Balance Testing - Class 8

Question 1

almost all neurological issues will have

Answer 1

balance affected

Question 2

we should complete a balance assessment on

Answer 2

a pt with a neuro dz/disorder

history of falls

complaints of dizziness or vertigo

Question 3

definitions of balance

Answer 3

ability to receive afferent sensory input and organize it in an appropriate manner to maintain

upright posture and COG over to BOS

** must have appropriate strength as well**

Question 4

what systems play a role in balance

Answer 4

somatosensory

vision

vestibular

Question 5

somatosensory

Answer 5

proprioception and kinesthesia

Question 6

vision

Answer 6

we rely heavily on vision

big problems in 6th generation +

Question 7

vestibular

Answer 7

awareness of head into space

Question 8

testing somatosensory

Answer 8

superficial and deep sensory assessment

Question 9

vision testing

Answer 9

CN testing of 2,3,4,6

Question 10

strategies for balance

Answer 10

automatic postural responses

3 automatic postural responses

Question 11

automatic postural responses

Answer 11

to keep COG over BOS

occurs rapidly, not under volitational control

Question 12

3 automatic postural responses

Answer 12

ankle strategy

hip strategy

stepping strategy

Question 13

ankle strategy

Answer 13

distal to proximal muscle response

Question 14

when is ankle strategy used

Answer 14

when the sway is small, slow and near midline

Question 15

ankle strategy example

Answer 15

anterior to posterior push will cause DF

vice versa

Question 16

hip strategy

Answer 16

head and hips move in opposite direction

muscle contraction are from proximal to distal

Question 17

when is hip strategy used

Answer 17

when sway is large, fast and nearing the limit of stability

Question 18

example of hip strategy

Answer 18

anterior to posterior push will cause hip/trunk flexion

Question 19

stepping strategy

Answer 19

LE attempts to re-establish a new BOS w/ the active limb by taking a step

Question 20

when is stepping strategy done

Answer 20

done when the COG exceeds BOS

Question 21

vestibular system role in balance

Answer 21

stabilize visual images on the fovea of the retina during head movement to allow clear vision

maintain postural stability, esp during movement of the head

provide info used for spatial orientation

Question 22

standing tests

Answer 22

standing progression tests

Question 23

standing progression tests are done with

Answer 23

arms crossed

must be held for 20-30 s

Question 24

positive standing progression test

Answer 24

pt is unable to maintain position or excessive sway is noted

Question 25

examples of standing progression tests

Answer 25

feet together (romberg test)

tandem (sharpened/tandem romberg)

single leg stance

Question 26

clinical test for sensory interaction on balance (CTSIB) is used to

Answer 26

differentiate which afferent system is not contributing to balance

often called foam and dome testing

Question 27

CTSIB attempts to

Answer 27

take away either 1 or 2 of the 3 sensory components of balance

see how the remaining structures compensate

Question 28

how many components of CTSIB

Answer 28

6

Question 29

how do we progress CTSIB

Answer 29

standing feet together –> stance –> tandem –> SLS

Question 30

goal of CTSIB

Answer 30

not lose their balance for 30 s

for each portion of the test

Question 31

interpreting the results

Answer 31

if a pt fails a test remaining systems are unable to compensate

Question 32

CTSIB results –> eyes are closed

Answer 32

vestibular and SS are working

Question 33

CTSIB results –> isolating

Answer 33

isolate the vestib and the SS on its own or see how the vestib works with vision or how SS w/ vision

Question 34

CTSIB results –> what if vestib fails on its own with conjunction w/ vision

Answer 34

vestib is at fault

Question 35

how do we eliminate vision

Answer 35

close their eyes

Question 36

how do we eliminate SS

Answer 36

stand on unstable surface

Question 37

how do we eliminate vestibular

Answer 37

suppose to put a lantern (foam) over their head or move the walls (via a machine)

clinically have the pt turn thier head side to side

Question 38

fxnal scales

Answer 38

fxnal reach test

berg

tinetti

DGI (dynamic gait index)