week 10: balance and flexibility Flashcards
what is flexibility
the ability of joints to move through their full ROM (think about what the normal range would be for individual clients)
two types of flexibility
static flexibility and dynamic flexibility
static flexibility
the ability to hold an extended position at one end or point in a joint’s ROM
dynamic flexibility
the ability to move a joint through its ROM with little resistance
what is balance
the ability to control the centre of mass in relationship to the base of support
two types of balance
static balance and dynamic balance
static balance
the ability to maintain the centre of gravity within the supporting base while standing or sitting
- eg. quiet standing
dynamic balance
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
balance (ACSM 2021)
the maintenance of equilibrium while stationary or moving
reactive balance
the ability to compensate and recover from perturbations while standing or walking
functional balance
the ability to perform daily movement tasks requiring balance
what factors contribute to the risk of falls
body function and structure, personal factors, environmental factors
body function and structures
- muscle
- sensory
- attention
- cognition
- cardiovascular (BP)
personal factors
- previous falls/ near falls
- confidence
- fear of falling
environmental factors
- slippery or uneven surfaces
- stairs
- lighting
- clothing/ footwear
- thick/ loose rugs
- pets
how do we assess balance
direct vs indirect measures
direct measures of assessing balance
force plates
indirect measures of assessing balance
field and clinical tests (outcome measures)
- general screen
- one-legged stance test
- Berg balance scale
- Y balance
how to assess static balance
- standing eyes open and closed
- decrease BOS
- feet together, tandem stance, unipedal stance
how to assess dynamic balance
- rotating, bending, turning 360, alternate stepping
unipedal (one-leg) stance
- simple assessment of static balance
- not a standardized test, many variations exist
berg balance scale
- 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)
BBS items
- sit to stand
- standing unsupported
- sitting unsupported
- standing to sitting
- transfers
- standing with eyes closed
- standing with feet together
- reaching forward with outstretched arm
- retrieving object from floor
- turning to look behind
- turning 360
- placing alternate foot on stool
- standing with one foot in front
- standing on one foot
BBS score
5 point ordinal scale (0-4)
max score = 56
BBS fall risk
- 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
Y-balance test
- 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
ACSM’s recommendations for balance
- progressively difficult postures that gradually reduce the BOS
- dynamic movements that perturb the center of gravity
- stressing postural muscle groups
- reducing sensory input
- tai chi
