Balance Lab (9/20a) [Examination]

Question 1

Why do we test balance

Answer 1

Assess safety, fall risk

Postural control involved in all activities

Documentation about impairment to base standard for their improvement (we get paid)

Question 2

Usual performance

Answer 2

how they perform day to day

We want to see their worst to understand what we can work on

Question 3

Best performance

Answer 3

how they perform under optimal conditions

Question 4

Dual task paradigm

Answer 4

Doing two tasks at the same time

we may introduce a second task to distract pt to see how they perform when they aren’t solely concentrating on doing the activity at their best

Question 5

Two popular threshold tests for fall risks

Answer 5

Mini BESTest ***

Berg Balance Test

Question 6

Problems with balance threshold tests

Answer 6

We treat fall risk as if it’s a pass/fail activity, but it truly isn’t

We should be least confident when someone is around the middle/threshold

Test values make no clinical sense, but they are used for insurance properties

Question 7

Sensory systems affected by aging

Answer 7

Vision

Vestibular

Question 8

Proprioception

Answer 8

perception or awareness of the position and movement of the body

not affected by aging – affected by diseases

Question 9

Can we restore diminished proprioception

Answer 9

No

No evidence that proprioception can be restored

Question 10

4 Main Categories of Mini BESTest

Answer 10

Anticipatory
Reactive postural control
Sensory orientation
Dynamic gait

Question 11

Two quick proprioception tests

Answer 11

***Moving the big toe with eyes closed→ is toe up or down?

Eyes closed, move one arm into a position → ask them to match with other arm

Question 12

Big toe proprioception - interpretation

Answer 12

pt should be able to quickly tell whether toe is up or down

any hesitation at all indicates something is abnormal → may need to refer out

Question 13

Functional Reach test

Answer 13

<6” is at increased fall risk

hold yard stick vertically at shoulder height
pt stands perpendicular to stick
middle finger of fist aligns with edge of stick
pt reaches, measure farthest distance

Question 14

Short Physical Performance Battery (SPPB) test

Answer 14

1) Balance tests - side by side stand, semi tandem stand, tandem stand
2) Gait speed test - 4 meter walk
3) Chair stand test - pretest (able to stand from chair with arms crossed), test (time to repeat 5 times)

Question 15

Timed Up and Go (TUG) test

Answer 15

Time to get up from chair, walk 3 m (or 10 ft), and sit back in chair

1) Instruct patient
2) On the word “go” begin timing
3) Stop timing when patient sits back down
4) Record time

Question 16

To really test a patient’s balance you have to

Answer 16

make them be unstable by:
changing speed
changing intensity
changing surface
remove some sensory information
introduce dual task