Balance

Question 1

somatosensory receptors location

Answer 1

in joints, muscles, ligaments and skin

Question 2

What information do somatosensory receptors provide?

Answer 2

length, tension, pressure, pain and joint position

Question 3

How do you challenge the somatosensory system?

Answer 3

examine vibration and pressure

observe a pt when changing the surface they are standing on (slopes, uneven surfaces, standing on foam)

Question 4

What are the purpose of visual receptors?

Answer 4

allow for perceptual acuity regarding verticality, motion of objects and self, environmental orientation, postural sway and movements of the head/neck

Question 5

Who rely heavily on the visual system for maintenance of balance?

Answer 5

children

Question 6

how do you challenge the visual system?

Answer 6

examine quiet standing w/ eyes open
observe balance strategies to maintain COG w/ and w/o visual input

assessment of potential visual field cuts, hemianopsia, pursuits, saccades, double vision, gaze control and acuity is necessary

Question 7

What does the vestibule system provide»

Answer 7

the CNS w/ feedback regarding the position and movement of the head w/ relation to gravity

Question 8

what does the labyrinth consist of?

Answer 8

3 semicircular canals filled w/ endolymph and 2 otolith organs

Question 9

what do semicircular canals respond to?

Answer 9

movement of fluid w/ head motion

Question 10

what do otoliths measure?

Answer 10

effects of gravity and movements w/ regard to acceleration/decceleration

Question 11

How do you challenge the vestibular system?

Answer 11

examine balance w/ head movement

testing such as Dix hall pike test, bithermal caloric testing, assessment for nystagmus, head thrust sign, testing the VOR reflex

Question 12

What does the vestibuloocular reflex (VOR) allow for?

Answer 12

head/eye movement coordination

Question 13

what does VOR support and how?

Answer 13

gaze stabilization through eye movement that counters movements of the head

This maintains a stable image on the retina during movement

Question 14

vestibulospinal reflex (VSR)

Answer 14

attempts to stabilize the body and control movement

Question 15

what does the VSR assist with/.

Answer 15

stability while the head is moving as well as coordination of the trunk during upright postures

Question 16

ankle strategry

Answer 16

elicited by a small range and slow velocity perturbation when the feet are on the ground

Question 17

Which automatic postural strategy is activated first by a small range and slow velocity perturbation?

Answer 17

ankle

Question 18

Pattern of muscle group contraction w/ ankle strategy

Answer 18

distal to proximal fashion

Question 19

hip strategy

Answer 19

elicited by a greater force, challenge or perturbation through the pelvis and hips

Question 20

which way do the hips move w/ hip strategy?

Answer 20

opposite direction from the head

Question 21

Pattern of muscle group contraction w/ hip strategy

Answer 21

proximal to distal fashion

Question 22

suspensatory strategy

Answer 22

used to lower the COG during standing or ambulation in order to better control the COG

Question 23

examples of suspensatory strategy

Answer 23

knee flexion, crouching or squatting

Question 24

when is the suspensatory strategy normally used?

Answer 24

when both mobility ands stability are required during a task (think surfing)

Question 25

stepping strategy

Answer 25

elicited through unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the COG is beyond the base of support LE step and/or UE reach

Question 26

What does Berg balance scale assess?

Answer 26

pt's risk for falling

Question 27

tasks in berg balance scale

Answer 27

static activities, transitional movements, and dynamic activities in sitting and standing positions

Question 28

Berg Balance Scale score for risk for falling

Answer 28

< 45 = increased risk for falls

Question 29

What does the Fregly-Graybiel Ataxia Test Battery asses?

Answer 29

balance dysfunction for pt's w/ high level motor skills

Question 30

Test conditions w/ Fregly-Graybiel Ataxia Test Battery

Answer 30

``` stand on beam EO and EC walk on beam w/ EO sharpened Romberg standing w/ EO and EC standing on one leg EC walking on the floor w/ EC ```

Question 31

What does Fugl Meyer asses

Answer 31

balance specifically for pt's w/ hemiplegia

Question 32

What does the functional reach test asses?

Answer 32

standing balance and risk for falling

Question 33

What score correlated w/ an increased risk for falling on the functional reach test?

Answer 33

20-40 y/o= < 14.5in 41-69 t/o= < 13.5in 70-87y/o = <10.5in

Question 34

what does the Romberg test assess?

Answer 34

balance and sensory ataxia

Question 35

What does the timed up and go (TUG) asses?

Answer 35

mobility and balance

Question 36

What times correlate with an increased risk of falling on the TUG?

Answer 36

>20 sec | >30 sec high risk

Question 37

What does the Tinetti Performance Oriented Mobility Assessment assess>

Answer 37

increased risk for falling balance and gait

Question 38

What score on the Tinetti POMA correlates to increased risk for falling?

Answer 38

<19 = high risk for falls

Question 39

Romberg test w/ BPPV

Answer 39

negative

Question 40

Romberg test w. Unilateral vestibular hypofunction

Answer 40

acute: (+) | chronic (-)

Question 41

Romberg test w/ bilateral vestibular hypofunction

Answer 41

acute: (+) chronic: (-)

Question 42

Romberg test w/ central lesion

Answer 42

often (-)

Question 43

Tandem Romberg w/ BPPV

Answer 43

(-)

Question 44

SLS w/ BPPV

Answer 44

(-)

Question 45

gait w/ BPPV

Answer 45

normal

Question 46

turn head while walking w/ BPPV

Answer 46

may produce slight unsteadiness

Question 47

Tandem Romber w/ Unilateral vestibular hypofunction

Answer 47

(+), eyes closed

Question 48

SLS w/ Unilateral vestibular hypofunction

Answer 48

may be (+)

Question 49

gait w/ Unilateral vestibular hypofunction

Answer 49

acute: wide BOS, slow, decreased arm swing and trunk rotation compensated: normal

Question 50

turn head while walking w/ Unilateral vestibular hypofunction

Answer 50

acute: may not keep balance compensated: normal

Question 51

Tandem Romberg w/ bilateral vestibular hypofunction

Answer 51

(+)

Question 52

SLS w/ bilateral vestibular hypofunction

Answer 52

acute: (+) chronic: (-)

Question 53

gait w/ bilateral vestibular hypofunction

Answer 53

acute: wide BOS, slow, decreased arm swing and trunk rotation compensated: mild gait deviation

Question 54

turn head while walking w/ bilateral vestibular hypofunction

Answer 54

may not keep balance or slows cadence

Question 55

Tandem Romberg w/ central lesion

Answer 55

(+)

Question 56

SLS w/ central lesion

Answer 56

may be unable to perform

Question 57

Gait w/ central lesion

Answer 57

may have pronounced ataxia

Question 58

turn head while walking w/ central lesion

Answer 58

may not keep balance, increased ataxia