Flashcards in Balance Deck (58)
somatosensory receptors location
in joints, muscles, ligaments and skin
What information do somatosensory receptors provide?
length, tension, pressure, pain and joint position
How do you challenge the somatosensory system?
examine vibration and pressure
observe a pt when changing the surface they are standing on (slopes, uneven surfaces, standing on foam)
What are the purpose of visual receptors?
allow for perceptual acuity regarding verticality, motion of objects and self, environmental orientation, postural sway and movements of the head/neck
Who rely heavily on the visual system for maintenance of balance?
how do you challenge the visual system?
examine quiet standing w/ eyes open
observe balance strategies to maintain COG w/ and w/o visual input
assessment of potential visual field cuts, hemianopsia, pursuits, saccades, double vision, gaze control and acuity is necessary
What does the vestibule system provide>>
the CNS w/ feedback regarding the position and movement of the head w/ relation to gravity
what does the labyrinth consist of?
3 semicircular canals filled w/ endolymph and 2 otolith organs
what do semicircular canals respond to?
movement of fluid w/ head motion
what do otoliths measure?
effects of gravity and movements w/ regard to acceleration/decceleration
How do you challenge the vestibular system?
examine balance w/ head movement
testing such as Dix hall pike test, bithermal caloric testing, assessment for nystagmus, head thrust sign, testing the VOR reflex
What does the vestibuloocular reflex (VOR) allow for?
head/eye movement coordination
what does VOR support and how?
gaze stabilization through eye movement that counters movements of the head
This maintains a stable image on the retina during movement
vestibulospinal reflex (VSR)
attempts to stabilize the body and control movement
what does the VSR assist with/.
stability while the head is moving as well as coordination of the trunk during upright postures
elicited by a small range and slow velocity perturbation when the feet are on the ground
Which automatic postural strategy is activated first by a small range and slow velocity perturbation?
Pattern of muscle group contraction w/ ankle strategy
distal to proximal fashion
elicited by a greater force, challenge or perturbation through the pelvis and hips
which way do the hips move w/ hip strategy?
opposite direction from the head
Pattern of muscle group contraction w/ hip strategy
proximal to distal fashion
used to lower the COG during standing or ambulation in order to better control the COG
examples of suspensatory strategy
knee flexion, crouching or squatting
when is the suspensatory strategy normally used?
when both mobility ands stability are required during a task (think surfing)
elicited through unexpected challenges or perturbations during static standing or when the perturbation produces such a movement that the COG is beyond the base of support
LE step and/or UE reach
What does Berg balance scale assess?
pt's risk for falling
tasks in berg balance scale
static activities, transitional movements, and dynamic activities in sitting and standing positions
Berg Balance Scale score for risk for falling
< 45 = increased risk for falls
What does the Fregly-Graybiel Ataxia Test Battery asses?
balance dysfunction for pt's w/ high level motor skills