Balance and FMS

Question 1

functional balance tests focus on

Answer 1

1: static balance
2: dynamic balance
3: balance responses to manual perturbations
4: functional mobility (gait)

Question 2

static balance

Answer 2

maintenance of posture

examples:
- standing (double limb stance, single limb stance (SLS), tandem stance (heel to toe))
- Romberg test

Question 3

dynamic balance

Answer 3

balance during weight shifting or voluntary movement

examples:

• sit to stand (STS)
• sit down (SIT)
• reaching movements
• turning
• step ups

Question 4

gait balance tests

Answer 4

include timed walking, walking with commands to turn directions, turn the head,

Question 5

functional balance grades

Answer 5

Normal
Good
Fair
Poor

Question 6

normal balance grade

Answer 6

STATIC: patient able to maintain steady balance without handhold support

DYNAMIC: pt accepts maximal challenge and can shift weight easily within full range in all directions

Question 7

Good balance grade

Answer 7

STATIC: pt able to maintain balance without handhold support, limited postural sway

DYNAMIC: pt accepts moderate challenge; able to maintain balance while picking object off floor

Question 8

Fair balance grade

Answer 8

STATIC: pt able to maintain balance with handhold support; may require occasional minimal assistance

DYNAMIC: pt accepts minimal challenge; able to maintain balance while turning head/trunk

Question 9

Poor balance grade

Answer 9

STATIC: pt requires handhold support and moderate to maximal assistance to maintain position

DYNAMIC: pt unable to accept challenge or move without loss of balance

Question 10

romberg test

Answer 10

used to determine proprioceptive contributions to upright balance.

1: Pt instructed to stand with feet together, eyes open (EO) unaided for 20-30 seconds. If the patient falls with EO the test is over.
2: pt then stands with eyes closed (EC)

negative = minimal sway
positive = pt able to stand with EO but demonstrates increased instability o falls with EC 

• if unsteady with EO, this test is not appropriate
• *in the sharpened Romberg test, the feet are placed in tandem

Question 11

positive Romberg test indicates..

Answer 11

loss of proprioception that can occur with posterior column lesions in the spinal cord (spondylosis, tumor, degenerative spinal cord disease, tabes dorsal is) and peripheral neuropathy

Question 12

other balance grades

Answer 12

poor (P): PT needs to hold the pt up

Fair (F): independent by needs external support

Fair(F): can sit unsupported

Good (G): min resistance

Good + (G+): mod resistance

Normal (N): max resistance

Question 13

functional movement screen (FMS)

Answer 13

7 position screen to analyze movement
graded 0-3
not a diagnostic tool; maps out someone’s functional status- catch problems before they worsen

quality vs. quantity

Question 14

7 FMS steps

Answer 14

• a;ways do both sides!
  1: squats
  2: hurdle up and over
  3: in line lunge
  4: shoulder mobility
  5: active straight leg raise
  6: trunk stability push up
  7: rotary stability

Question 15

FMS grades

Answer 15

0= pain
1= can't complete
2= compensation
3= perfect movement 

*anything lower than 2= risk of injury

Question 16

1: squats

Answer 16

slide board under heels when needed?

Question 17

2: hurdle up and over

Answer 17

**score the leg moving forward.

Tibial tuberosity= point of reference to clear

• looking for stability on stance leg, touch with heel and return
• no sidebending, lumbar flexion, IR/ER at hip, no touching with toe, stable torso, hip/knee/ankle aligned,
• hand stick should stay parallel to string

Question 18

3: in line lunge

Answer 18

• test leg is forward
• same distance as tibial height
• looking for weakness and asymmetry
• feet on board in lung position, back heel can rise.
• Back foot is same side of shoulder overhead holding onto dowel
• points of contact for hand stick: head, sacrum, T-spine. keep vertical throughout

Compensation: not finishing

Question 19

4: shoulder mobility test

Answer 19

• score is for flexed shoulder
• *important to remember than problem could be related to opposite arm
• take distal wrist crease to measure hand length
• patient puts hands behind back to attempt to get within that length

1=not within range
2=within 1 and 1/2 hand length
3=within hand length

Question 20

5: active straight leg raise

Answer 20

• supine, hips neutral, feet dorsiflexed
• stick half way between knee and ASIS

3= ankle passes stick
2= malleolus between stick and middle knee
1= doesn't pass knee joint

Question 21

6: trunk stability push up

Answer 21

• pt lies flat on ground. feet together, dorsiflexed. hands at top of forehead, shoulder width apart
• females can start with hands at chin level
• perform a push up with stomach and chest as a unit

compensation: hyperextension

3= up as a unit
2=hyperextension, lagging of lumbar spine.
-move hands down to chin level (males) or to shoulder/clavicle level (females)

Question 22

7: rotary stability

Answer 22

tests ability to be stable around a mobile UE/LE

on all 4s
pick up same arm and leg.
if can’t: pick up opposite arm and leg

• controversial bc a lot of ppl can’t perform a 3
• *balance is key to this test

Question 23

total FMS score

Answer 23

21 total points

average=15