Balance Interventions Flashcards
What is a general approach to balance intervention?
Address underlying motor, sensory, and cognitive impairments.
What should be included in the developmental progressions for balance interventions?
Quadruped, kneeling, half kneeling, modified plantigrade, standing.
What is the goal of decreasing dependence on assistive devices in balance training?
To improve balance confidence and active control.
What is the progression for treatment in balance interventions?
Elevate COM, narrow BOS, increase cognitive demand, include sensory manipulation.
Why is it important to withdraw support gradually in balance training?
To focus on active control while ensuring safety.
What does balance intensity refer to?
The degree of challenge to the balance control system relative to the individual’s capacity to maintain balance.
What is high balance intensity?
The highest level of balance-enhancing exercises that can be tolerated without inducing a fall or near fall.
What scale is used to measure balance exercise intensity in older adults?
The Balance Intensity Scale (BIS).
What does the Rating of Perceived Stability (RPS) scale measure?
How stable a patient feels during and after each exercise.
Why is it important to determine the ‘ideal’ balance exercise intensity?
To optimize balance training without inducing a fall or near fall.
What should be targeted in sitting balance interventions?
Specific impairments causing balance loss.
What is an example of a reactive balance control intervention in sitting?
Small range manual perturbations to the trunk.
How can perturbations be varied in sitting balance training?
By changing the speed, direction, and timing.
What is the progression for reactive balance interventions in sitting?
From predictable perturbations to unpredictable perturbations.
What is a tool that can be used for perturbation training in sitting?
A rockerboard, inflated disc, or therapy ball.
What is a method to improve posture in standing balance training?
Standing with a mirror for feedback.
How can somatosensory feedback be increased in standing posture training?
Using a towel roll on the wall.
What is an example of a static standing progression?
Progressing to pliable surfaces like foam or a rockerboard.
How can BOS be reduced in static standing balance training?
Progressing to Romberg, semi-tandem, tandem stance, or single-leg stance.
What is a dual task that can be added to standing balance training?
Performing resistance training while maintaining steady state.
What is a technique for reactive balance training in standing?
Manual perturbations applied to the shoulders, trunk, or hips.
What is an example of a stepping strategy training exercise?
Leaning forward until COM is outside BOS, then stepping to prevent a fall.
How can sensory conditions be varied in balance training?
By altering vision and somatosensory conditions.
What is an ankle strategy in balance training?
Small shifts in COM alignment or slow sway movements activating ankle strategy.
What is a hip strategy in balance training?
Upper trunk moving opposite the direction of hips for larger shifts in COM or faster sway movements.
What is a stepping strategy in balance training?
Larger shifts where COM exceeds BOS.
How can ankle strategy be trained?
Swaying gently forward and backward using ankle DF/PF.
What is a training exercise for the hip strategy?
Standing with back 8-12 inches from a wall and bringing buttocks to rest on the wall.
How can medial/lateral hip motions be trained?
Balancing in a narrow BOS or standing on a balance beam.
How can stepping strategy be practiced?
Leaning forward against a resistive band and stepping to maintain balance.
What is the progression for perturbation training in reactive strategies?
From predictable to unpredictable perturbations.
What is the goal of sensory manipulation in balance training?
To improve the use of somatosensory, vision, and vestibular systems.
What is an exercise to improve use of somatosensory?
Standing activities with eyes closed on a solid surface.
What is an exercise to improve use of vision?
Standing on a foam surface with eyes open.
What is an exercise to improve use of vestibular?
Standing on foam or an inclined surface with eyes closed.
How can vision be compromised to improve somatosensory reliance?
Using glasses smeared with Vaseline.
How can both vision and somatosensory be compromised to improve vestibular reliance?
Standing on foam with eyes closed and performing dynamic activities.
What is an example of a dynamic standing activity?
Toe taps to a step or cones.
What is a task-specific balance training exercise in standing?
Shaking hands while maintaining balance.
How can the environment be altered for task-specific balance training?
By changing terrain characteristics like curbs, stairs, grass, or ramps.
What is a balance activity to incorporate during ambulation?
Gait with narrowed BOS and 180-degree turns on different surfaces.
What is dual task training?
Performing balance activities while simultaneously engaging in cognitive or manual tasks.
What is an example of a dual task during walking?
Carrying on a conversation or texting while walking.
How can cognitive tasks be incorporated into balance training?
Counting or spelling backward while performing balance exercises.
What is a manual task that can be added to balance training?
Carrying a tray of food or a cup of water while maintaining balance.
