balance re-education

Question 1

how to perform

Answer 1

physio hand reaches far out, physio keeps looking at patients muscles

start in wide BoS/most stable position
test: reaching, observe alignment and righting reactions
progression: rotation, plinth height, unstable sitting surface, walking, backwards, take away vision, using balls

Question 2

contraindications

Answer 2

no contras
dizziness

[MSK: fracture, recent surgery
CR: infection
CV: disease, uncontrolled hypertension
N: pain]

Question 3

principles

Answer 3

safety: 2nd person, stable environment, start simple to minimise risk of falling
progress/regress with BoS and speed, challenge stability limits
treatment should be functional
Check righting reactions/compensatory strategies throughout.
both sides

Question 4

structure

Answer 4

trunk/limb muscles having to stabilize when CoG is outside BoS

visual - limiting sight
vestibular - challenging equilibrium/reaction by throwing
proprioception - extending joints, reaching to touch

Question 5

physiological effects

Answer 5

activating/strengthening correct muscles, improving posture & bone density
neuromuscular control
joint mobility, somatosensory input, vestibular function

Question 6

rational

Answer 6

improving strength, stability & efficiency of visual/vestibular/proprioceptive systems to reach functional goals
reduce fall risk