Week 10: Balance and Flexibility

Question 1

Flexibility (2 types)

Answer 1

Flexibility: the ability of joints to move through their full range of motion.

2 types:
1. Static flexibility
-The ability to hold an extended position at one end or point in a joint’s range of motion.
2. Dynamic flexibility
-The ability to move a joint through its range of motion with little resistance.

Question 2

Balance (4 types)

Answer 2

The ability to control the centre of mass in relationship to the base of support
1. Static balance
2. Dynamic balance
3. Reactive balance
4. Functional balance

Question 3

Static balance

Answer 3

The ability to maintain the center of gravity within the supporting base while standing or sitting
⁃ E.g., quiet standing

Question 4

Dynamic balance

Answer 4

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 of the supporting base
⁃E.g., walking, playing sports

Question 5

Reactive balance

Answer 5

The ability to compensate and recover from perturbations while standing or walking.

Question 6

Functional balance

Answer 6

The ability to perform daily movement tasks requiring balance.

Question 7

How do we assess balance?

Answer 7

1. Direct measures
   -Force plates
2. Indirect measures
   -Field and clinical tests (outcome measures)
   -General screen
   -One-legged stance test
   -BBS
   -Y-balance

Question 8

Berg Balance Scale

Answer 8

-14-item objective measure that assesses static balance and fall risk in older adults
-Used in many clinical populations including:
⁃Older adults
⁃Stroke
⁃Spinal injuries
⁃Pulmonary diseases
⁃Parkinson’s disease
⁃Osteoarthritis
⁃Alzheimer’s

Standardized test, gait aids cannot be used during test
-5-point ordinal scale (0-4)
-Maximum score = 56

Fall risk
≤40 is associated with almost a 100% risk of falling.
< 45 on BBS indicates an individual may be at increased risk of falls and may benefit from a walker or other walking aid.
≤50 indicates the individual is more likely to fall and should be assessed further for fall risk.

Question 9

Intra-rater reliability, inter-rater reliability and minimal detectable change (MDC) for older adults

Answer 9

-Excellent intra-rater reliability (ICC = 0.98)
-Excellent inter-rater reliability (ICC = 0.98)
-Minimal Detectable Change (MDC) for older adults:

Score-> MDC
0-24 -> 4.6
25-34 -> 6.3
35-44 -> 4.9
45-56 -> 3.3

Question 10

ACSM’s recommendations for balance

Answer 10

General recommendations for balance training include using the following:
a) progressively difficult postures that gradually reduce the base of support (e.g., two-legged stand, semi tandem stand, tandem stand, one-legged stand)
b) dynamic movements that perturb the center of gravity (e.g., tandem walk, circle turns)
c) stressing postural muscle groups (e.g., heel, toe stands)
d) reducing sensory input (e.g., standing with eyes closed), and
e) tai chi