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Management of aging/complex pts > Balance / Assessment > Flashcards

Balance / Assessment Flashcards

1
Q

Goals of the postural control system

A

-maintain a steady stance
-anticipate volitional goal directed movements
-adapt to changing requirements

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2
Q

Components of the postural control

A

-motor
-sensory
-central processing (awareness, attention, automatic reactions)

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2
Q

Postural control is achieved by continually …..

A

positioning the body’s center of gravity over the
base of support during both static and dynamic situations

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3
Q

Balance is simply defined as

A

keeping the center of gravity within the base of support in a given environment

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4
Q

Deficits within any single component of balance are typically not sufficient to cause postural
instability, because….

However,

A

compensatory mechanisms from other components prevent that from
happening

deficits across multiple components may lead to instability and falls

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5
Q

The balance system consists of a complex set of control process that can be divided into
two distinct and interdependent systems

A

Gaze and postural

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6
Q

the gaze stabilization system maintains

A

gaze direction and visual acuity during activities involving active head and body movements

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7
Q

postural stabilization system function

A

keeps the body in balance for static and dynamic
activities

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8
Q

a rapidly acting system that reflexively drives eye
movements that are equal and opposite to those of the head.

A

VOR (vestibule-ocular reflex)

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8
Q

The 2 components of the balance system are

A

interdependent

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9
Q

Does the VOR require visual information?
What is it influenced by?
Is it effective in slow movements?

A

-NO
-the individuals state of arousal
-NO

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10
Q

VOR is effective for stabilizing gaze during

A

rapid movements

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11
Q

allows the direction of gaze to smoothly follow a
visual target during active movement

A

smooth pursuit eye movement system

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12
Q

What does the smooth pursuit eye movement system require

it is not affected by

it dominates during

A

the presence of a visual target

the absence or presence of vestibular info

slow movements

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13
Q

When
the VOR and smooth pursuit systems fail to maintain gaze on the target

A

saccadic eye movement system can generate rapid catch-up eye movements

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14
Q

when gaze is
first directed to a new visual target

A

saccadic eye movement system can generate rapid catch-up eye movements

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15
Q

The saccadic eye movement system requires

it is not affected by

A

the presence of a visual target
and is not affected by vestibular information

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16
Q

Maintaining postural stability is a more complex balance process that relies on the
interaction of three major components

A
  • vision, vestibular, propio, contact with support surface in combo
  • motor reactions among muscles
  • integration of sensory and motor info and adaptation of env
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17
Q

Alignment contributes to postural stability by

A

allowing the body to remain in equilibrium
with the least amount of energy

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18
Q

Factors that influence postural tone
include

A

activation of cutaneous receptors against a surface, visual, and vestibular inputs.

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18
Q

During upright posture, there is background activity in the
anti-gravity muscles, which is termed

A

postural tone

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19
Q

Muscles that tend to be tonically active during stance include

A

the gastrocnemius and soleus,
tibialis anterior, gluteus medius and tensor fascia lata, iliopsoas, thoracic erector spinae,
and intermittent contractions of the abdominals.

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20
Q

There are five basic strategies that have been identified as responses to unexpected
postural perturbations.

2 hip is?

What is the pattern?

Who tends to use this more?

A

A hip strategy is the activation of muscles around the hip joint as a result of a
sudden and forceful disturbance of the base of support or a perturbation to balance
while standing on a narrow support surface

proximal to distal

older adults

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20
Q

There are five basic strategies that have been identified as responses to unexpected
postural perturbations.

1 ankle strategy is?

What is required?

A

An ankle strategy is the activation of muscles around the ankle joint after a small
disturbance of the base of support when standing on a firm, level support surface

significant amount of ankle strength and mobility

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21
Q

There are five basic strategies that have been identified as responses to unexpected
postural perturbations.

3 stepping is?

A

The stepping strategy has been defined as taking a step rapidly in the direction of
the movement of the center of gravity, which has been displaced beyond the limits
of the base of support.

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22
Q

There are five basic strategies that have been identified as responses to unexpected
postural perturbations.

4 reaching is?

Has a significant role in?

A

The reaching strategy includes moving the arm to grasp or touch an object for
support

preventing falls

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23
Q

There are five basic strategies that have been identified as responses to unexpected
postural perturbations.

5 suspensory is?

A

The suspensory strategy includes bending knees during standing or walking for the
purpose of maintaining a stable position during a perturbation

24
Q

Adaptations when unexpected postural perturbations happen are based on

A

Adaptations are based on what the CNS perceives to be the safest.

25
Q

Visual inputs provide the CNS with information about

A

the position and motion of the head with respect
to surrounding objects

26
Q

Visual inputs are important source of information for postural control, but are they
absolutely necessary?

They are not always accurate for ..

A

No, since most of us can keep our balance when we close our eyes or
are in a dark room
They are also not always an accurate source of orientation info about self motion

27
Q

Somatosensory system inputs provide the CNS with information about?

receptors?

