week 10: balance and flexibility

Question 1

what is flexibility

Answer 1

the ability of joints to move through their full ROM (think about what the normal range would be for individual clients)

Question 2

two types of flexibility

Answer 2

static flexibility and dynamic flexibility

Question 3

static flexibility

Answer 3

the ability to hold an extended position at one end or point in a joint’s ROM

Question 4

dynamic flexibility

Answer 4

the ability to move a joint through its ROM with little resistance

Question 5

what is balance

Answer 5

the ability to control the centre of mass in relationship to the base of support

Question 6

two types of balance

Answer 6

static balance and dynamic balance

Question 7

static balance

Answer 7

the ability to maintain the centre of gravity within the supporting base while standing or sitting
- eg. quiet standing

Question 8

dynamic balance

Answer 8

the ability to maintain an upright position while the center of gravity and base of support are moving, and the center of gravity is moving outside the supporting base
- eg. walking, playing sports

Question 9

balance (ACSM 2021)

Answer 9

the maintenance of equilibrium while stationary or moving

Question 10

reactive balance

Answer 10

the ability to compensate and recover from perturbations while standing or walking

Question 11

functional balance

Answer 11

the ability to perform daily movement tasks requiring balance

Question 12

what factors contribute to the risk of falls

Answer 12

body function and structure, personal factors, environmental factors

Question 13

body function and structures

Answer 13

• muscle
• sensory
• attention
• cognition
• cardiovascular (BP)

Question 14

personal factors

Answer 14

• previous falls/ near falls
• confidence
• fear of falling

Question 15

environmental factors

Answer 15

• slippery or uneven surfaces
• stairs
• lighting
• clothing/ footwear
• thick/ loose rugs
• pets

Question 16

how do we assess balance

Answer 16

direct vs indirect measures

Question 17

direct measures of assessing balance

Answer 17

force plates

Question 18

indirect measures of assessing balance

Answer 18

field and clinical tests (outcome measures)
- general screen
- one-legged stance test
- Berg balance scale
- Y balance

Question 19

how to assess static balance

Answer 19

• standing eyes open and closed
• decrease BOS
• feet together, tandem stance, unipedal stance

Question 20

how to assess dynamic balance

Answer 20

• rotating, bending, turning 360, alternate stepping

Question 21

unipedal (one-leg) stance

Answer 21

• simple assessment of static balance
• not a standardized test, many variations exist

Question 22

berg balance scale

Answer 22

• 14 item objective measure that assesses static balance and fall risk in older adults
• standardized test
• used in clinical populations (older adults, stroke, spinal injuries, pulmonary diseases, parkinsons disease, osteoarthritis, alzheimers)

Question 23

BBS items

Answer 23

1. sit to stand
2. standing unsupported
3. sitting unsupported
4. standing to sitting
5. transfers
6. standing with eyes closed
7. standing with feet together
8. reaching forward with outstretched arm
9. retrieving object from floor
10. turning to look behind
11. turning 360
12. placing alternate foot on stool
13. standing with one foot in front
14. standing on one foot

Question 24

BBS score

Answer 24

5 point ordinal scale (0-4)
max score = 56

Question 25

BBS fall risk

Answer 25

• less than or equal to 40 associated with almost a 100% risk of falling
• less than 45 on BBS indicates individual may be at increased risk of falls and may benefit from a walker
• less than or equal to 50 indicates the individual is more likely to fall and should be assessed further for fall risk

Question 26

Y-balance test

Answer 26

• assessment for dynamic balance
• developed to standardize the star excursion balance test
• client slides moveable block with their toes as far as possible in anterior, posteromedial, and posterolateral directions

Question 27

ACSM’s recommendations for balance

Answer 27

1. progressively difficult postures that gradually reduce the BOS
2. dynamic movements that perturb the center of gravity
3. stressing postural muscle groups
4. reducing sensory input
5. tai chi