Quiz 1: Intro, Balance, & Posture Flashcards
What is balance?
an even weight distribution that allows an object to remain upright and in a state of equilibrium.
What is equilibrium?
state of zero acceleration with no change in speed or direction (very still)
What is static balance?
the center of gravity is maintained within its base of support
What is dynamic balance?
postural control is maintained when moving outside the body’s base of support
Possible deficits in balance and stability can result from: (5)
- postural weakness
- joint tightness/contracture
- decreased strength
- impaired motor coordination
- pain impairments
Where is the body’s center of gravity located at?
slightly anterior to the S2 (sacral segment 2)
What is stability?
the ability to counter forces that destabilize equilibrium
What is center of gravity?
the point at which the body’s mass and weight are equally balanced or equally distributed in all directions
True or False:
Changing the body’s center of gravity impacts stability.
True
What kind of a postural change can alter the body’s center of gravity?
kyphotic/lordotic/scoliotic
True or False:
Lowering the center of gravity decreases balance.
False, lowering the c.o.g. increases balance because it’s more stable.
Widening the stance _________ balance
increases
Narrowing the stance _______ balance
decreases
Shifting body weight to one foot also ________ balance
decreases
On what type of surface is balance most optimal on? Least optimal on?
Most: Hard surface
Least: Soft surface
True or False:
Increasing an objects weight increases balance.
True
True or False:
Increasing the friction between a body and its contact surface enhances balance.
True
When resisting an oncoming force, where should you place the body’s center of gravity?
Towards the oncoming force to increase stability (lean forward if the object is coming at you from the anterior side)
What are some activities to increase balance? (5)
- wide BOS —> narrow BOS
- tandem stance (1 foot in front of other)
- single leg stance (flamingo)
- change surfaces
- dynamic activities (reaching/throwing/etc) to increase difficulty
What are some balance mobility tests? (5)
- Berg Balance scale
- Tenetti (balance/gait)
- TUG test (timed up and go)
- Functional Reach Test (yard stick)
- Balance Evaluation Systems Test (BESTest) (look @ what’s affected? eyes? ankle? etc.)
What is the BERG balance scale?
functional scale to objectively measure a patient’s balance in order to document progression though out plan of care.
- 14 tasks total
- Total: ___/ 56
What are the tests of the BERG balance?
- sit to stand
- stand unsupported
- sit unsupported
- stand to sit
- transfers
- stand unsupported w/ eyes closed
- stand unsupported w/ feet together
- reach forward
- pick up object from floor
- turn over shoulder w/ feet planted
- turn 360 degrees
- steps
- tandem stance
- single leg stance
True or False:
The nervous system simplifies motor control by creating strategies or synergies.
True
What types of patterns can be quickly and automatically accessed by the CNS?
Flexible and repeatable
True or False:
Nervous system uses these pre-programmed strategies to ensure maintenance of balance.
True
What is the order of “landmarks” on the body needed to increase stability?
1st: ankle (distal to proximal)
2nd: hip/trunk
3rd: stepping
What are the movement strategies of the ankle?
- used in response to small perturbations or LOB
- EX: body sway forward and toes dig into floor, ankle/calf/posterior leg contract to prevent forward falling
What are the movement strategies of the hip/trunk?
- used if perturbation is too large
- EX: bend at waist or arch back to keep center of gravity over base of support
What are the movement strategies of stepping?
- used if ankle/hip strategies are insufficient
- EX: COG moves past BOS and requires forward or backward step
Balance disturbances at the joint/ankle activate the ____________ or __________
plantar flexors or dorsiflexors
ANKLE:
- an ANTERIOR ANKLE LEAN from a standing position results in:
1. Eccentric contraction of the….
2. Concentric contraction of the….
(works the gastroc)
- Eccentric contraction of the plantar flexors to control momentum followed by a static (isometric) contraction to stop momentum
- Concentric contraction of the plantar flexors to restore standing posture
ANKLE:
- a POSTERIOR ANKLE LEAN from a standing position results in:
1. Eccentric contraction of the….
2. Concentric contraction of the….
(works the TA)
- Eccentric contraction of the dorsiflexors, to slow momentum, followed by a static (isometric) contraction to stop momentum
- Concentric contraction of the dorsiflexors to restore standing posture.
Balance disturbances at the hip activate the _________, ___________, and ____________
hip flexors, hip extensors, and hip abductors
TRUNK:
- an ANTERIOR TRUNK LEAN from a standing position results in:
1. Eccentric contraction of the….
2. Concentric contraction of the….
- Eccentric contraction of the erector spinae and hip extensors, followed by a static (isometric) contraction to stop momentum
- Concentric contraction of the erector spinae and hip extensors to restore standing posture.
TRUNK:
- a LATERAL TRUNK LEAN from a standing position results in:
1. Eccentric contraction of the….
2. Concentric contraction of the….
- Eccentric contraction of the glute medius, and glute mini, followed by a static (isometric) contraction to stop momentum
- Concentric contraction of the glute med and glute mini to restore erect standing posture
TRUNK:
- a POSTERIOR TRUNK LEAN from a standing position results in:
1. Eccentric contraction of the….
2. Concentric contraction of the….
- Eccentric contraction of the trunk flexors, followed by a static (isometric) contraction to stop momentum
- Concentric contraction of the trunk flexors to restore standing posture
Why is core stability essential?
