Neuromuscular 2 Unit 9 Balance and Gait Interventions Flashcards
Category 1
What are the 3 Control Strategies for Balance?
- Steady State (static) Postural Control
- Anticipatory Postural Control
- Reactive Postural Control
Category 1: Control Strategies for Balance
What is Steady State Postural Control?
The ability to control the location of the body’s COM within the area defined by the BOS under predictable, quasi-static conditions.
- This includes the ability to adapt motor behavior to meet the demands of different task and environmental conditions
Category 1: Control Strategies for Balance
What is Anticipatory Postural Control?
The ability to generate postural adjustments prior to the onset of and during voluntary movement for the purpose of either countering an upcoming postural disturbance due to voluntary movement or realigning the body’s COM prior to changing the BOS.
- This includes the ability to adapt motor behavior to meet the demands of different task and enviornmental conditions
Category 1: Control Strategies for Balance
What is Reactive Postural Control?
The ability to respond to sensory input that signals a need for a response to ensure successful maintenace of postural control. The need for response is unanticipated but may be generated externally (pertubation originating external to body) or secondary to an internally generated movement.
- This includes the ability to adapt motor behavior to meet the demands of different task and environmental conditions
Category 1: Control Strategies for Balance
What are the Deficits in Steady State Postural Control (SSPC)?
- Postural Movement Strategies: Primarily related to abnormal postural movement strategies
- Sensory Processing: Primarily related to abnormal sensory integrity/processing
- Balance confidence: Primarily related to fear of falling/reduced self-efficacy
- Verticality: Primarily related to impaired orientation with respect to gravity
Category 1: Control Strategies for Balance
What are the Deficits in Anticipatory Postural Control (APC)?
- Postural Movement Strategies: Primarily related to abnormal postural movement strategies
- Sensory Processing: Primarily related to abnormal sensory integrity/processing
- Balance confidence: Primarily related to fear of falling/reduced self-efficacy
- Executive Function/Multi-task Ability: Primarily related to impaired dual-task ability
Category 1: Control Strategies for Balance
What are the Deficits in Reactive Postural Control (RPC)?
- Postural Movement Strategies: Primarily related to abnormal postural movement strategies
- Sensory Processing: Primarily related to abnormal sensory integrity/processing
With the Sitting Core Task, what balance type is used?
- Steady State
- Anticipatory: Dynamic Task Variation
- Reactive: Spontaneous LOB or pertubated
With Sit to Stand Core Task, what balance type is used?
Anticipatory
With the Standing Core Task, what balance type is used?
- Steady State
- Anticipatory: Dynamic Task Variation
- Reactive: Spontaneous LOB or pertubated
With the Walk and Turn Core Task, what balance type is used?
Anticipatory
With the Step Up Step Down Core Task, what balance type is used?
Anticipatory
With the Reach and Grasp Core Task, what balance type is used?
Anticipatory
Category 2
What are the Underlying Determinants of Balance?
- MSK: ROM, Flexibility, Muscle performance, alignment/posture
- Neuromuscular: Coordination, postural movement strategies, sensory integrity, sensory processing, perceptual function including verticality
- Cognitive/Metal Function: Arousal, attention, exclusive function, multi-task ability
- Behavioral Factors: Balance confidence, falls self-efficacy, fear of falling, past experience
What are the Focus of Interventions for Steady State Postural Control: Postural Movement Strategies?
Develop initial conditions appropriate for tasks and increase efficiency for organiziation and timing of motor responses generated to allow for sitting and standing under various task and environmental conditions
What are the Suggested Intervention strategies for Test Specific Training for Steady State Postural Control: Postural Movement Strategies?
- Practice aligning body during various tasks while using augmented sensory feedback (visual, manual, verbal auditory, vibrotactile) to assist in finding a vertical posture that maintains line of gravity within individual’s stability limits
- Practice maintaining alignment and stability in sitting and standing during various base of support conditions
What are the Focus of Interventions for Steady State Postural Control: Sensory Processing?
Improve organization and selection of appropriate sensory information for postural control under various task and environmental conditions
What are the Suggested Intervention strategies for Test Specific Training for Steady State Postural Control: Sensory Processing?
Practice maintaining sitting or standing under predictable and unpredictable sensory and BOS conditions while systematically varying availability and accuracy of 1 or more senses for orientation (Vestibular, visual, somatosensation)
What are the Focus of Interventions for Steady State Postural Control: Verticality?
Improve internal reference for vertical position for postural control under various task and environmental conditions
What are the Suggested Intervention strategies for Test Specific Training for Steady State Postural Control: Verticality?
Practice achieving midline in sitting and standing using environmental vertical cues (mirror, doorway, wall) to augment individual’s perception of vertical
What are the Focus of Interventions for Steady State Postural Control: Balance Confidence?
Improve balance confidence and self-efficacy so individual’s perceived balance abilities more closely align with actual balance abilites under various task and environmental conditions
What are the Suggested Intervention strategies for Test Specific Training for Steady State Postural Control: Balance Confidence?
Practice sitting or standing postures under conditions that do not necessitate use of balance recovery strategies. Focus is on self-efficacy coaching while altering degree of postural control challenge (e.g., reducing UE support, changing BOS)
What are the Focus of Interventions for Anticipatory Postural Control: Postural Movement Strategies?
Improve organization and timing of motor responses generated prior to and concomitant with voluntary movement use to control COM under various task and environmental conditions
What are the Suggested Interventions Strategies for Task-Specific Training for Anticipatory Postural Control: Postural Movement Strategies?
Practice tasks that require predictable dynamic control of COM