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Tests & Measures Exam #2 > Balance > Flashcards

Balance Flashcards

1
Q

Postural Control

A

Controlling the body position in space for stability and orientation

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2
Q

Balance

A

Ability to hold COM in relation to BOS

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3
Q

Center of Gravity

A

Vertical projection of COM

-Neuro POV = slightly anterior to L2 in standing

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4
Q

Base of Support

A

Area of body in contact with a support force

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5
Q

Postural Orientation

A

Ability to maintain an appropriate relation b/w body segment and b/w the body and the environment

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6
Q

Limits of Stability

A

Internal representation of how far the body can move over its BOS before changing the support or losing balance

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7
Q

Anticipatory Postural Responses

A

Active movement of the body’s COM in anticipation of a postural transition from one body position to another

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8
Q

Reactionary Postural Responses

A

Active response to an external perturbation

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9
Q

Sensory Interaction/Orientation

A

Ability to maintain balance during altering sensory conditions

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10
Q

Balance Examination Contents

A

1) Taking a History
2) Systems Review
3) Tests & Measures (ICF model)

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11
Q

Taking a History

A 
Chief complaint
Medical history
Recent history of falls
Medication
Confidence level
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12
Q

Systems Review

A

Cardiovascular
Integumentary
Neuromuscular
Musculoskeletal

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13
Q

ICF Model

A

Health Condition
Body Functions/Activities/Participation
Environmental/Personal Factors

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14
Q

Body Functions and Structure

A 
ROM
Muscle Strength
Muscle Tone
Coordination
Cognition
Posture
Pain
Perception
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15
Q

Sensory Systems used to hold balance

A

1) Somatosensory: Light touch, Proprioception/Vibration, Pain
2) Vision
3) Vestibular

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16
Q

Ankle Strategy

A
  • control of postural sway from ankles and feet
  • head and hips travel in same direction @ same time with the body moving as a unit over the feet
  • Use when…
    1) Firm surface
    2) Feet well supported
    3) Slow moving w/ min displacement
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17
Q

Hip Strategy

A
  • Control of postural sway from pelvis and trunk
  • Head and hips travel in opposite directions
  • Use when…
    1) Feet not completed supported
    2) Quick and large displacements
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18
Q

Stepping Strategy

A

-Steps with the feet to establish a new BOS when COG has exceeded the original BOS

  • Use when…
    1) The other strategies aren’t enough to maintain equilibrium
19
Q

Clinical Test for Sensory Interaction in Balance (CTSIB) AKA “Foam & Dome”

A
  • does not require computerized force plate
  • selects and combines sensory information in different environments
  • Does NOT measure the INTEGRITY of the 3 sensory systems
20
Q

Sensory Weighting: Firm Surface

A

70% Somatosensory
20% Vestibular
10% Vision

21
Q

Sensory Weighting: Unstable Surface

A

10% Somatosensory
60% Vestibular
30% Vision

22
Q

“Foam & Dome” Conditions

A

1) Firm, EO
2) Firm, EC
3) Firm, dome
4) Foam, EO
5) Foam, EC
6) Foam, dome

usually do not test 3) or 6)

23
Q

Condition 1 & 4 passed…Condition 2 & 5 failed

What are they relying on?
What sensory system(s) would need to be examined further?

A

Relying on…Vision

Need to examine…Somatosensory & Vestibular

24
Q

All conditions passed except Condition 5 failed

What are they relying on?
What sensory system(s) would need to be examined further?

A

Relying on…Somatosensory & Vision

Need to examine…Vestibular

25
Q

Condition 1) Firm, EO

A

Somatosensory is dominant

26
Q

Condition 2) Firm, EC

A

Somatosensory is dominant

27
Q

Condition 4) Foam, EO

A

Vision is dominant

28
Q

Condition 5) Foam, EC

A

Vestibular is dominant

29
Q

Balance Error Scoring System (BESS)

A
  • assesses static postural stability
  • designed for the mild concussions…to assist in return to sports play decisions

-population tested: concussion, mild TBI, ankle instability, vestibular disorders

30
Q

BESS testing conditions

A

6 conditions: barefoot, EC for 20 seconds each:

  • DLS(feet together) (firm/foam)
  • SLS (non-dominant foot) (firm/foam)
  • Tandem (non-dominant foot in back) (firm/foam)
31
Q

BESS errors

A
  • Hands off the hips
  • Opening eyes
  • Step, stumble or fall
  • ABD/flex of hip > 30°
  • Lifting forefoot/heel off surface
  • Out of test position >5 sec

Score 0-60…low score=better balance

7-9 points for detectable change

32
Q

SLS (Anticipatory)

A
  • Knee flex 90°
  • Arms crossed

-Document: # attempts, time, visual observations

33
Q

Romberg/Tandem Romberg (Anticipatory

A
  • feet together (Romberg) & EO
  • Repeat test with EC
  • One foot in front of other (Tandem Romberg)
  • Normal = hold 30 seconds
  • Document: # attempts, time, visual observations
34
Q

Activity Balance Tests

A
  • Berg
  • Tinetti
  • Functional Reach
  • TUG (normal, manual, cognitive)
35
Q

Participation Balance Tests

A

-Activities Based Confidence Scale

36
Q

Berg Balance Scale

A

-14 items to assess common ADL’s safety

  • Each test = 0-4
  • Max. score = 56
  • Score < 36 = fall risk

-Need 3-8 points for detectable change!

37
Q

Tinetti

A

-2 subscales to screen for balance and mobility skills in older adults and determine likelihood of falls

1) Balance (9 tests)
2) Gait (7 tests)

  • Each test scored 0-2
  • Score 19-24 = Mod fall risk
  • Score < 19 = High fall risk

**Need 4 points for detectable change!

38
Q

Functional Reach

A
  • Max distance reaching forward beyond arm’s length while maintaining fixed BOS in standing
  • Examines limits of stability in forward direction
  • Pt. stands next to wall, shoulder flex 90°, make a fist and lean forward
  • 3 trials, average of the last 2

**3 to 9 cm for detectable change!

39
Q

Activities Based Confidence Scale

A
  • 16 item questionnaire
  • Balance self-efficacy

-Rate confidence performing a variety of home and community based functional activities

  • Scores 0-100
  • High scores = greater confidence
40
Q

Timed Up and Go (TUG)

A

-Stand up from a chair, walk 3 meters as quickly and safely as possible, cross a line marked on the floor, turn around, walk back, and sit down. The patient may use AD.

> 15sec = 90% fall prediction

41
Q

TUG Manual

A

Same as TUG but patient must walk holding a cup filled with water

42
Q

TUG Cognitive

A

Same as TUG but patient asked to complete the test while counting backward by 3’s from a randomly selected number between 20 and 100
(can also ask the patient to recite alternating letter of the alphabet “a-c-e” aloud)

43
Q

Body Structure/Function Balance Tests

A 
CTSIB
BESS
Single Leg Stance
Romberg
Tandem Romberg

Tests & Measures Exam #2 (7 decks)

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