MC: Posture & Balance

Question 1

Center of Pressure (COP)

Answer 1

• center of the distribution of total forces applied to the support surface
• average “location” of these forces

It is a point on a 2-D plane!

Question 2

“cone of stability”

Answer 2

boundaries within which the body can maintain stability without changing the base of support.

Question 3

Describing balance…

Answer 3

Zero: unable to maintain balance or no attempt made

Poor: able to balance with or without UE support for 5 seconds or less

Fair: able to balance with or without UE support from 15 - 60 seconds and/or able to hold against slight resistance

Good: able to hold balance against moderate resistance

Question 4

Four Types of Balance

Answer 4

Static
Dynamic
Protective
Functional

Question 5

Balance Skill Set

Answer 5

Static Balance(T)
Static Balance(R)
Static Balance(AFF)
Dynamic Balance(RFB)
Dynamic Balance(AFF)
Protective Reactions
Functional Balance

Question 6

Static BalanceT - Time

Answer 6

Maintain a position over time

Question 7

Static BalanceR - Resistance

Answer 7

Subjective assessment

• rhythmic stabilization
• alternating isometrics

Objective assessment
-hand-held dynamometer

Question 8

Static Balance Basic ProceduresPatient Position - Sitting

Answer 8

Sitting on a height-adjustable table

Feet flat on the floor

Hips and knees at 90deg

Maximize thigh contact on support surface - stable BOS

UE unsupported or supported

Question 9

PT force application

Answer 9

Anterior – mid-sternum
Posterior – mid-upper back b/w scapula
Lateral – acromion

Question 10

Static BalanceAFF-Anticipatory, feed-forward

Answer 10

Reach in various directions WITHIN arm’s

Anticipating what muscle actions or motor control is necessary to prevent falling due to the progressive weight of the arm

Question 11

Dynamic Balance RFB - Reactive, feedback

Answer 11

Manually displace the COM toward the edges of the BOS to elicit the equilibrium or balance reactions

(stimulus > response = feedback)

Question 12

Dynamic BalanceAFF - Anticipatory, feed-forward

Answer 12

Reach in various directions BEYOND arm’s length to elicit trunk and arm (sitting) and whole body (standing) balance reactions

Question 13

Dynamic Balance – Protective Reactions

Answer 13

PT manual perturbations to elicit patient change in BOS to accommodate COM beyond BOS

• 1st Slow perturbations to just beyond BOS or “cone of stability”
• 2nd, relatively faster perturbations (yet safe)