Lecture 15

Question 1

3 Stages of information processing

Answer 1

Sensory input
sensorimotor integration
motor output generation

Question 2

Sensorimotor integration impairments

Answer 2

impairments in: basal ganglia, cerebellum, motor area
brain, afferent, sensory

Question 3

Results of sensorimotor impairments

Answer 3

impairment in processing of incoming sensory info

difficulty utilizing sensory info from changes in environment

decreased coordination

disruption of anticipatory and reactive postural adjustments

Question 4

Motor output generation

Answer 4

cannot properly execute the action
peripheral problem, efferent, motor
neuromusculoskeletal impairment

compromised posture
compromised joint instability
ROM limitations
decreased muscle performance
pain

Question 5

Neurologic impairments

Answer 5

disorder of peripheral nerve, unable to generate muscle force for balance

CMT = results in abnormal myelin that is unstable and spontaneously break down. Foot drop, high-step gait

Question 6

Intrinsic factors that are risk factors for falls

Answer 6

muscle weakness
visual deficit
history of falls
arthritis, diabetes, stroke, dementia, incontinence
gait & balance problems
fear of fallings
age > 80

Question 7

Extrinsic factors that are risk factors for falls

Answer 7

lack of stair handrails
poor stair design
lack of bathroom grab bars
dim lighting or glare
tripping hazards
slippery or uneven surfaces
psychoactive medications
improper use of assistive devices

Question 8

Screening Tool Questions

Answer 8

Have you fallen in the past year?
Do you feel unsteady when standing or walking?
Do you worry about falling?

Yes to ANY = conduct fall risk assessment
No to ALL = prevent future fall risk

Question 9

Exam and Eval of Impaired Balance and Mobility

Answer 9

Balance: static, dynamic, anticipatory, reactive, sensory organization
Functional activities
Safety during gait, locomotion, balance

Question 10

Static balance control

Answer 10

used during stationary tasks, standing or sitting

Question 11

Dynamic balance control

Answer 11

used when support surface or body is moving. Sit to stand, walking, sports

Question 12

Static Balance Test

Answer 12

used to determine ability to maintain different postures

Question 13

Dynamic Balance Test

Answer 13

Determines ability to sit or stand on unstable surface; perform walking, jumping, hopping

Question 14

Anticipatory postural control

Answer 14

mechanisms predict disturbances and produce preprogrammed responses that maintain a desired state

Question 15

Reactive postural balance control

Answer 15

mechanisms are activated by sensory events following the loss of desirable posture or in response to sensory signals compared to desired state. split second decisions

Question 16

Functional Reach Test

Answer 16

anticipatory
reach as far as possible w/o changing BOS

Question 17

Push and Release Test

Answer 17

reactive
pt pushes scapulae into examiner’s hands, then examiner removes hands. score on steps to regain balance

Question 18

Functional Balance Tests

Answer 18

used to determine activity and participation restrictions, to identify tasks that pt needs to practice, to assess risk fall in elderly

TUG test = timed up and go test. walk 3 meters.
<10s = completely independent
>30s = requires assistance/dependent in most activities

Question 19

Foam and Dome Test

Answer 19

ability to balance under 6 different conditions.
EO, EC, vision, solid surface, thick foam.

Helps to differentiate between visual, somatosensory, vestibular

Question 20

Contraindications of balance exercises

Answer 20

inherently unsafe when balance is challenged

cognitive impairments

condition that prevents ability to understand the purpose or hazard of activity

medication or drugs

Question 21

EO/EC

Answer 21

eyes open, eyes closed

Question 22

Sensory input challenges

Answer 22

visual: EO/EC
vestibular: head turning
proprioceptive: stable/unstable

Question 23

Perturbations

Answer 23

include anticipatory and reactive tasks

Question 24

Environmental complexity

Answer 24

changing surfaces, lights, quiet to busy, etc

Question 25

Prevention of Falls in Older Persons

Answer 25

exercise should be included
programs should target strength, gait, balance
home environment assessment
perturbation training

Question 26

Internal perturbations

Answer 26

self-initiated generation of power

Question 27

External perturbations

Answer 27

caused by forces outside participants control

Question 28

Dosage ACSM Neuromotor Exercise

Answer 28

2 or 3 days per week
20-30 minutes per session
balance, agility, coordination, gait