balance testing

Question 1

how to perform

Answer 1

patient sits with feet on floor, hands on thighs
observe: alignment, BoS, weight into pelvis, how active trunk is to maintain posture, head/spine orientation
move: hands from midline, to touch physios, look to see stability
increase plinth height, close eyes with arms crossed over chest, pull shoulders back/side/forwards, speed up
standing with hand on plinth, stretch to touch > without plinth > eyes closed > narrow feet/BoS > unstable surface > 1 leg (in front of plinth)
walking balance, posture, gait > eyes closed > backwards

vestibular system: track, scan, catching ball

Romberg’s test:
Patient stands with 1 foot in front of another
Observe postural sway with eyes open/closed, hold for 10sec
sharpened R test:
1 leg, eyes open, stand in front of plinth

Question 2

contraindications

Answer 2

MSK: fracture, recent surgery
CR: infection
CV: disease, uncontrolled hypertension
N: pain, conscious

Question 3

purpose

Answer 3

capability to balance effectively when placed under differing pressures, capacity to remain in a stable threshold and maintain postural control
Highlights any abnormalities to formulate treatment
test righting reactions of body when made unstable

Question 4

how to know if normal

Answer 4

normal alignment/posture - equal weight through thighs, BoS on ischial tuberosities, lumbar spine in mid flexion
correct muscles activated
compare sides
quick reaction times, responding when eyes are closed
discuss with patient if any changes in balance/sitting

Question 5

principles

Answer 5

2 physios in a safe environment, patient is supported by plinth if needed
taking CoG outside BoS
functional, static & dynamic assessment

Question 6

structures

Answer 6

muscles of trunk & limb
capability of vision, proprioception, vestibular systems

affecting/manipulating BOS and COG, reaching stability limit
testing whether correct muscles maintain form
add stimulus/ball to test vestibular system