Week 2: Ch. 7 - Balance & Coordination Flashcards
Balance
Ability to maintain COM over the base of support
Base of Support (BOS)
Feet making contact with the floor
Postural Equilibrium (Control System)
Balancing all forces acting on the body’s COM
( Somatosensory, Visual, Vestibular ) & Musculoskeletal Systems
Somatosensory Sources
- Plantar surface of foot
- Joints
- Muslce Tissue
- Ligaments
How do you maintain balance?
Moving COM anywhere within the BOS
Coordination
Ability to produce patterns in the context of environmental objects and events
Neuromuscular Control
Subconscious activation of muscles occurring in preparation for joint motion/loading
Proprioception
Joint position, Movement, Resistance/Tension
Kinesthesia
Awareness of the position and movement of the parts of the body using sensory organs (proprioceptors) in the muscles and joints.
Mechanoreceptors
(Muscle Spindles, Golgi Tendon Organs, Ligaments & Joint Capsule)
- Sensory receptors
- Convert mechanical events to neural signals
- Deliverd to Nervous system
Muscle Spindles
Convery info on muscle length & rate of length
Golgi Tendon Organs (GTO’s)
Convey info on muscle tension
Ligaments & Joints
Provide CNS with speed of joint position, movement, and tissue load levels
What are the types of Balance Tests to establish a baseline for patients?
Berg and Tinetti Balance, CTSIB, Romberg/Sharpened Romberg Tests
CTSIB Test Procedure
- Eyes open, stable surface
- Eyes closed, stabel surface
- Eyes open, unstable surface
- Eyes closed, unstable surface
Romberg Test Procedure (Feet Together)
(Test stops if patient opens eyes, moves feet, or starts to fall)
- Feet together, eyes open, arms to side (60 sec.)
- Repeat with (eyes closed)
(Minimal sway is ok)
Semi-tandem Romberg Test Procedure
Domiate foot slight in front of non-dominate.
Sharpened Romberg Test Procedure
Dominate foot placed directly in fron of the non-dominant foot (Tandem)
Types of Coordination Test
- Rapid Alternating Movements
- Finger to Nose
- Finger Opposition
- Heel on Shin
- Tapping foot or hand
- Throwing and catching a ball
Rapid Alternating Movement Test
palms down, then up rapidly (10 reps)
Finger to Nose Test
tip of index finger to tip of the nose
Finger Opposition Test
tip of each finger with the tip of the thumb
Heel on Shin Test
slide the heel of leg grom ankle to the knee of the opposite leg (Supine)
Tapping Hand or Foot Test
tapping while maintaing contact with base
Throwing and Catching a Ball Test
receive and deliver a ball
Postural Stress Test
Patient wears a belt attached to a pulley system with weights
Balance dysfunction may be related to…
- Perception
- Behavior
- Range of motion
- Biomechanical alignment
- Weakness
- Sensory
- Synergistic organization strategy
- Coordination
- Adaptability
Tasks and Drills Progression (LE)
- Progressive balance training from seated position
- Progress to standing then reaching and lifting
- Use of the physioball or Swiss ball
- Vertical weight bearing and progressive balance training
- Closed Chain Exercises (Squats, Sidestepping)
Seated Exercises
- Eyes Open/Closed
- Postrual Stress
- Throwing and Catching a ball
- Uneven surface (Swiss Ball)
Standing Exercises
- Changing Incalnation and types of surfaces
- Foam Padding
- Blance Boards
Pertubration
unexpected movements
Poor Grade
Static: Patient requires handhold support and moderate to maximal assistance to maintain position
Dynamic: Patient unable to accept challenge or move without loss of balance
Fair Grade
Static: Patient able to maintain balance with handhold support (May require occasional minimal assistance)
Dynamic: Patient accepts minimal challenge
(Able to maintain balance while turning head/trunk)
Good Grade
Static: Patient able to maintain balance without handhold support (Limited postural sway)
Dynamic: Patient accepts moderate challenge
(Maintain balance while picking object off floor)
Normal Grade
Static: Patient able to maintain steady balance without handhold support
Dynamic: Patient accepts maximal challenge and can shift weight easily within full range in all directions
