CH 7: Balance tests and training, coordination tests

Question 1

How can we quantify a patient’s coordination abilities?

Answer 1

• Counting number of reps completed in a given time frame
• Number or % of successes per numbers of attempts
• Qualitatively examining and describing the patient’s abilities and difficulties (steadiness, control, speed)

Question 2

What are the multiple elements that affect coordination?

Answer 2

• Sensory organs
• Muscle function
• CNS centers
• Deficits in coordination revealed by assessments often require follow-up assessments to determine source of coordination deficiency

Question 3

What coordination test?
-An alternating movement test in which patient places hands on thighs (palms down) and then turns the hands over (palms up) and lifts them off thighs as quickly as possible. Patient rapidly returns to starting position to complete 10 reps

Answer 3

Rapid alternating movement

Question 4

What coordination test?

-A reciprocal motion test in which the patient touches the tip of the index finger to the tip of nose

Answer 4

Finger to nose

Question 5

What coordination test?

-A reciprocal motion test in which the patient alternately touches the tip of each finger with the tip of the thumb

Answer 5

Finger opposition

Question 6

What coordination test?

-A static position test in which the arms are held horizontally or the knees are extended

Answer 6

Fixation position hold

Question 7

What coordination test?
-A reciprocal motion and accuracy test in which the patient is supine and is asked to slide the heel of one leg from the ankle to the knee of the opposite leg

Answer 7

Heel on shin

Question 8

What coordination test?

-A reciprocal motion test in with palms are rotated up and down

Answer 8

Pronation-supination

Question 9

What coordination test?
-A reciprocal motion test in which the patient is asked to tap the ball of one foot repeatedly while keeping the heel in contact with the floor. With the hand, the patient is asked to tap the hand on the knee.

Answer 9

Tapping foot or hand

Question 10

What coordination test?

-A reciprocal motion test in which the patient is asked to receive and deliver a ball.

Answer 10

Throwing and catching a ball

Question 11

What often requires a progressive battery of specific tasks of incremental difficulty including various stances, support surfaces, unexpected perturbation, and voluntary movements?

Answer 11

Comprehensive balance assessment and training

Question 12

Progressive Balancing Exercise

-Eyes open, eyes closed, manually applied postural stress. Throwing and catching a ball

Answer 12

Seated

Question 13

Progressive Balancing Exercise

-Uneven surfaces, less stable surface (swiss ball). Eyes open, eyes closed

Answer 13

Seated

Question 14

Progressive Balancing Exercise

• Double leg standing, eyes open, eyes closed, manually applied postural stress, weight shifting
• Single leg standing: eyes open, eyes closed, postural stress

Answer 14

Standing

Question 15

Progressive Balancing Exercise

-All standing drills can be advanced: concrete, carpet, asphalt, tile, grass, loose gravel, dirt

Answer 15

Surface changes

Question 16

Progressive Balancing Tests:

• Double leg: eyes open, closed, hopping
• Single leg: eyes open, closed, hopping

Answer 16

Minitrampoline

Question 17

Progressive Balancing Tests:

-Double and single leg, standing, ambulating, eyes open and closed

Answer 17

Foam padding

Question 18

Progressive Balancing Tests:

-Rocker boards, BAPS, biodex, standing, seated, eyes open and closed

Answer 18

Balancing devices

Question 19

What measures include variables such as length of time in equilibrium, error scoring systems, and distances reached with arms or legs?

Answer 19

Noninstrumental measures

Question 20

What measures often involve technology that records the forces exerted on a support surface or sensors that detect movement and position of the support surface?

Answer 20

Instrumental measures

Question 21

What quantifies static balance?

Answer 21

Postural stress test

Question 22

What measures patient’s ability to maintain balance during a series of progressive graded destabilizing forces?

Answer 22

Postural stress test

Question 23

How does the postural stress test work?

Answer 23

• Pt wears a belt attached to a pulley system with weights
• Without knowledge, weight is applied providing sudden force
• Test is graded on scale from 0 (inability to correct balance) to 9 (no loss of balance)

Question 24

What are the factors that contribute to balance dysfunction?

Answer 24

• Perception
• Behavior
• ROM
• Biomechanical alignment
• Weakness
• Sensory
• Synergistic organization strategy
• Coordination
• Adaptability

Question 25

What are initiated and progress according to the patient’s abilities and goals?

Answer 25

Tasks and drills

Question 26

What are ways to progress LE training?

Answer 26

• Progressive balance training seated
• Progress to standing then reaching and lifting
• Use of physioball and swiss ball

Question 27

What exercises replicate activities of daily living or athletic skills?

Answer 27

CKC exercises

Question 28

What are examples of CKC exercises?

Answer 28

Double leg squats
Forward/Backward gait
Sidestepping
Heel to toe walking
Braiding steps

Question 29

What are some advanced functional balance drills?

Answer 29

• Hopping
• Minitrampoline (hip, knee, ankle)
• Single leg and double leg or hopping with eyes closed
• Commercial training devices (wobble board, BAPS)

Question 30

How would we progress the UE?

Answer 30

Same as LE

Question 31

What of the glenohumeral joint can be enhanced with use of medicine balls or physioballs?

Answer 31

Global stability