Chapter 10

Question 1

What are some of the neurologic disorders that are at risk for falls?

Answer 1

Stroke, PD, TBI, MS, Cerebellar disorders, CP

Question 2

What is the rate for falls for stroke patients?

Answer 2

25 - 46%

Question 3

What is the rate for falls for PD patients?

Answer 3

40 - 68%

Question 4

What 3 activities are most associated with falls in neurologic pathologies?

Answer 4

Mobility (gait), transfers, stair climbing

Question 5

What factors can contribute to the variability of postural control problems in patients with neurological injuries?

Answer 5

• type of neurological injury
• degree of lesion
• location
• age
• premorbid condition
• extent of compensation

Question 6

What are the contributions to abnormal postural control?

Answer 6

• problems in the action system, sensory/perceptual systems, cognitive systems
• loss of anticipatory postural control
• impaired seated postural control

Question 7

What postural abnormalities exist within children with CP while seated?

Answer 7

Pelvis tipped backwards (shortened hamstrings)

Question 8

What postural abnormalities exist within children with CP while standing?

Answer 8

Toe walking (shortened gastrocnemius)
Increased knee flexion (tight hip flexors)

Question 9

What causes “stooped” posture in PD?

Answer 9

Rigidity and decreased spinal flexibility

Question 10

What are some characteristics of “stooped” posture?

Answer 10

Staring gaze, forward bent posture, tremor, rigidity, flexed elbows/wrists, short shuffling steps

Question 11

What happens to spontaneous sway when PD patients take levodopa?

Answer 11

Decreases

Question 12

What is the result of abnormal sequencing?

Answer 12

Less torque and larger shifts of the body’s COM in spastic limb

Question 13

What changes can take place in quiet stance?

Answer 13

Alignment

Spontaneous sway

Question 14

What are the impaired movement strategies seen during perturbed stance?

Answer 14

Sequencing problems
Coactivation
Delayed activation of postural responses
Problems modifying postural strategies

Question 15

What is coactivation?

Answer 15

A common postural coordination strategy in people with neurologic conditions

Question 16

Normal posture requires…

Answer 16

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

Question 17

What’s the effect of a loss of sensory input?

Answer 17

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

Question 18

Visually dependent CTSIB findings

Answer 18

2,3,5,6

Question 19

Surface dependent CTSIB findings

Answer 19

4,5,6

Question 20

Vestibular loss CTSIB findings

Answer 20

5,6

Question 21

Sensory selection problems findings

Answer 21

3,4,5,6

Question 22

What are sensory selection problems?

Answer 22

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

Question 23

Which populations have sensory selection problems?

Answer 23

stroke, TBI, CP, down syndrome, learning disabilities

Question 24

Acquisition of sitting balance is a good predictor of ______.

Answer 24

functional outcomes, it’s a prognostic indicator