Balance Assessment

Question 1

What types of input do the components of the sensory systems provide to the central nervous system (CNS)

Answer 1

• visual
• somatosensory (ability to feel where you are in space)
• vestibular

Question 2

What are the 3 balance strategies

Answer 2

• ankle strategy
• hip strategy
• stepping strategy

Question 3

Different balance assessments

Answer 3

• survey/self rating scale such as the activities specific balance confidence (ABC) scale
• sitting balance both static & dynamic
• standing balance

Question 4

Describe the Romberg Test

Answer 4

• patient stands feet together and holds position for at least 30 seconds
• this can be down with eyes open or closed
• a positive Romberg Test is documented when the patient can complete the eyes open portion but not the eyes closed portion

Question 5

Describe single limb stance test

Answer 5

• patient standing on one limb and holds for how ever long they can
• can be done eyes open or closed
• can use varying surfaces
• < 5 secs = 2.5x fall risk compared to those > 5 secs

Question 6

Describe the nudge/push test

Answer 6

• also called a perturbation test
• keep nudges random in timing and direction
• increase force as able

Question 7

Describe the functional reach test

Answer 7

• measure start & end position from 3rd MCP joint
• compare to norms
• can be predictive of falls in older adults
• can be performed laterally & posteriorly or while seated if necessary

Question 8

Describe catching test

Answer 8

• use ball, beanbag, anything
• assess individual’s ability to attend to situational balance while catching incoming object

Question 9

Describe the timed up and go test

Answer 9

• time to rise from chair without using the armrests, walk 3 meters, turn around, & sit back down
• Normal: < 10 secs
• greater than 15 secs indicates fall risk

Question 10

Describe the Tinetti performance oriented mobility assessment (POMA)

Answer 10

• 25 to 28 = low fat risk
• 19 to 24 = medium fall risk
• <19 = high fall risk

Question 11

Describe the 5 times sit to stand (FTSST)

Answer 11

• patient sits with arms folded across chest & back against the chair
• timing begins at “GO” and ends when the buttocks touches the chair after the 5th repletion
• inability to complete 5 reps without assistance or use of UE support indicates failure of the test
• > 16 secs indicates risk of falls

Question 12

Describe the clinical test of sensory integration on balance (CTSIB-M)

Answer 12

• there are 4 conditions each with 3 trials
• the trial is over when: A) the patient opens their eyes in an eyes closed condition, B) raises arms from sides, C) loses balance and requires manual assistance to prevent a fall

Question 13

When is it a priority to test balance

Answer 13

• history of falls or episodes of instability
• known or suspected CNS dysfunction that affects postural stability
• somatosensory loss to lower extremities
• frequent injury or surgery of LE
• general reconditioning or weakness
• use of an assistive device
• patients over the age of 65

Question 14

When is it pointless to test balance

Answer 14

• no known of suspected balance difficulties of falls