Impairment of Coordination and Balance Flashcards
What is coordination?
Coordination is the ability to solve any motor task precisely, quickly, rationally and deftly with flexibility with respect to the changing environment
How do we assess coordination?
Using measures of speed and accuracy of movements (e.g. LEMOCOT for lower limb coordination)
What is the relationship btw strength and coordination?
There is some independence btw recovery of strength and dexterity (coordination), but strength is the major independent contributor to function. Therefore, function is not possible without strength, but strength and dexterity may recover independently. Clinical implications of this is that both loss of strength and loss of coordination need to be addressed in training
Training strength & coordination for muscle grade 0 - paralysed
STRENGTH: eliciting muscle activity in mid-range
COORDINATION: not practical
Training strength & coordination for muscle grade 1-2 - very weak
STRENGTH: full range exercises, resistance in mid-range only
COORDINATION: part or whole practice & automaticity applicable
Training strength & coordination for muscle grade 3 - weak
STRENGTH: resistance exercises across full range
COORDINATION: part or whole practice & automaticity applicable
Training strength & coordination for muscle grade 4 - strong
STRENGTH: not essential
COORDINATION: part or whole practice & automaticity applicable
What interventions are used to increase coordination?
- Task related part/modified training
- Whole task training
- Task training to increase automaticity and flexibility
What is balance?
Balance is the ability to maintain the projection of the body’s centre of mass within manageable limits of the base of support, as in standing or sitting, or in transit to a new base of support, as in walking
What do we use to assess balance?
- Balanced sitting item (3) MAS for stroke
- Berg Balance test
- Step test
What are postural adjustments?
Postural adjustments are the muscle activity and segmental movements concerned with the preservation of stability. They are anticipatory and ongoing, specific to forthcoming movements, and these movements are not just muscle activity. The clinical significance of these, is that we need to train tasks and not balance as a separate entity (e.g. train sitting, standing, walking, running, etc.)
What inputs assist with maintaining balance?
Proprioception, tactile sensation, vestibular system, and vision
Description and assessment for proprioception
Sensory information about body and limb position that is transmitted to the CNS from the proprioceptors
ASSESSMENT: Matching (Nottingham Sensory)
Description and assessment for tactile sensation
Sensory receptors in the skin that respond to pain, temperature, touch and pressure. Provides information about the BoS’s contact with the environment
ASSESSMENT: sharp vs blunt test, Nottingham Sensory assessment
Description and assessment for vestibular system
Provides information about the body’s orientation and movement. Vestibular system is made up of 3 semi-circular canals in the inner ear and utricle. Semi-circular canals are located at right angles to each other to provide information about all directions
ASSESSMENT: clinical symptoms, dizziness rolling over in bed
