Balance Interventions

Question 1

What is a general approach to balance intervention?

Answer 1

Address underlying motor, sensory, and cognitive impairments.

Question 2

What should be included in the developmental progressions for balance interventions?

Answer 2

Quadruped, kneeling, half kneeling, modified plantigrade, standing.

Question 3

What is the goal of decreasing dependence on assistive devices in balance training?

Answer 3

To improve balance confidence and active control.

Question 4

What is the progression for treatment in balance interventions?

Answer 4

Elevate COM, narrow BOS, increase cognitive demand, include sensory manipulation.

Question 5

Why is it important to withdraw support gradually in balance training?

Answer 5

To focus on active control while ensuring safety.

Question 6

What does balance intensity refer to?

Answer 6

The degree of challenge to the balance control system relative to the individual’s capacity to maintain balance.

Question 7

What is high balance intensity?

Answer 7

The highest level of balance-enhancing exercises that can be tolerated without inducing a fall or near fall.

Question 8

What scale is used to measure balance exercise intensity in older adults?

Answer 8

The Balance Intensity Scale (BIS).

Question 9

What does the Rating of Perceived Stability (RPS) scale measure?

Answer 9

How stable a patient feels during and after each exercise.

Question 10

Why is it important to determine the ‘ideal’ balance exercise intensity?

Answer 10

To optimize balance training without inducing a fall or near fall.

Question 11

What should be targeted in sitting balance interventions?

Answer 11

Specific impairments causing balance loss.

Question 12

What is an example of a reactive balance control intervention in sitting?

Answer 12

Small range manual perturbations to the trunk.

Question 13

How can perturbations be varied in sitting balance training?

Answer 13

By changing the speed, direction, and timing.

Question 14

What is the progression for reactive balance interventions in sitting?

Answer 14

From predictable perturbations to unpredictable perturbations.

Question 15

What is a tool that can be used for perturbation training in sitting?

Answer 15

A rockerboard, inflated disc, or therapy ball.

Question 16

What is a method to improve posture in standing balance training?

Answer 16

Standing with a mirror for feedback.

Question 17

How can somatosensory feedback be increased in standing posture training?

Answer 17

Using a towel roll on the wall.

Question 18

What is an example of a static standing progression?

Answer 18

Progressing to pliable surfaces like foam or a rockerboard.

Question 19

How can BOS be reduced in static standing balance training?

Answer 19

Progressing to Romberg, semi-tandem, tandem stance, or single-leg stance.

Question 20

What is a dual task that can be added to standing balance training?

Answer 20

Performing resistance training while maintaining steady state.

Question 21

What is a technique for reactive balance training in standing?

Answer 21

Manual perturbations applied to the shoulders, trunk, or hips.

Question 22

What is an example of a stepping strategy training exercise?

Answer 22

Leaning forward until COM is outside BOS, then stepping to prevent a fall.

Question 23

How can sensory conditions be varied in balance training?

Answer 23

By altering vision and somatosensory conditions.

Question 24

What is an ankle strategy in balance training?

Answer 24

Small shifts in COM alignment or slow sway movements activating ankle strategy.

Question 25

What is a hip strategy in balance training?

Answer 25

Upper trunk moving opposite the direction of hips for larger shifts in COM or faster sway movements.

Question 26

What is a stepping strategy in balance training?

Answer 26

Larger shifts where COM exceeds BOS.

Question 27

How can ankle strategy be trained?

Answer 27

Swaying gently forward and backward using ankle DF/PF.

Question 28

What is a training exercise for the hip strategy?

Answer 28

Standing with back 8-12 inches from a wall and bringing buttocks to rest on the wall.

Question 29

How can medial/lateral hip motions be trained?

Answer 29

Balancing in a narrow BOS or standing on a balance beam.

Question 30

How can stepping strategy be practiced?

Answer 30

Leaning forward against a resistive band and stepping to maintain balance.

Question 31

What is the progression for perturbation training in reactive strategies?

Answer 31

From predictable to unpredictable perturbations.

Question 32

What is the goal of sensory manipulation in balance training?

Answer 32

To improve the use of somatosensory, vision, and vestibular systems.

Question 33

What is an exercise to improve use of somatosensory?

Answer 33

Standing activities with eyes closed on a solid surface.

Question 34

What is an exercise to improve use of vision?

Answer 34

Standing on a foam surface with eyes open.

Question 35

What is an exercise to improve use of vestibular?

Answer 35

Standing on foam or an inclined surface with eyes closed.

Question 36

How can vision be compromised to improve somatosensory reliance?

Answer 36

Using glasses smeared with Vaseline.

Question 37

How can both vision and somatosensory be compromised to improve vestibular reliance?

Answer 37

Standing on foam with eyes closed and performing dynamic activities.

Question 38

What is an example of a dynamic standing activity?

Answer 38

Toe taps to a step or cones.

Question 39

What is a task-specific balance training exercise in standing?

Answer 39

Shaking hands while maintaining balance.

Question 40

How can the environment be altered for task-specific balance training?

Answer 40

By changing terrain characteristics like curbs, stairs, grass, or ramps.

Question 41

What is a balance activity to incorporate during ambulation?

Answer 41

Gait with narrowed BOS and 180-degree turns on different surfaces.

Question 42

What is dual task training?

Answer 42

Performing balance activities while simultaneously engaging in cognitive or manual tasks.

Question 43

What is an example of a dual task during walking?

Answer 43

Carrying on a conversation or texting while walking.

Question 44

How can cognitive tasks be incorporated into balance training?

Answer 44

Counting or spelling backward while performing balance exercises.

Question 45

What is a manual task that can be added to balance training?

Answer 45

Carrying a tray of food or a cup of water while maintaining balance.