A

with position and motion information about
the body with reference to supporting surfaces and report information about the relationship of body segments to one
another

muscle receptors, joint receptors, and cutaneous receptors

27
Q

The vestibular system provides the CNS with information about

A

the
position and movement of the head with respect to gravity and inertial forces

28
Q

There is no one
single test of balance due to the

A

complexity of the postural control system

29
Q

Romberg test

positive test is

positive test meaning

A

requires the patient to stand with feet together, arms either at side or across the chest, with eyes open and then eyes closed for 30 seconds

A positive
test is the inability of the patient to remain steady and control balance with the eyes closed

A positive finding is indicative of proprioceptive dysfunction

30
Q

The Sharpened or
Tandem Romberg requires the patient to

+ test

meaning

A

stand in a tandem stance with the eyes open.

A positive test is the inability of the patient to maintain balance or remain steady. This test
assesses cerebral and vestibular dysfunction.

31
Q

Single Leg Stance test

findings? if they can ____ if they cannot ____?

A

This is a timed test (usually up to 30 seconds). This suggests that individuals
who can stand on one leg for at least 30 seconds are at low risk of falling (high sensitivity).

However, being unable to stand on one leg for at least 30 seconds does not provide much
information about an individual’s risk of falling

31
Q

Normal individuals maintain body weight within ____ of equal on the two legs over
the full range of squatting positions

A

7%

32
Q

an assessment technique used to quantify and help to differentiate
among a wide variety of possible sensory, motor, and central adaptive impairments to
balance control

A

CDP

33
Q

CDP information is important in

A

the planning of treatment focused on impairment
reduction

34
Q

the patient stands on a movable force plate within a movable surround.
The force platform is under computer control, and can move either in a horizontal plane, or
rotate out of the horizontal plane

A

CDP testing

35
Q

Used to determine how quickly the automatic motor system can
recover following an unexpected external perturbation.

A

motor control test

36
Q

In young adults with a normal SOT and abnormal motor control
test, there is increased suspicion of

A

MS

37
Q

The adaptation test assesses

A

the patient’s ability to reduce sway when exposed to surface
irregularities and unexpected changes in the support surface.

38
Q

Individuals performing abnormally on the _____ tend to have difficulty in changes in the surface
inclination

A

ADT (adaptation test)

39
Q

ADT difficulties can arise due to the individual’s
inability to suppress

A

inappropriate automatic reactions and/or may have weakness of the
ankle muscles and restricted range of motion

40
Q

Assesses an individual’s ability to reach in different directions
and recover without altering the base of support

A

functional reach test

41
Q

This test quantifies the maximum distance a person can intentionally displace his or her
center of gravity without loss of balance (including stepping or reaching for assistance)

A

Limits of Stability

42
Q

A forward reach of less than
_______ has been reported as a fall risk factor for falling within the next six months

A

6 inches

43
Q

Patients with reduced
stability limits in the AP direction …..

Laterally reduced limits can …

A

tend to take smaller steps during gait

while laterally
reduced limits can lead to broad-based gaits.

44
Q

Differences in the amount of body sway in the various conditions are used to determine a
subject’s ability to adapt sensory information for postural control

A

Sensory organization test

45
Q

Conditions 1 and 2 of the sensory organization test

A

In condition one: all three senses are available and accurate
In condition two: vision is absent, vestibular and somatosensory are present and
accurate

46
Q

Conditions 5 and 6 of the sensory organization test

A

In condition five: somatosensory is inaccurate, vision is absent, vestibular is
accurate
In condition six, somatosensory and vision are inaccurate, vestibular is accurate

46
Q

Conditions 3 and 4 of the sensory organization test

A

In condition three: vision is inaccurate, vestibular and somatosensory are present
and accurate
In condition four: somatosensory is inaccurate, vision and vestibular are accurate

47
Q

Condition 2 over condition 1 low score finding

A

Low score may indicate patient makes poor use of somato reference

48
Q

Condition 4 over condition 1 low score findings

A

low score indicates patient makes poor use of visual reference

49
Q

Condition 5 over condition 1 low score findings

A

low score indicates patient makes poor use of vestibular cues or vestibular cues are unavailable

50
Q

Condition 3+6 over condition 2+5 low score findings

A

a low score indicates patient relies on visual cues, even when they are not accurate

51
Q

Conditions of mCTSIB

A

The four conditions are firm surface, eyes
open; firm surface, eyes closed; compliant surface, eyes open; and, compliant surface, eyes
closed. Timed for 30 sec

52
Q

Cut offs for fullerton advanced balance scale

A

those scoring 25 or fewer points are at higher risk for falls

53
Q

Cut off score for five times sit to stand

A

15 seconds

54
Q

Cut off score for four square step test

A

greater than 15 seconds

55
Q

Cut off score for berg balance

A

36 or less

56
Q

Cut off score for timed up and go

A

13.5 seconds or longer

57
Q

Cut off score for timed up and go dynmaic gait index

A

19 or less

58
Q

Cut off score for POMA

A

19 or less

59
Q

Cut off score for functional gait analysis

A

22/30

Management of aging/complex pts (4 decks)

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