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6 Neurological Dysfunction > L1 Balance Exam > Flashcards

L1 Balance Exam Flashcards

1
Q

Postural control standing vs sitting

A

standing & sitting are the same = static, proactive, reactive

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2
Q

Stable trunk for limb motion standing vs sitting

A

Standing = to allow for gait
Sitting = to allow for standing and gait

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3
Q

Direction of control standing vs sitting

A

standing = A/P
sitting = lateral and A/P

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4
Q

BOS standing vs sitting

A

Standing = feet
Sitting = feet, thighs, buttocks

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5
Q

Somatosensory input standing vs sitting

A

standing = feet
sitting = feet, thighs, buttocks

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6
Q

LE contribution standing vs sitting

A

Standing = multiple degrees of freedom
sitting = less degrees of freedom

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7
Q

Verticality

A

ability to orient appropriately with respect to gravity

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8
Q

Dynamic stability/balance

A

ability to maintain stable upright posture during self-initiated body or body-segment active movement

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9
Q

Static stability/balance

A

ability to maintain stable upright posture without self-initiated movement

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10
Q

Anticipatory/Proactive postural control

A

ability to activate muscles to shift the COM before a discrete voluntary movement
relies on fedforward motor control

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11
Q

Reactive postural control/balance

A

ability to recover a stable position following an unexpected perturbation to bring the COM within the BOS through corrective movements

relies on feedback motor control

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12
Q

Perturbation

A

deviation of an object from its normal state or path by an outside influence

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13
Q

Sensory integration

A

ability to integrate all sensory systems inputs to influence selection of motor output to maintain postural control

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14
Q

Sensory reweighting

A

ability to reweight sensory information when input is altered

individuals will reweight sensory input based on changes to environment. Individuals with impaired sensory systems will have limited ability to re-weight sensory info

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15
Q

Cognitive influences

A

ability to maintain stability while responding to commands during the task or attend to additional tasks

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16
Q

Postural constraint

A

a deficit in one or more balance resources that leads to impaired postural control or balance.

a body structure/function impairment can be the underlying cause of the postural constraint

17
Q

Balance emerges from the interaction of…

A

individual
task
environment

18
Q

Individual (postural control systems framework)

A

motor
sensory
cognitive

19
Q

Postural tasks (postural control systems framework)

A

proactive
reactive
steady state

20
Q

Environment (postural control systems framework)

A

support surfaces
sensory context
cognitive load

21
Q

Balance Resources

A

Biomechanical
Movement Strategies
Sensory Strategies
Orientation in Space/Verticality
Control of Dynamics
Cognitive Processing

22
Q

Biomechanical Resources

A

BOS
LOS
DOF (degrees of freedom)
Strength

23
Q

Movement Strategies

A

Strategies to maintain balance: Voluntary, Anticipatory, Reactive. Also includes ankle, hip, stepping, protective reactions.

24
Q

Protective Reactions

A

used to attempt to increase the BOS to either prevent the fall or to lessen injury if a fall occurs

protective extension
grasp for stable object

25
Q

Sensory Strategies

A

sensory information is integrated in the CNS to interpret complex sensory environment to create a motor plan to maintain equilibrium

somatosensory, visual, vestibular

26
Q

Posturography

A

test and examine sensory conditions with technology

27
Q

Modified Clinical Test of Sensory Interaction in Balance

A

used for when you don’t have technology

Record time, including amount of sway or loss of imbalance, and recovery strategy

28
Q

Eyes open and firm surface

A

baseline observation for sway

29
Q

Eyes closed and firm surface

A

increased sway indicates balance problem, possible vestibular or somatosensory impairment

30
Q

Eyes open and on foam

A

increased sway indicates balance problem and visual or vestibular problem, OR over-reliant on somatosensory

31
Q

Eyes closed and on foam

A

increased sway indicates balance problem and likely vestibular problem OR over reliant on vision and somatosensory systems

32
Q

Orientation in Space/Verticality

A

-ability to orient the body parts with respect to gravity, the support surface, visual surround and internal references

-healthy nervous systems automatically alter how the body is orientated in space depending on the context and the task

33
Q

Control of Dynamics

A

ability to control balance during gait and while changing from one posture to another. requires complex control of COM.

body structure/function impairments in any part of this complex control system can interfere with control of dynamics

stability during gait comes from placing the swing limb under the falling COM, essentially a controlled fall

34
Q

Cognitive Processing

A

control of posture and other processing share cognitive resources

balance task difficulty increases or cognitive challenge increase, one will decline to compensate. If you have decreased cognitive processing, you will have decreased balance

35
Q

What is a significant risk factor for falling?

A

cognitive impairment
less able to dual task

36
Q

What is the most dangerous patient subjective impression vs performance?

A

high confidence, low performance

37
Q

ABC scale

A

Activities-specific balance confidence scale

most commonly used by PTs
higher score indicates more confidence

score below 67% indicates increased risk of falling

38
Q

Total score of balance exam

A

use to document severity of balance
change over time of balance impairment
predict fall risk and safety at home, guiding towards need for AD, helping decide if they need PT

39
Q

Item by Item of Balance Exam

A

gives you idea of what balance contraints and tasks need to be addressed

6 Neurological Dysfunction (16 decks)

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