Lecture 11: Trunk Control and Balance

Question 1

functional independence requires which 3 factors related to trunk control

Answer 1

Contraction to move opposite gravity

Preventing movement occurring due to gravity

Controlling speed of movement

Question 2

insufficient control of trunk flexors can lead to which 2 issues with seating

Answer 2

pelvis moves posteriorly

extension of unaffected U/E and L/E to push off surface

Question 3

insufficient control of trunk extensors can lead to which 3 issues

Answer 3

shoulder elevation of the reaching arm with associated lateral flexion to the opposite side

trunk flexion with resultant change in scapula position

change in head position in space for vision and swallowing
concerns

Question 4

Loss of co-activation of the trunk flexor and extensor muscles usually leads to which 3 issues

Answer 4

nability to shift weight over pelvis and results in collapsing laterally over trunk

overuse of shoulder elevation and lateral flexion

unilateral increased trunk flexion or extension

Question 5

what is the number 1 muscle function indicator of independence post stroke

Answer 5

trunk control

Question 6

why is posterior tilt an issue for wheelchair users

Answer 6

very high pressure area on butt

Question 7

what are the 2 needs of the elderly manual wheelchair population

Answer 7

Comfort

Propulsion

Question 8

can most elderly wheelchair users could propel their own wheelchair under their own power

Answer 8

less than half!

Question 9

what are the 2 common issues that elderly people have with their wheelchairs

Answer 9

fit of the wheelchair (seat height is usually too high)

set up of the wheelchair (location of rear wheels)

Question 10

What are the 4 key factors to consider for fit and function for a wheelchair

Answer 10

Seat width

Seat depth

Seat height

Upper extremity support

Question 11

what should you keep in mind when determining weight height for foot propulsion

Answer 11

Making the foot touch the ground

Lower leg length – 1”

Question 12

what happens if the Seat to floor height too high a foot propellor

Answer 12

Cannot foot propel adequately

Increased posterior pelvic tilt

Question 13

what happens if seat width is too wide

Answer 13

Promotes pelvic obliquity (one side lower than the other)

Hard to reach wheels to propel with right arm

Question 14

what happens if the rear wheels too far back

Answer 14

Very difficult to self-propel chair

Majority of their weight is distributed in front of the rear axles making the chair feel very heavy

Question 15

where should the rear wheel be

Answer 15

in line with middle finger and shoulder

Question 16

when observing someones balance, what 4 things should you look for

Answer 16

Postural alignment

BOS (narrow or wide)

Movement strategies used to maintain standing balance

Presence or absence of anticipatory postural adjustment

Question 17

what are 3 remediation strategies for poor balance

Answer 17

Standing postural control (reteaching using hips not arms)

Postural alignment and movement strategies

Retraining sensory organization (adapting to
changing sensory conditions)

Question 18

what are 2 compensation strategies for poor balance

Answer 18

wheelchair, sitting bench in shower