Postural Control in Older Adults Flashcards

1
Q

What are the 2 major factors to aging?

A
  • genetic (primary)

- experimental (secondary)

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2
Q

_____ factors we have little control over, whereas _____ factors we have more control over

A

Genetic

experimental

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3
Q

What are a few examples of secondary aging factors?

A
  • nutrition
  • exercise
  • insults
  • pathologies
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4
Q

Describe the continuum of physical function among older adults from physically elite to disabled

A

1) physically elite
2) physically fit
3) physically independent
4) physically frail
5) physically dependent
6) disabled

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5
Q

Describe physically elite older adults

A

They engage in competitive sports and are considered to undergo optimal aging

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6
Q

Describe physically fit older adults

A

They engage in sports, hobbies, and games and are capable of moderate physical work

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7
Q

Describe physically independent older adults

A

They engage in less physically demanding activities such as gold or social dancing. They are also independent in all basic ADLS and instrumental ADLs

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8
Q

Describe physically frail older adults

A

They are usually independent in basic ADLs but are dependent in many instrumental ADLs. They are capable of light housekeeping, but often require assistance to continue living independently

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9
Q

Describe physically dependent older adults

A

They are dependent in both basic and instrumental ADLs and require full-time assistance.

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10
Q

How many individuals over the age of 65 fall each year?

A

1/3

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11
Q

Falls make up what percentage of unintentional injuries?

A

67%

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12
Q

Falls are the __ leading cause of death in the elderly

A

5th

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13
Q

About ___ of the deaths from falls occur in people over 65 years.

A

3/4

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14
Q

What are some intrinsic risk factors for fall in community-dwelling older adults?

A
  • age and gender
  • muscle weakness
  • visual, gait or balance deficits
  • history or fear of falls
  • social isolation
  • anxiety
  • depression
  • cognitive impairment
  • impaired ADLs
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15
Q

What are some extrinsic risk factors for fall in community-dwelling older adults?

A
  • stairs
  • rugs
  • slippery surfaces
  • poor lighting
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16
Q

Falls result from the interaction of what 3 things?

A

The individual, the task and the environment.

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17
Q

What are 4 age-related changes in the musculoskeletal system of postural control?

A
  • decreased muscle strength
  • decreased ROM
  • diminished spinal flexibility
  • altered posture
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18
Q

Describe why there is a decrease in muscle strength with age

A
  • the number of motor unit declines

- there is a loss of type I and II fibers

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19
Q

Is the reduction in muscle mass greater in UE or LE?

A

LEs

20
Q

Are concentric or eccentric contractions more effected with age?

A

concentric

21
Q

Is strength or endurance better preserved with age?

A

endurance

22
Q

What does decreased ROM and loss of spinal flexibility in older adults lead to?

A

flexed or stooped posture

23
Q

Due to this loss of spinal flexibility the center of mass moves in what direction?

A

Posteriorly, towards the ankles

24
Q

What other joint loses flexibility as one ages?

A

ankle joint

25
Q

Decreased extensor muscle strength results in what?

A

increased kyphosis

26
Q

What postural changes occur in older adults?

A
  • forward head
  • increased kyphosis
  • increased lordosis
  • hip flexion
  • knee flexion
27
Q

How does the neuromuscular system contribute to postural control?

A

Through the coordination of forces effective in controlling the body’s position in space

28
Q

True or False

Older adults have more difficulties controlling spontaneous sway during the quiet stance

A

True

29
Q

When responding to a moving platform that causes postural sway, older adults demonstrate what 2 things?

A
  • slower response onset (decreased response strategy) in key muscles
  • increased co-activation to stiffen the joint
30
Q

What are 2 compensatory mechanisms in aging?

A
  • stepping reaction: forward or backward stepping with one or more lateral steps
  • reaching reaction: initiation of arm movement and reach-to-grasp movement
31
Q

In summary what are 3 motor system changes that can contribute to the inability to maintain balance as one ages?

A

1) muscle weakness
2) impaired timing and organization among synergistic muscles activated in response to instability
3) limitations in the ability to adapt movements for balance in response to changing task and environment demnads

32
Q

What 3 sensory systems are affected by age?

A
  • somatosensory
  • visual
  • vestibular
33
Q

Does the threshold for vibratory sense (somatosensory system function) increase or decrease with age?

A

Increase

34
Q

Does tactile sensitivity (somatosensory system function) increase or decrease with age?

A

decrease

35
Q

Does the visual threshold increase or decrease with age?

A

increase

36
Q

Does visual acuity increase or decrease with age?

A

decrease

37
Q

Does aging cause a amplification or reduction in vestibular function?

A

reduction

38
Q

By the age of 70 a person will have lost __% of their vestibular hair

A

40

39
Q

Describe the difference of sensory adaptation between older and younger adults

A

Healthy older adults do not show a significantly larger sway than young adults when a single sense is reduced. However, when the availability of two senses is reduced, there appears to be a significant effect on steadiness.

40
Q

Why might adults in their 70s and 80s have more difficulty maneuvering in the world?

A

Because they have lost some of their ability to integrate balance adjustments into ongoing voluntary movements such as lighting or carrying objects

41
Q

Under what 3 circumstances does the majority of falls occur?

A
  • walking
  • lifting
  • carrying
42
Q

What happens to a person’s anticipatory adjustments as they age? What does this result in?

A

Older adults have problems making anticipatory adjustments quickly and efficiently, suggesting that impairments associated with anticipatory postural ability contribute to falls in many elderly people.

43
Q

Can fear of falling significantly affect how we perceive and move in relation to balance control?

A

Yes

44
Q

How do cognitive issues alter posture control?

A

When faced with situations in which they are required to perform multiple tasks at once they may not have the attention or information-processing capacity and therefore processing is reduced.

45
Q

In order to test cognitive impairments that may affect balance one can perform what type of intervention?

A

Dual-Task Intervention

- Patient is asked to walk while performing subtraction by 3’s

46
Q

The most important thing to remember is that aging is characterized by ______

A

heterogeneity