the response to a change in the condition

66
Q

Gait initiation - feedforward anticipatory - in those with PD

A

they showed a longer APA duration overall with a lower peak (dec amplitude of it)

Semester 5 FSNM Exam 3 (1 decks)

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