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Motor Control > Chapter 11 > Flashcards

Chapter 11 Flashcards

1
Q

What are some examples of body functions and their structures?

A

Mental functions [structures of the nervous system]
Sensory functions and pain [eye, ear and related structures]
Neuromusculoskeletal and movement-related functions [structures related to movement]
Voice and speech functions [structures related to voice and speech]
Functions and [structures] of the cardiovascular, haematological, immunological and respiratory systems

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2
Q

What are some examples of different activities and participation?

A 
Learning and applying knowledge 
General tasks and demands 
Communication 
Movement 
Self care 
Domestic life areas 
Major life areas 
Interpersonal interactions 
Community, social and civic life
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3
Q

What are some examples of various environmental factors?

A 
Natural environment
Human-made changes to the environment 
Support and relationships 
Attitudes 
Services, systems and policies 
Products and technology
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4
Q

T/F Balance can be examined by one test.

A

False

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5
Q

What are self efficacy scales?

A

Questionnaires on confidence in doing certain ADLs

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6
Q

What are two self efficacy scales often used in clinics?

A

Activity-specific Balance Confidence Scale (ABC)

Falls Efficacy Scale (FES)

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7
Q

What are the instructions for the TUG?

A

Stand up, walk 3 m (10 ft), turn around, return and sit in chair

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8
Q

What do the TUG results indicate?

A 
10 = freely independent
20 = independent in basic transfers
20-29 = gray zone
>30 = need help with chair/toilet transfers, in/out tub, assistance with stairs, unable to go out alone
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9
Q

Who is the TUG indicated for?

A

Sensitive and specific indicator for falls in community dwelling older adults (>15)

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10
Q

What is the functional reach test (FRT) used for?

A

Quick screen for balance problems and risk for falls in older adults

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11
Q

What is the Performance Oriented Mobility Assessment used for? What are the subscales/point totals?

A

Used for frail elderly

Balance subscale = 9 items, 16 points
Gait subscale = 7 items, 12 points
MAX TOAL = 28 points

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12
Q

What do POMA scores indicate?

A 
<19 = high risk
19-24 = moderate risk
24-28 = low risk
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13
Q

Who is the Berg Balance Test indicated for?

A

Community dwelling older adults

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14
Q

How many items are on the Berg Balance Test? What do the scores mean?

A

14 items, each on a (0-4) scale

> 32 = 100% risk of falls
decreases from there, at 10% with 56 points

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15
Q

What is the Short Physical Performance Battery used for?

A

Measures LE performance (strength, balance, mobility) in older adults

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16
Q

Who developed the BESTest and what does it look at?

A

Balance Evaluation Systems Test

By Horak in 2009, examines multiple aspects of postural control, 36 items in 6 systems

17
Q

What are the 6 systems of the BESTest?

A 
1 = biomechanical constraints
2 = stability limits
3 = anticipatory-transitions
4 = postural responses
5 = sensory organization
6 = dynamic gait
18
Q

What postural alignment strategies are used to maintain balance?

A

posture, weight bearing, width of BOS, location of COP

19
Q

What are automatic postural responses?

A

Keep the COG over the BOS in response to a stimulus or unexpected perturbation. They are rapid and involuntary

20
Q

What are some examples of automatic postural responses?

A

Ankle, hip, stepping strategies
Adaptive postural responses
Reactive postural responses

21
Q

How do you test reactive control?

A

Nudge Test (POMA #6) = unexpected external perturbation at sternum, pt has feet as close together as possible, PT pushes lightly 3 times

22
Q

What are the scores for the Nudge Test?

A 
0 = begins to fall
1 = staggers, grabs, catches self
2 = steady
23
Q

How can you examine proactive postural responses?

A

Have pt lift a heavy grocery bag

24
Q

What motor problems are examined?

A

Motor coordination
Muscle strength, power
Involuntary movements

25
Q

What cognitive status aspects are examined?

A 
Alertness
Memory
Orientation
Attention
Learning
26
Q

What sensory/perceptual status aspects are examined?

A

Somatosensory problem
Visual problem
Vestibular problem
Impaired body image and spatial relationship

27
Q

What is the ultimate goal of task-oriented balance rehab?

A

To improve participation outcomes, reflected in ability to participate in social roles, tasks and activities important in ADLs

28
Q

How can you progress sitting balance?

A

Progressively less surface contact

  • Remove UE support
  • Make surface less stable
  • Add UE activities
  • Increase limits of stability through reaching and throwing activities
29
Q

What are some ways to improve control of COG in standing?

A 
Slow weight shifts
Elastic band LE exercise
Standing sway
Sit to stand
Tai Chi
Add UE activities
30
Q

What are some exercises to promote ankle strategy?

A

Standing sway exercise
Slow small perturbations either self generated or external
Computerized limits of stability training
Increase difficulty with UE, head or eye movements
Functional activities
Increase difficulty with resistance

31
Q

What are some exercises to promote hip strategy?

A

Standing sway using a table and a wall, patient instructed to bow to move nose towards the table
Standing on a rail, add UE activities as able
Use moderate rapid perturbations either self generated or external
Tandem standing (sharpened Romberg) or walking
Single limb support
Large anterior/posterior weight shifts on a variety of surfaces
Functional activities (reaching into trunk of a car, laundry dryer)

32
Q

What are some exercises to promote stepping strategy?

A

Standing sway with large sways, consciously taking step forward and backward
Ambulate in tandem, promote balance steps
Stepping over obstacle
Walking on uneven surfaces
Large rapid perturbations such that the hip strategy would be inadequate and stepping or reaching is required; progress from predictable to unpredictable disturbances

33
Q

What are the benefits of combined exercise programs?

A

Improve balance
Improve mobility
Reduce risk for falls

Motor Control (6 decks)

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