Balance Flashcards

(43 cards)

1
Q

Postural Control

A

Controlling the body position in space for stability and orientation

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2
Q

Balance

A

Ability to hold COM in relation to BOS

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3
Q

Center of Gravity

A

Vertical projection of COM

-Neuro POV = slightly anterior to L2 in standing

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4
Q

Base of Support

A

Area of body in contact with a support force

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5
Q

Postural Orientation

A

Ability to maintain an appropriate relation b/w body segment and b/w the body and the environment

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6
Q

Limits of Stability

A

Internal representation of how far the body can move over its BOS before changing the support or losing balance

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7
Q

Anticipatory Postural Responses

A

Active movement of the body’s COM in anticipation of a postural transition from one body position to another

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8
Q

Reactionary Postural Responses

A

Active response to an external perturbation

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9
Q

Sensory Interaction/Orientation

A

Ability to maintain balance during altering sensory conditions

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10
Q

Balance Examination Contents

A

1) Taking a History
2) Systems Review
3) Tests & Measures (ICF model)

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11
Q

Taking a History

A
Chief complaint
Medical history
Recent history of falls
Medication
Confidence level
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12
Q

Systems Review

A

Cardiovascular
Integumentary
Neuromuscular
Musculoskeletal

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13
Q

ICF Model

A

Health Condition
Body Functions/Activities/Participation
Environmental/Personal Factors

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14
Q

Body Functions and Structure

A
ROM
Muscle Strength
Muscle Tone
Coordination
Cognition
Posture
Pain
Perception
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15
Q

Sensory Systems used to hold balance

A

1) Somatosensory: Light touch, Proprioception/Vibration, Pain
2) Vision
3) Vestibular

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16
Q

Ankle Strategy

A
  • control of postural sway from ankles and feet
  • head and hips travel in same direction @ same time with the body moving as a unit over the feet
  • Use when…
    1) Firm surface
    2) Feet well supported
    3) Slow moving w/ min displacement
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17
Q

Hip Strategy

A
  • Control of postural sway from pelvis and trunk
  • Head and hips travel in opposite directions
  • Use when…
    1) Feet not completed supported
    2) Quick and large displacements
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18
Q

Stepping Strategy

A

-Steps with the feet to establish a new BOS when COG has exceeded the original BOS

  • Use when…
    1) The other strategies aren’t enough to maintain equilibrium
19
Q

Clinical Test for Sensory Interaction in Balance (CTSIB) AKA “Foam & Dome”

A
  • does not require computerized force plate
  • selects and combines sensory information in different environments
  • Does NOT measure the INTEGRITY of the 3 sensory systems
20
Q

Sensory Weighting: Firm Surface

A

70% Somatosensory
20% Vestibular
10% Vision

21
Q

Sensory Weighting: Unstable Surface

A

10% Somatosensory
60% Vestibular
30% Vision

22
Q

“Foam & Dome” Conditions

A

1) Firm, EO
2) Firm, EC
3) Firm, dome
4) Foam, EO
5) Foam, EC
6) Foam, dome

usually do not test 3) or 6)

23
Q

Condition 1 & 4 passed…Condition 2 & 5 failed

What are they relying on?
What sensory system(s) would need to be examined further?

A

Relying on…Vision

Need to examine…Somatosensory & Vestibular

24
Q

All conditions passed except Condition 5 failed

What are they relying on?
What sensory system(s) would need to be examined further?

A

Relying on…Somatosensory & Vision

Need to examine…Vestibular

25
Condition 1) Firm, EO
Somatosensory is dominant
26
Condition 2) Firm, EC
Somatosensory is dominant
27
Condition 4) Foam, EO
Vision is dominant
28
Condition 5) Foam, EC
Vestibular is dominant
29
Balance Error Scoring System (BESS)
- assesses static postural stability - designed for the mild concussions...to assist in return to sports play decisions -population tested: concussion, mild TBI, ankle instability, vestibular disorders
30
BESS testing conditions
6 conditions: barefoot, EC for 20 seconds each: - DLS(feet together) (firm/foam) - SLS (non-dominant foot) (firm/foam) - Tandem (non-dominant foot in back) (firm/foam)
31
BESS errors
- Hands off the hips - Opening eyes - Step, stumble or fall - ABD/flex of hip > 30° - Lifting forefoot/heel off surface - Out of test position >5 sec Score 0-60...low score=better balance 7-9 points for detectable change
32
SLS (Anticipatory)
- Knee flex 90° - Arms crossed -Document: # attempts, time, visual observations
33
Romberg/Tandem Romberg (Anticipatory
- feet together (Romberg) & EO - Repeat test with EC - One foot in front of other (Tandem Romberg) - Normal = hold 30 seconds - Document: # attempts, time, visual observations
34
Activity Balance Tests
- Berg - Tinetti - Functional Reach - TUG (normal, manual, cognitive)
35
Participation Balance Tests
-Activities Based Confidence Scale
36
Berg Balance Scale
-14 items to assess common ADL's safety - Each test = 0-4 - Max. score = 56 - Score < 36 = fall risk -Need 3-8 points for detectable change!
37
Tinetti
-2 subscales to screen for balance and mobility skills in older adults and determine likelihood of falls 1) Balance (9 tests) 2) Gait (7 tests) - Each test scored 0-2 - Score 19-24 = Mod fall risk - Score < 19 = High fall risk **Need 4 points for detectable change!
38
Functional Reach
- Max distance reaching forward beyond arm’s length while maintaining fixed BOS in standing - Examines limits of stability in forward direction - Pt. stands next to wall, shoulder flex 90°, make a fist and lean forward - 3 trials, average of the last 2 **3 to 9 cm for detectable change!
39
Activities Based Confidence Scale
- 16 item questionnaire - Balance self-efficacy -Rate confidence performing a variety of home and community based functional activities - Scores 0-100 - High scores = greater confidence
40
Timed Up and Go (TUG)
-Stand up from a chair, walk 3 meters as quickly and safely as possible, cross a line marked on the floor, turn around, walk back, and sit down. The patient may use AD. >15sec = 90% fall prediction
41
TUG Manual
Same as TUG but patient must walk holding a cup filled with water
42
TUG Cognitive
Same as TUG but patient asked to complete the test while counting backward by 3's from a randomly selected number between 20 and 100 (can also ask the patient to recite alternating letter of the alphabet “a-c-e” aloud)
43
Body Structure/Function Balance Tests
``` CTSIB BESS Single Leg Stance Romberg Tandem Romberg ```