exam 3: dynamic standing assessment & interventions Flashcards
What are the 3 types of postural control:
steady-state, reactive, proactive
Standing unsupported = _________ holds
BOS changes: _________,_______ stance
Compliant vs ________ surfaces
Sensory integration changes:
Which type of postural stability is being described:
isometric
Romberg, tandem
firm
EO vs. EC
steady state
Perturbations =
Sensory integration challenges =
Which type of postural stability is being described:
nudges or pulls
compliant vs. firm surfaces
reactive
Dynamic reaching or ________
_______ limb movement
Preparing for Transfer or movement =
Which type of postural stability is being described:
weight shifts
resisted
SLS, look over shoulder
proactive
Balance grading scale: - patient able to maintain a steady balance without handhold support (static)
4- normal
Balance grading scale: - patient unable to maintain balance
0- absent
Biomechanics of Standing:
ASIS is _____ with each other
______ pelvis
Head in _______ with “chin in”
______ muscles active maintaining upright posture
Feet flat on floor weight disturbed ______
level
neutral
midline
trunk
evenly
Posture changes with age: True or False?
True
As a PT you need to assess the patients ________ to inform evaluation and POC
limit of stability (LOS)
What is limit of stability:
maximum excursion in any direction without losing balance
Where does balance fall in the ICF domain?
body function and structure domain
You should likely always be assessed with support on _________ side
-cueing for:
affected
hip/knee/truck extension
Physical therapist is testing the patient with a neurological condition and they have an assistive device. What is the highest grade pt. can score
2- fair: patient able to maintain balance with handhold support; may require occasional min assistance (static)
Standing is maintained by:
postural tone with antigravity muscles throughout trunk and LEs
Task oriented:
Dual cognitive task:
Environmental changes:
folding clothes, put shoes on
organizing pills, counting cards
lights on/off
Key elements to observe and document:
BOS, COM, use of UE, and LE support
Explain the setup assessment for Sit>Stand:
a. Initial condition-
b. Weight-bearing symmetry-
c. Use bedside table as AD-
a. feet are both flat on floor; hips and knee flexed 90º
b. both arms placed in a position of WB, use UEs to
push off, DO NOT use unilat. ADs for standing activities
c. provide stable surface for WB through BL arms
You are a physical therapist performing a push-and-release test on a patient. The patient takes 4 or more steps backward but recovers independently. What would you grade them?
2
High score on push-and-release test/ retropulsive pull test =
increase risk of fall
The ______ provides the clinician with a means to quantify postural control under various sensory conditions
-conditions include:
clinical test of sensory interaction on balance (CTISB) “foam & dome”
normal, eyes closed, dome
If patient is timed for 30 secs. in each condition and unable to maintain the position they can get unlimited attempts. True or False?
False; 2 additional attempts
Fill in the blanks: Example of Postural Stability Goals:
Postural adjustments become more _______
________ goals
Independently self-corrects to midline =
Decreased _______ dependence
Improved _________ of posture or limb
automatic
timed
orientation
care giver
awareness
What does your assessment of a patient’s dynamic postural stability mean?
fall/safey risk -
support needed -
limits of stability -
DC planning
-nursing, SLP needed, OOB safety
-is a caregiver needed for cueing, needs physical assistance for transfers
-upper/lower body dressing standing, balance strategies present
-safety with out of bed independently
Highly recommended measures for Patients with Stroke in Acute Care: (3)
Orpington porgnostic scale
Postural assessment Scale for Stroke Patients
Stroke Rehabilitation Assessment of Movement