Balance

Question 1

What 2 elements are there in balance?

Answer 1

Center of gravity and base of support

Question 2

When does compensation occur?

Answer 2

If sway exceeds the limits of stability

Question 3

What is postural stability?

Answer 3

If sway is within limits of stability

Question 4

What a normal anterior/posterior sway?

Answer 4

12 degrees from most posterior or anterior position.

Question 5

What is a normal amount of lateral sway?

Answer 5

16 degrees

Question 6

What happens when sway exceeds boundaries?

Answer 6

Initially, compensation is employed to retain balance, and a smaller sway envelope is created.

Question 7

What are the 3 sensory systems that contribute to balance?

Answer 7

• Visual
• Somatosensory
• Vestibular

Question 8

What are the 6 somatosensory contributions to balance?

Answer 8

• Free nerve endings
• Ruffini endings
• Paciniform corpuscles
• Golgi-mazzoni corpuscles
• Golgi ligament endings
• Muscle spindles

Question 9

What is the visual component of balance?

Answer 9

• Sensory information regarding the position of the head relative to the environment, and orients head to maintain level gaze

Question 10

What is the vestibular component of balance?

Answer 10

• Provides information regarding orientation of the head in space and acceleration

Question 11

What brain areas contribute to balance?

Answer 11

• Cerebellum
• Basal ganglia
• Supplemental motor area

Question 12

What type of response strategy is used when the displacements are small?

Answer 12

Ankle strategy.

Question 13

How does the ankle strategy work?

Answer 13

Displaces COG by rotation about the ankle joint.

Question 14

How does the ankle respond to a posterior displacement of COG?

Answer 14

• Dorsiflexion

- Contraction of anterior tibialis, quadriceps, and abdominals

Question 15

How does the ankle respond to a anterior displacement of the COG?

Answer 15

• Plantar flexion

- Contraction of gastrocnemius, hamstring, and trunk extensors

Question 16

When is the hip strategy employed?

Answer 16

• When ankle motion is limited
• Displacement is greater
• Standing on unstable surface disallows ankle strategy
• Perturbation is rapid and near limits of stability

Question 17

How does the hip respond to posterior displacement of COG?

Answer 17

• Backward sway

- Activation of hamstrings and paraspinals

Question 18

How does the hip respond to anterior displacement of COG?

Answer 18

• Forward sway

- Activation of abdominals and quadricep muscles

Question 19

When is the stepping strategy employed?

Answer 19

• If displacement is large enough, a forward or backward step is used to regain postural control

Question 20

What are the 3 phases of motor learning?

Answer 20

• Cognitive phase
• Associative phase
• Autonomous phase

Question 21

What is the cognitive phase?

Answer 21

What to do

Question 22

What is the associative phase?

Answer 22

How to do it better

Question 23

What is the autonomous phase?

Answer 23

Just do it

Question 24

What types of traumatic injury can affect balance?

Answer 24

• Eyes
• Inner ear
• Peripheral receptors
• Spinal cord
• Cerebellum
• Basal ganglia
• Cerebrum
• Ankle
• Hip
• Back

Question 25

What non-traumatic pathologies can affect balance?

Answer 25

- Degenerative joint disease - CVAs - Tumors - Visual field loss - Age

Question 26

What are 4 measures of the effect of training on balance?

Answer 26

- Increased LE strength - Increased scores in balance measures - Reduces effect of, or exposure to risk factors for falling in the elderly

Question 27

What are 3 categories of balance evaluation categories?

Answer 27

- Balance during functional activities with or with assistive devices - Balance in static or dynamic situations with or without the use of assistive devices - Safety during gait locomotion, or balance

Question 28

What 3 causes should the evaluation differentiate between?

Answer 28

- Biomechanical - Motor - Sensory

Question 29

What is the 5 step progression of impaired balance examination and evaluation?

Answer 29

- Standing with eyes open - fixed platform - Standing blindfolded - fixed platform - Sway-referenced vision - fixed platform - Normal vision with sway - referenced support - Absent vision with sway-referenced support - Sway-referenced vision and support

Question 30

What is the base treatment for balance?

Answer 30

Strength

Question 31

What is the modular element for balance treatment?

Answer 31

Motor control

Question 32

What is the cognitive/ affective element for balance treatment

Answer 32

Fear

Question 33

Describe the progression graded balance interventions.

Answer 33

- Weight shifts on stable surface - Increase sway - Increase surface challenges

Question 34

Describe the progression of posture training as it relates to balance.

Answer 34

- Begin with core stability for COG control and a sense of trunk posture - Begin in supine or seated position - Use variety of arm positions, unstable surfaces, single leg stances, etc.

Question 35

Describe the progression of movement training as it relates to balance.

Answer 35

- Add movement patterns to acquired stable static postures to increase balance challenge - Add anterior/ posterior sway to increase stability limits - Add trunk rotations and altered head positions to alter vestibular input - Use PNF techniques during trunk rotation - Step back/ forward assists in re-stabilization exercises

Question 36

What types of patients are trained for balance the most in the clinic?

Answer 36

The elderly

Question 37

Where may active individuals carry out their balance activities?

Answer 37

- At home | - At the local health club

Question 38

Describe a basic progression for all balance therex.

Answer 38

BOS: Advance from wide to narrow base Posture: Stable to unstable posture Visual: Close the eyes COG: Greater disruption to elicit hip or stepping strategy Progress to dynamic activities, unstable surfaces, and unstable movement patterns

Question 39

What are contraindications and precautions for balance training?

Answer 39

- Persons who are inherently in balance challenged positions