Other Neuro Stuff

Question 1

Stepping strategy

Answer 1

elicited through unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the center of gravity is beyond the base of support.

Question 2

Which balance grade would be most appropriate for a patient that is able to maintain balance without support, but cannot maintain balance while weight shifting?

Answer 2

Fair

Question 3

Which of the balance reflexes attempts to support gaze stabilization by ensuring that the retina creates a stable image during head movement?

Answer 3

Vestibulo-ocular relfex (VOR)

coordinates head and eye movement. This allows the retina to create a stable image when the head is moving. An example of this reflex in action occurs when an image is held stable 12-18 inches from the face and the patient moves their head side to side. The VOR allows the patient to coordinate their eyes to produce a clear image.

Question 4

VOR

Answer 4

coordinates head and eye movement. This allows the retina to create a stable image when the head is moving. An example of this reflex in action occurs when an image is held stable 12-18 inches from the face and the patient moves their head side to side. The VOR allows the patient to coordinate their eyes to produce a clear image.

Question 5

An individual who exhibits the ability to maintain stability and orientation with the center of mass over the base of support without movement would be demonstrating:

Answer 5

Postural Stability Control

Question 6

Postural stability control

Answer 6

Ability to maintain stability and orientation with the center of mass over the base of support at rest. An example of an individual who exhibits appropriate postural stability control is an individual who maintains their balance while standing still.

Question 7

Rhomberg test

Answer 7

A/P balance measurement

Question 8

Sharpened Rhomberg test

Answer 8

• Medial/lateral balance testing
• Feet positioned heel-to-toe with the eyes closed for one minute

Question 9

What is a positive Rhomberg test?

Answer 9

• • = patient being able to stand with no more than minimal sway with the eyes open, but presents with increased instability or falls with the eyes closed.
• Indicative of a loss of proprioception often associated with a posterior column lesion in the spinal cord or a peripheral neuropathy.

Question 10

In standing, which muscle group would initially respond to a small anterior perturbation?

Answer 10

plantar flexors

A small perturbation would elicit an ankle strategy to regain balance. Since it was an anterior perturbation, the plantar flexors would be elicited in response.

Question 11

Anticipatory postural activity is most heavily dependent on:

Answer 11

previous experience and learning

Loss of anticipatory processes that activate postural adjustments in advance of potentially destabilizing voluntary movements can be a source of instability in many individuals with neurologic impairments.

Question 12

Functional Reach test

Question 13

If pt presents with OH on tilt table what is the next step?

Answer 13

Lower then recheck BP

Question 14

What is Bernstein’s approach to motor learning

Answer 14

3 stages:
1st - reduction of the number of degrees of freedom of the joints to be controlled to a minimum.
Example: learning to use a hammer may co-contract muscles at the wrist joint to siffen this joint and primarily control hammer movement.

2nd - muscle synergies across a number of joints would be used to create a well-coordinated movement.

3rd - the individual now has released all the degrees of freedom necessary to perform the task in the most efficient and coordinated way.