Balance and Fall Prevention in Older Adults Flashcards

1
Q

Balance Feedback Control

A

Sensory input to central processing to Motor Output

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2
Q

Feedforward Control of balance is:

A

Central processing to
APA motor output to
Motor output with ongoing sensory feedback

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3
Q

APA motor ouput aka

A

anticipatory postural adjusments via stabilizer muscles

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4
Q

central processing is the

A

thinking about doing a task

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5
Q

3 main ways we get sensory info about positioning

A
  1. Vestibular
  2. Vision
  3. Somatosenosry
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6
Q

info about position from mvmt of head with respect to gravity and inertial forces

A

vestibular input

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7
Q

what changes about vestibular input with age?

A

decrease in DVA (dynamic visual acuity)

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8
Q

info about position and motion of head with respect to surrounding objects

A

vision input

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9
Q

info about position and motion of body with reference to supporting surface, relationship of body seg to each other

A

somatosensory

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10
Q

cerebellums role in central processing

A

integrates and compares sensory input and motor ouput and adapting response as needed

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11
Q

4 key factors CNS does for balance

A
  1. scan for cues
  2. anticipate
  3. focus +/- switch attention (dual task)
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12
Q

motor output components

A
  1. Joint ROM
  2. Muscle strength/for of muscle force
  3. latency of muscle firing
  4. timing of antag/agonist muscle
  5. grading of muscle response
  6. power
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13
Q

who might have problems with motor output

A

arthritis, parkinsons, MS, neuromuscular issue, frail

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14
Q

what is a task?

A

CNS organiszes around the mvmt goal

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15
Q

3 task requirements

A

speed
accuracy
force

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16
Q

crosswalks are ex of..

A

external pacing

17
Q

dependence, loss of autonomy, depression, decreased confidence in ambulation, fam anxiety about injury, limits moblitiy

all s/s of..

A

post fall syndrome

18
Q

Fear of falling predictors (3)

A
  1. cognitive impairment
  2. decreased social activity
  3. poorer physical function
19
Q

ex of intrinsic fall risk factors

A
  1. hx fall
  2. sensory loss
  3. decreased ROM/Strength/rxn time
  4. mobility prob
  5. depression
  6. incontinence
  7. decreased cognition
  8. chronic health conditions
  9. meds
20
Q

decreased cognition defined as

A

score of MMSE under 26 = moderate to sever high risk of serious fall related injuries

21
Q

polypharmacy when there are _- more drugs

A

4+

22
Q

psychotropic drugs

A

act directly on CNS

23
Q

psychotropic drug ex

A

antidepressants
anxiolytics/hypnotics (BZD)
Dementia meds

24
Q

taking psychotropic meds increases fall risk by ___

A

47%

25
Q

t/f increased incidence of recurrent falls in older people with DM

A

true

26
Q

pts with DM PN have __ risk for falls

A

20X higher fall risk than others their age

27
Q

5 factors from DM that increase fall risk

A
  1. decreased ankle muscle strength
  2. decreased ankle ROM
  3. increase foot and body pain
  4. Polypharmacy / psychotrophic meds
  5. Symptomatic hypoglycemia
28
Q

__ doubles risk for hip fracture

A

stroke doubles risk for hip fractures

29
Q

ex of extrinsic fall RF

A
poor lighting 
objects on floor 
unstable furniture 
low furniture or toilets 
improper footwear 
assistive device
30
Q

low fall risk adults..

A

refer to community exercise and fall prevention programs

31
Q

when screen old ppl for falls?

A
  1. after age 65 screen each yr
  2. after hospitalizations, transfer of care, high rate of falls
  3. observation of walking or balance using timed up and go or other balance / gait measures
32
Q

what 3 questions count for fall screen?

A

fall in past yr?
difficulty walking or balance?
observe with timed get up and go

33
Q

CDC STEADI test includes

A

basic fall info
case studies
standardized gait / balance tests
and educational handouts

34
Q

score from stay independent brochure that indicates fall risk

A

score over 4

35
Q

timed get up and go over 12 sec

A

high fall risk

36
Q

t/f pacemaker reduced rate of falls in ppl with carotid sinus hypersensitivity

A

true

37
Q

exercise programs targets 2+ of what..?

A

strength, balance, flexibility or endurance

38
Q

exercise recommendations

A

50+ hours total, 2 times per week for 6 mo minimum

= high total dose

39
Q

Otago balance Program

A

home based: strength + balance + walking

sit to stand, stair walking, sitting exercises etc.