Balance Flashcards

(45 cards)

1
Q

Postural control

A

controlling body position in space for stability and orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Balance

A

ability to hold center of mass in relation to base of support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Center of gravity

A

vertical projection of the COM (slightly anterior to L2 in standing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Base of support

A

area of body in contact with a support surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Postural orientation

A

ability to maintain an appropriate relation between body segment and between the body and the environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Limits of stability

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Reactionary postural responses

A

active response to an external perturbation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Sensory interaction/orientation

A

ability to maintain balance during altering sensory conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Balance Examination: Systems Review

A

Cardiovascular
Integumentary
Neuromuscular
Musculoskeletal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Balance Examination: Body Functions and Structure

A
ROM
Muscle Strength
Muscle Tone
Coordination
Cognition
Posture
Pain
Sensory Systems
-Somatosensory
--Light touch
--Proprioception/Vibration
---Pain
-Vision
-Vestibular
Perception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Motor Strategies

A

Ankle
Hip
Stepping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Balance Examination:Motor Strategies: Ankle

A
  • Control of postural sway from ankles and feet
  • Head and hips travel in the same direction at the same time with the body moving as a unit over the feet
  • When it is appropriate to use an ankle strategy?
  • -Firm surface
  • -Foot well supported
  • -Slow moving with minimal displacement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Balance Examination:Motor Strategies: Hip

A
  • Control of postural sway from pelvis and trunk
  • Head and hips travel in opposite directions
  • When is it appropriate to use a hip strategy?
  • -Foot not completely supported
  • -Quick and large displacements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Balance Examination: Motor Strategies: Stepping

A
  • Steps with the feet to establish a new base of support when the center of gravity has exceeded the original base of support
  • When is it appropriate to use a stepping strategy?
  • -When the other strategies are not sufficient enough to maintain equilibrium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Balance Examination: Clinical Test for Sensory Interaction in Balance (CTSIB)

A
  • Clinical version of the Sensory Organization Test that does not require computerized force plate
  • Designed to assess the patient’s ability to select and combine sensory information in different environments
  • Does not measure the integrity of the three sensory systems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Stages of Foam and Dome

A
Condition 1:  Firm surface, eyes open
Condition 2:  Firm surface, eyes closed
Condition 3:  Firm surface, dome
Condition 4:  Foam surface, eyes open
Condition 5:  Foam surface, eyes closed
Condition 6:  Foam surface, dome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is somatosensory dominant?

A

Condition 1

Condition 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where is Vision dominant?

20
Q

Where is vestibular dominant?

A

Condition 3
Condition 5
Condition 6

21
Q

Balance Error Scoring System [Purpose and Population]

A
  • Purpose: Objective measure of assessing static postural stability (designed for the mild head injury population-concussion, to assist in return to sports play decisions).
  • Population tested: Concussion, mild TBI, ankle instability, vestibular disorders
22
Q

Balance Error Scoring System Conditions

A
  • 6 conditions each tested barefoot, eyes closed for 20 seconds each:
  • Double leg stance (feet together): Firm & Foam
  • Single leg stance (non-dominant foot): Firm& Foam
  • Tandem stance (non-dominant foot in back): Firm & Foam
23
Q

Scoring Balance Error Scoring System

A

Count number of errors (deviations) from proper stance:

  • Moving hands off the hips
  • Opening the eyes
  • Step, stumble or fall
  • Abduction or flexion of the hip beyond 30°
  • Lifting the forefoot or heel off of the testing surface
  • Remaining out of the proper testing position for greater than 5 seconds
24
Q

What do the Balance Error Scoring System mean?

A
  • Score of 0-60 (lower scores indicate better balance and less errors)
  • MDC – 7 to 9 points
  • BESS
25
Single Leg Stance (Anticipatory)
-Person stands with knee flexed 90° (legs should not be touching each other) -Arms crossed around shoulders -Norms -Document: Number of attempts Time Visual observation during trial
26
Romberg/Tandem Romberg (Anticipatory)
-Person stands with feet together (Romberg) and eyes open -Repeat the test with eyes closed -Person stands with one foot directly in front of the other (Tandem Romberg) -Normal is the ability to hold the test position for 30 sec -Document: Number of attempts Time Visual observation during trial
27
Activity Balance Measures
Berg Balance Scale Tinetti Performance Oriented Mobility Assessment Functional Reach TUG, TUG manual, TUG cognitive
28
Participation Balance Measures
Activities Based Confidence Scale
29
Berg Balance Scale
- 14 test items intended to assess a person's ability to perform common ADLs safely - Items are scored from 0 to 4, maximum score is 56 - MDC: 3-8 points - In home Berg Balance Assessment
30
Berg Balance Scale Cut-offs
Older adults: - History of falls and Berg < 51 or no history of falls & Berg < 42 predictive of falls (91% sensitivity, 82% specificity) (Shumway-Cook et al, 1997) - Score of < 40 on Berg associated with almost 100% fall risk CVA: 45/56
31
Tinetti Performance Oriented Mobility Assessment (POMA)
- Consists of 2 subscales to screen for balance and mobility skills in older adults and determine likelihood of falls - -Balance (9) - -Gait (7) - 16 items total - Scored: 0-2
32
Tinetti Scores
General - Score 19-24 are at moderate risk of falls - Score <19 are considered high risk for falls - MDC: 4
33
Functional Reach
- Define max distance one can reach forward beyond arm’s length while maintaining fixed BOS in standing - Examines limits of stability in forward direction - Person stands near wall with feet parallel, raises arm nearest wall to 90° of shoulder flexion, makes a fist and leans as far forward as possible - Three trials, average of the last two - MDC: 3 to 9 cm
34
Functional Reach Cut-off
- < 6 inches predictive of increased risk of falls in community dwelling elderly - <18.5 cm (75% sensitivity, 67% specificity) in frail elderly - PD: 25. 4 cm (30% sensitivity, 92% specificity) 30. 1 cm (56%sensitivity, 77% specificity)
35
Activities Based Confidence Scale
-16 item questionnaire Measure of balance self-efficacy -Subjects rate their confidence performing a variety of in home and community based functional activities such as walking in a variety of environments, reaching, picking things up from the floor. -Scores range from 0-100 where higher scores indicate greater balance confidence
36
Activities Based Confidence Scale Cut-off
- <67% fallers and non-fallers - <69% PD - <81% CVA -MDC: For Parkinson’s is11-13%
37
Timed Up and Go
Individuals are given verbal instructions to 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 any assistive device.
38
TUG manual
the client must walk holding a cup filled with water.
39
TUG cognitive
Same as TUG, but individuals are asked to complete the test while counting backward by threes 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)
40
TUG Scores
>15 sec gave a 90% prediction rate for faller
41
Examination of Balance: Documentation
-Subjective: History of falls, close falls& Fear of falling Objective: Name of the test Trials (if applicable) Use of assistive device (if applicable) Assessment: Interpretation of score -Plan:Implementation of balance into plan of care
42
Body Structure/ Function | Tests and Measures
``` CTSIB BESS Single Leg Stance Romberg Tandem Romberg ```
43
Activity Tests and Measures
``` Berg Tinetti Functional Reach TUG TUG manual TUG cognitive ```
44
Participation Tests and Measures
Activities-Specific Balance Confidence Scale
45
SAFETY of Balance Test
- Guarding closely | - Gait belt