Chapter 10 Flashcards
What are some of the neurologic disorders that are at risk for falls?
Stroke, PD, TBI, MS, Cerebellar disorders, CP
What is the rate for falls for stroke patients?
25 - 46%
What is the rate for falls for PD patients?
40 - 68%
What 3 activities are most associated with falls in neurologic pathologies?
Mobility (gait), transfers, stair climbing
What factors can contribute to the variability of postural control problems in patients with neurological injuries?
- type of neurological injury
- degree of lesion
- location
- age
- premorbid condition
- extent of compensation
What are the contributions to abnormal postural control?
- problems in the action system, sensory/perceptual systems, cognitive systems
- loss of anticipatory postural control
- impaired seated postural control
What postural abnormalities exist within children with CP while seated?
Pelvis tipped backwards (shortened hamstrings)
What postural abnormalities exist within children with CP while standing?
Toe walking (shortened gastrocnemius) Increased knee flexion (tight hip flexors)
What causes “stooped” posture in PD?
Rigidity and decreased spinal flexibility
What are some characteristics of “stooped” posture?
Staring gaze, forward bent posture, tremor, rigidity, flexed elbows/wrists, short shuffling steps
What happens to spontaneous sway when PD patients take levodopa?
Decreases
What is the result of abnormal sequencing?
Less torque and larger shifts of the body’s COM in spastic limb
What changes can take place in quiet stance?
Alignment
Spontaneous sway
What are the impaired movement strategies seen during perturbed stance?
Sequencing problems
Coactivation
Delayed activation of postural responses
Problems modifying postural strategies
What is coactivation?
A common postural coordination strategy in people with neurologic conditions
Normal posture requires…
Organization of sensory info from visual, somato and vestibular systems that provide information about body’s position and movement with respect to the environment and coordination of sensory info with motor action
What’s the effect of a loss of sensory input?
Depends on
- availability of other senses to detect body position in space
- availability of accurate orientation cues
- ability to accurately interpret and select sensory information for orientation
Visually dependent CTSIB findings
2,3,5,6
Surface dependent CTSIB findings
4,5,6
Vestibular loss CTSIB findings
5,6
Sensory selection problems findings
3,4,5,6
What are sensory selection problems?
Inability to appropriately select a sense for postural control in environments in which one or more orientation cues inaccurately report body’s position in space
Which populations have sensory selection problems?
stroke, TBI, CP, down syndrome, learning disabilities
Acquisition of sitting balance is a good predictor of ______.
functional outcomes, it’s a prognostic indicator
