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PTRS 853 Final > Examination of Balance > Flashcards

Examination of Balance Flashcards

1
Q

List the components of postural control (2)

A
  1. Postural stability
  2. Postural orientation
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2
Q

Define postural stability

A

Balance

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3
Q

Define postural orientation

A

Ability to maintain appropriate relationship b/t body segments and b/t body and environment

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4
Q

List the areas to observe with a posture examination (3)

A
  1. Alignment [vertical, symmetry]
  2. Foot position [BOS]
  3. Weight scale/Force plates
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5
Q

List what should be noted about the initial position during a posture examination (3)

A
  1. Appropriate for functional tasks?
  2. Efficient [min mm to maintain position]?
  3. Stable [line of gravity with in stability limits]?
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6
Q

List reasons to examin a patients balance (3)

A
  1. ID fall risk
  2. Determine ability to participate in Pt
  3. ID impairment
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7
Q

List the 5 types of balance scales and their goal

A
  1. Quiet standing [goal to stand still]
  2. Active standing [goal of voluntary weight shift
  3. Sensory Manipulation [alt surface/visual condition to assess postural control]
  4. Functional scales [whole body movement]
  5. Dual task
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8
Q

List the quiet standing balance scales (4)

A
  1. Romberg
  2. Sharpened Romberg
  3. One-legged stance test
  4. Postural sway
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9
Q

List the active standing balance scales (2)

A
  1. Functional reach test
  2. Multi-directional reach test
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10
Q

List the sensory manipulation balance scales (2)

A
  1. Sensory organization test
  2. Clinical Test of Sensory Interaction and Balance (CTSIB)
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11
Q

List the functional scales (5)

A
  1. Berg Balance Scale
  2. TUG
  3. Tinetti
  4. DGI
  5. Functional Gait Assessment
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12
Q

List the dual task balance scales (2)

A
  1. Walk and Talk
  2. Mutliple Tasks Test [8 item]
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13
Q

List considerations when selecting an appropriate test (5)

A
  1. Purpose/Population
  2. Reliability/Validity/Ease of Use
  3. Modifications
  4. Norm data available for comparision
  5. Which components of posture will be assessed
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14
Q

Test:

  • Quiet Standing
  • Fold arms across chest, picks one leg and holds hip in neutral and knee flexed to 90 [test both sides]
  • Normal = 30 sec
  • Go intra-rater reliability
  • SLS required for gait, steps, ADLs
A

One leg stance test

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15
Q

Test:

  • Quiet standning
  • Feet together, assess sway EO vs. EC
  • Abnormal = excessive sway, LOB, stepping
  • Subjective
A

Romberg

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16
Q

Test:

  • Quiet standing
  • Feet in heel-toe position, arms folded across chest, EC for 60 sec
A

Sharpened Romberg

17
Q

Test:

  • Active standing
  • Quick screen for balance
  • Norm = > 10” [less = fall risk]
  • Reliable and Valid
  • Modifications include sitting and multi-directional
A

Functional Reach Test

18
Q

Test: Examine the limits of stability in forward, backward, and medial/lateral directions

A

Multi-directional Reach Test

19
Q

Test:

  • Measure balance by assessing functional task
  • 14 item, total score 56, higher score = better function
  • Sitting component
  • Reliable and Valid
  • Has ceiling effect
A

Berg Balance Scale

Low fall risk = 41-56

Medium fall risk = 21-40

High fall risk = 0-20

20
Q

Test:

  • Gait and Balance sub scores
  • Total score = 28
  • Reliable and Valid
A

Tinetti

Low fall risk = 25-28

Moderate fall risk = 19-24

High fall risk = < 19

21
Q

List the test with the best test-retest reliability and predictive ability for fall risk in people > 65 yo

A

POMA

22
Q

List the items of the Tinietti that are for

  1. Steady state balance
  2. Proactive balance
  3. Reactive balance
  4. Sensory component
A
  1. 1 and 5
  2. 2, 3, and 9
  3. 6
  4. 7
23
Q

List the self report measures and what they assess (3)

A

Activity Specific Balance Confidence Test [fear of falling]

Falls efficacy scale [fear of falling

Dizziness Handicap inventory [self perfeived handicap]

24
Q

Test:

  • Assess balance in lying, sitting, standing
  • 12 item
  • Looks at how they maintain balance and change posture
A

Postural Assessment Scale for Stroke

25
Q

Test:

  • Steady state balance
  • Center of gravity location
  • Amount of sway
  • Functional performance
  • Objective, uses force plates
A

Balance Master Assessment

26
Q

Test:

  • USes movable force plate and moveable visual surround to alter the surface and visual environment systematically
  • Stand on force plate, 3, 20 sec trials under each condition
A

Sensory Organization Test

27
Q

Test:

  • Sensory integration test
  • 3-5 trails of 30 sec
  • Use stopwatch and visual observation
  • foam and dome
  • normal = 30 sec w/o LOB
A

CTSIB

28
Q

Test:

  • Assess gait
  • Change surface, speed, horizontal and vertical head position
A

DGI

29
Q

Goals of Balance Tx (4)

A
  1. Objectivity for assessment of prorgression
  2. ID impairments to be addressed
  3. Effective sensory and motor strategies
  4. Consider stead state/reactivity/anticipatory control in functional environments
30
Q

A _________ approach should be used to treat balance

A

Systems

31
Q

Treatment Strategy (4)

A
  1. Postural alignment [efficient, stable, functional]
  2. Motor strategies
  3. Sensory strategies
  4. Gradually increase demand
32
Q

Types of augmented feedback for posture tx (4)

A
  1. Verbal cue
  2. Manual cue
  3. Visual cue
  4. Forceplate
33
Q

Posture Tx (3)

A
  1. Augmented feedback on symmetric/verticla posture
  2. EO vs. EC
  3. Effect of AD
34
Q

Motor Strategies (5)

A
  1. Ankle strategy = small perturbations, sway A/P
  2. Hip strategy = larger perturbations
  3. Stepping strategy = largest perturbation
  4. Add functional meaning
  5. Strength and ROM
35
Q

Control of COG (5)

A
  1. Establish a stable BOS and transfer weight over it
  2. Progression: establish > maintain > reduce BOS to produce automatic/anticipatory responses to weight shift
  3. Sitting [remove UE, move LE]
  4. Sit to stand [alter surface and height]
  5. Standing [stable > reach> narrow BOS > SLS]
36
Q

Sensory Strategies (4)

A
  1. Goal: learn to coordinate/select appropriate sensory info for postural control
  2. Reliance on vision = remove vision to increase somatosensation
  3. Reliance on surface = alter surface to increase vision
  4. Enhance vestibular by altering surface and removing vision

** hard surface rocker bottom = challenges somatosenation

** soft surface rocker bottom = takes somatosensation out of the picture

37
Q

Physical Problems to address in elderly with fall risk (5)

A
  1. Mm strength
  2. Hearing loss
  3. Vision deficit
  4. AD
  5. Activity level

PTRS 853 Final (10 decks)

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