balance PP

Question 1

defined as the ability to maintain the body’s center of mass over its base of support (BOS)

Answer 1

Balance

Question 2

The area contained within the parts of the body making physical contact with the external enviornment

Answer 2

Base of support

Question 3

3 system linked to balance control

3 legged stool

Answer 3

• Vestibular
• Visual
• Somatosensory
  
  • Musculskeletal and neuromuscular compnents

Question 4

KC adds to the

3 systems. what do they add?

Answer 4

sensory organization for balance control

Question 5

Knowing where your body is in space
Input from body regarding its position and movement

Answer 5

Proprioception

Question 6

Responsible for processing information about movement with respect to gravity

• Rotation, acceleration/deceleration and head stabilization
• Postural control and coordination of eye and head movements
• What are you working on ?

Answer 6

Vestibular system

Question 7

Allows the information provided by the other systems to be integrated into a whole picture

• Reduced response time, fear and exaggerated responses

Answer 7

Cognitive or Sensory Organization

Question 8

K & C, pg 263
React to maintain balance in response to the unexpected
Pertubations

Question 9

HIP STRATEGY

Answer 9

• Occurs with larger LOBs or when unable to use ankle strategy
  
  • Proximal to distal manner
  • uses hiop flex or ext to moe the center of mass within the BOS

Question 10

what muscles kicking in?

1. LOB- in anterio direction ?
2. LoB in posterio direction?

Answer 10

1. ant- lowr back then hamstrng muscles
2. Post-lower abs then quads

Question 11

when LOB is too great and COG is too far off BOS and need to increase area of BOS

Person will step in direction of LOB

Answer 11

Stepping Strategy

Question 12

Factors that will influence balance strategies

KC 264 box 8.1

Answer 12

speed and intensity of displacing forecs

characteristics of the support surface

manitude of the dipacement of the COM

subjects

FINISH

Question 13

Internal Risk Factors

Answer 13

• Age
  
  • Decreased flexibility and reflexes
• Fear and Hx of falls
• Visual deficits
  
  • Vertigo, orthostatic hypotension
• Weakness
• Cognition
• Infections
• Diabetes/other neuro issues
• CVA/Cardiac/Parkinson’s/Co-morbidities

Question 14

Environmental Factors

external factors

Answer 14

• Tripping hazards
• Medicines
• Poor lighting
• Unsteady surfaces and changes in surfaces

NO THROW RUGS!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Question 15

Most Common Risk Factors for Falls Among the Elderly
Box 8.2, K & C, pg 269

put in

Question 16

what are some Age-related changes in balance that are the result of changes in every system in our bodies

Answer 16

• Neurologic changes
• Orthopedic changes
• Psychomotor changes
• Sensory changes
• Reduction in the function of the vestibular system

Question 17

Safety During Balance Exercises

K & C, Box 8.3 pg 273

Answer 17

USE GAIT BELT

• STAND slightly behind and to the side of the pt with one arm hold the belt and the other arm on or near the top of shoulder
• Perform exercises in // bars or with AD to help pt maintain balance
• Be aware of environment
  
  • Avoid sharp objects
• Check equipment to ensure that it is operating correctly
  GUARD pt when getting on and off equipment
  Ensure environment free of debris

Question 18

Evidence Based Practice

Exercises for Elderly with Low Physical Functioning
Box 8.4, pg 265 K & C

put in

Question 19

Evidence Based Practice

Exercise Program for Elderly with Balance Deficits One Year Following Stroke
Box 8.5, pg 266 K & C

put in

Question 20

Evidence Based Practice

Balance Ex Program Incorporating Strengthening, Walking and Functional Activities
Box 8.6, pg 267 K & C

put in

Question 21

Evidence Based Practice

Circuit Training Program to Address Balance Impairments and Function
Table 8.3, pg 268

put in

Question 22

Evidence Based Practice

Progressive Balancing Exercises
Box 6-2 Shankman, pg 98

put in

Question 23

How can we help?

Individualize a therapeutic exercise program to improve your patient’s function.

Definition of therapeutic ex pg 2 K & C

put in

Question 24

Balance Testing- name some tests

Answer 24

Unilateral Stance/SLS Test-single leg test
Functional Reach- how far can they reach and keep bal
Timed Get Up and Go-sit to stand
Tinetti Test-
Berg Balance Test

Question 25

what are you Reviewing in the pts chart to assess CLOF

Answer 25

Meds
Vitals as needed

Question 26

What can you do? what can we recommend?

Environmental recommendations

Answer 26

Grab bars/shower bench
NO THROW RUGS!!!!!!!!!!!!!!!

Question 27

Try to address cause
Focus on impairments (Nagi Model) to improve function

Answer 27

Ex: If pain is limiting, address pain
Ex: Decreased ROM, address ROM
Ex: Weakness, perform strengthening exs
Ex: Gait deficits, perform gait training
Assistive devices may be needed
WHEN?

Question 28

Sitting Balance
Static Balance
Dynamic Balance
Proprioception Deficits
Vestibular Deficits
Continuing Ed Classes
Fear

Question 29

What can you do if there is Fear of Falls

Answer 29

Assistive Devices
LRAD
Start in pool if possible
Contact Guard Assist (CGA)
Document!!!
LOTS of practice and feedback as needed
Vary environments to keep pt challenged
DON’T FORGET GAIT BELT TO ENSURE SAFETY!!!!!!!
Relaxation techniques

Question 30

kc 262-263 vestibular

Question 81

Ringed sideroblasts are found in which genetic forms of iron deficiency anemeia

Answer 81

Glutaredoxin5

Question 87

Selective progesterone receptor modulator

Answer 87

Isoprisinol