Core stability is essential to maintaining structural integrity of the trunk.
What are the 4 primary core muscles?
- rectus abdominis
- transverse abdominis
- internal and external obliques
- erector spinae
What are the 2 secondary core muscles?
- latissimus dorsi/teres major
- illiopsoas
True or False:
The transverse abdominis compresses abdominal contents, and stabilizes the core musculature, thus reducing compressive forces along the spine
True
What does the quadratus lumborum do?
provides pelvic elevation and lateral trunk flexion
What does the rectus abdominus do?
flexion of the trunk
What does the erector spinae do?
extends the trunk
What does the illiopsoas do?
flexes the hip
What does the latissimus dorsi/teres major do?
extends the shoulder and depresses the scapula
What does the diaphragm do?
separates the abdominal cavity from the thoracic cavity, a primary muscle for inspiration
True or False:
You should begin with isolated exercises to correct muscle imbalances before progressing to the basic complex movement patterns
True
What does single-leg stance and stepping involve?
involves weight transference over the stance leg, while preserving optimal alignment among the hip, knee, and foot.
Squatting and lifting objects from the floor…..
increase stress on the anterior cruciate ligament
Gluteus maximus engagement during knee and hip flexion prevents….
excessive internal tibial rotation and knee abduction
Quadriceps dominance during a squat as opposed to hip dominance predisposes….
the knee to the risk of injury
What is posture?
body position relative to the center of gravity and line of gravity
What is line of gravity?
line passing vertically through the spinal column, the center of gravity and the base of support
True or False:
Posture is static only.
False, it is BOTH static and dynamic
How is standing posture assessed?
anatomical position
To have correct posture it requires: (3)
- normal ROM across all joints
- balanced agnonist/antagonist muscle relation
- strong postural muscle stabilization
What are the key postural stabilization muscles? (8)
- cervical extensors (lay down head push pillow)
- shoulder external rotators (theraband robbers)
- scapular retractors (rows)
- trunk extensors (RDLs)
- trunk flexors (crunches)
- hip extensors (donkey kicks)
- knee extensors (knee extension)
- ankle plantar flexors (calf raises)
What are some causes of postural imbalance?
- obesity
- pregnancy
- decreased joint flexibility
- muscle weakness
- standing and walking in elevated heels (constantly)
Muscle actions within a kinetic chain:
1. Agonist muscles cause the action to ____
2. Antagonist muscles ________
3. Synergist muscles________
4. Stabilizer muscles _________
- occur
- oppose agonist action
- assists the agonist
- co-contract to protect and maintain joint positioning
True or False:
With joint contractures, antagonist muscles prevent agonist muscles, restricting full ROM
Ex: tight knee flexors restrict knee extensors from fully contracting to reach terminal knee extension
True
True or False:
Stretching the agonist muscle does not fully restore normal ROM, without concurrent strengthening of the agonist muscles.
True, they must do BOTH
What are the 4 standard postural deviations?
- Kyphosis (hunch over)
- Scoliosis (S shaped spine)
- Flat-back (sway back, posterior pelvic tilt/hip extension/lower back flattened)
- Lordosis (leaned back)
What is a winged scapula?
the medial border of the scapula moves away from the thoracic wall and projects outward
What does a winged scap result from?
weak serratus anterior
What are some exercises for a winged scapula?
- serratus push up
- lat pulldown
- lateral raise
- rear fly
- unilateral shoulder extension
Does scoliosis typically occur in left handed or right handed people?
Right handed
What is structural scoliosis?
a fixed and irreversible change in spinal alignment resulting in a lateral curvature of the spine with fixed rotation of the vertebrae
(cannot be altered through positioning, exercise or manipulation)
What is nonstructual scoliosis?
deviations in spinal alignment in which the vertebrae can be realigned through positioning instruction and exercise
What is genu valgum?
knock knee appearance
- hip external rot/knee hyperextension/pronated foot
What is genu varum?
bow legged appearance
- hip internal rotation/knee hyperextension/pronated foot
What is genurecurvatum?
knee hyperextension
- caused by tight soleus
What tibial torsion?
pigeon toed fr
- caused by a inward rotation of tibia
What is pronation and supination of the foot?
Pronation: eversion walk on medial side
Supination: inversion walk on lateral side
True or False:
If identified early, pronation or supination of the foot can be remedied with corrective shoes and exercise
True
What is pes planus?
flat footed
- can be acquired
- common in kids
- treatment includes corrective exercises and orthotics (shoe inserts)
What is pes cavus?
high arch
- characterized by high arch
- usually congenital
- can be treated with orthotics
- surgery for severe cases
True or False
Reduced dorsiflexion results from tight plantar flexors and vice versa
True
How far from the spine should the medial border of the scapula be?
2-2.5 inches
