Postural Control An Balance

Question 1

define: postural orientation, balance, COM, base of support, limits of stability

Answer 1

postural orientation- the ability to maintain appropriate control of body segments in relation to each other and gravity
balance- ability to maintiain COM in BOS
COM- average position of all parts of the system according to their masses
base of support- area of body or extension of body in contact with a support surface
limits of stability- the maximum distance that one can lean to without losing balance or having to change BOS

Question 2

Three parts of postural control?

Answer 2

sensory (afferent) input (visual, vestibular, somatosensory)
CNS integration
Motor (efferent) output

Question 3

Clinical test for sensory interaction in balance (CTSIB) test (also called the sensory organization test- SOT)

Answer 3

30 secs recorded with 6 conditions (eyes open, closed, on a dome- on a firm or foam surface)
2 attempts allowed, test stops if arm or feet position changes

Question 4

What are the postural control stratgies?

Answer 4

Reactive and proactive

Question 5

What are the motor strategies

Answer 5

Ankle
Hip
Stepping

Question 6

Ankle strategy: forward and backward sways

Answer 6

forward: gastroc, hmstrings, paraspinals
backward: tib ant, quads, abdominals

Question 7

Hip strategy, backward and forward sway

Answer 7

forward: abs, quads
backwards: parapsinals, hamstrings

Question 8

Stepping strategy- explained

Answer 8

re-estabilishing BOS with the mvmt of a body part to contact supporting surface

Question 9

Functional balance grades

Answer 9

functional balance grades
romberg test
functional reach tests
berg balance scale
performance-oriented mobility assessment
Get up and go test (GUG)
TUG

Question 10

The Romberg test

Answer 10

standing with feet together arms by my side EO and EC
positive test- patient able to stand with EO but is unstable or falls with EC

Question 11

Functional reach test

Answer 11

how far they can reach in a standing fixed BOS position
<6 inches is indicative of fall predicition

Question 12

Berg balance test

Answer 12

14 items, scaled 0-4 with a max of 56 points
41-56= low fall risk
21-40= medium fall risk (walking with assistance)
0-20= high fall risk (wheelchair bound)

Question 13

Performance-oriented mobility assessment (POMA) and Tinnetis

Answer 13

brief and reliable measure of static and dynamic balance
balance - 9 test max 16 score
gait- 7 test max 12
grading:
- <19 high risk of falls
19-24 moderate risk for falls

Question 14

Get up and go test (GUG)

Answer 14

stand up from chair and walk 3 meteres at their normal speed and turn, walk back and return sitting.
grading
1- normal
2- very slightly abnormal
3- mildly abnormal (>3= increased risk of falls)
4- moderatley abnormal
5- severly abnrmal

Question 15

Timed up and go test (TUG)

Answer 15

stand up from chair and walk 3 meteres at their normal speed and turn, walk back and return sitting.
grading:
<10 sec- normal for most adults
>12 sec- fall risk
11-20 sec- within normal limits for frail elderly or individuals with disability
>30 sec- impaired functional mobility

Question 16

Balance training- General principles

Answer 16

clear obstacles in room
proper footwear
giard appropriately
monitor face
guage patients abilities
start with most to least stable positions
challenge with progression
regress positions or mvmts where necessary

Question 17

How can you challenge balance?

Answer 17

alter BOS
internal pertubations
reactive balance stratgies (external pertubations)
- expected vs unexpected
altered vision
altered speed
moving COM higher
include cognitive demanding tasks