Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Semester 5 PMNM Exam 3 > Coordination and Balance > Flashcards

Coordination and Balance Flashcards

(74 cards)

Start Studying
1
Q

Coordination - definition

A

ability to perform smooth accurate movements

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

Hypermetria deficit

A

Inability to grade forces appropriately for the distance and speed of a task

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

Hypermetria deficit is usually associated with what

A

cerebellar dysfunction

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

Coordination deficit

A

inability to coordinate an intersegmental task due to deficit in timing and sequencing of one segment to another

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

Requirements for coordination

A

Intact motor cortex, BG, Cbm and proprioception

REquires biomechanical and neuromuscular systems

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

Cerebellar coordination deficit - can lead to what

A 
Ataxia
Dysmetria
Dysdiadochokinesia
Intention tremor
Dysarthria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dorsal column medial lamniscus coordination deficit can lead to what

A

decreased proprioception

dysmetria

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

Basal ganglia coordination deficit can lead to what

A 
Athetosis
Chorea
Dystonia
Hemiballismus
Resting tremor
Rigidity
Akinesia/bradykinesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Athetosis -

A

slow, involuntary, worm-like movement

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

Chorea -

A

involuntary, rapid, irregular, jerky mvmnt

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

Dystonia -

A

sustained voluntary contractions (spasmodic torticollis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dysarthria -

A

speech articulation, melodic element lost

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

Components of coordination

A

Sequencing
Timing
Scaling/Grading Forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is involved in sequencing (components of coordination)

A

Synergies

Co-activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is involved in timing (components of coordination)

A

Initiation - force generation, ROM, motivation, postural control
Execution - prox stability with distal mob
Termination - difficulty with stopping or changing direction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is involved in scaling/grading forces (components of coordination)

A

Hypermetria - overshooting

Dysmetria - judging force and distance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Documentation of coordination exam

A

Can do a scale - they were accurate 0 out of 5 times, or can be a percent
Narrative needs to be included

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Goals of interventions with coordination dysfuncition

A

Improve prox stability
Improve eye-hand coord for funct tasks
Improve coord of reciprocal mvmnts
Control mvmnts against gracity

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

What to be cautious of with adding weights

A

Rebound effect - can lead to ataxia being worse when take weights off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Frenkels exercises

A

progression of exercises for coordination

no evidence to support it - but can give good exercises for HEP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Interventions for those with mvmnt deficit associated with accuracy (timing and direction) or speed problem
1 Timing/speed
2 Sensory

A

If timing.speed - add music or metronome

If sensory deficit - add vibration, approximation, visual cues/targets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Interventions for those with mvmnt deficit associated with adaptability problem (sensing change, obstacles)

A

Empty cup vs full cup - can incorporate strength too
Set up obstacle to improve problem solving - can offer endurance component too
Maybe take away visual so they dont know if it is heavy or light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Interventions for those with mvmnt deficit associated with strength problem

A

Stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Postural control -

A

interaction of neural and musculoskeletal systems

Control of body positiions in space for purpose of stability, orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Postural stability
balance
26
System changes - vestibular
1 Can be peripheral or central 2 Info from peripheral system transmitted to vesibular nucleus and cbm - dec hair cells - degeneration of vest system
27
System changes - sensory
Tactile - dec prop and cutaneous receptors, inc thresholf for firing Visual - dec pupil reactivty and lends elasticity
28
Pathologies that can lead to vestibular changes
BPPV Menieres Bilateral vestibular dysfunction
29
Pathologies that can lead to sensory changes
Cataracts (cloudy) Glaucoma (loss of peripheral vision) Macular degeneration (loss of central vision)
30
System changes - musculoskeletal
``` Dec in bone density Dec in ROM/flexibility Mm dec in size type 1, dec in type 2 mm atrophy inc in mm fat and CT ```
31
System changes - neuromuscular
Dec in nerve cells Dec in cog processing Dec in speed of impulses Dec sensitivity of baroreceptors - ortho hypo
32
Central sesnory processing of input - sensory reweighting
postural control based on vision, vestib, somatosens They all come in together - but when one is not function we need to adjust the contributions to make up for the difference
33
Recurrent fallers -
2 or more falls in either a 6 or 12 months time span
34
Types of falls
Accidental or non Syncopal or non Intrinsic vs. extrinsic with or without injury
35
False assumpations with falls
due to carelessness normal with aging they just hapen cant be predicted or anticipated
36
MS - what percent fall risk
more then 50%
37
PD - what percent fall risk
60% one fall a year | 39% recurrent falls
38
CVA - what percent falls
double fall risk | most happen with ambulation
39
Alzheimers - what percent fall risk
double the fall risk
40
Intellectual/Developmental disability - fall risk screening
limited fall risk screenings for this populaion
41
Mvmnt system diagnosis - Sensory detection deficit
inability to execute intersegmental mvmnt due to lack of joint position sense of multisensory failure (joint position sense, vision, vestibular)
42
Mvmnt system diagnosis - sesnsory selection and weighting deficit
inability to screen for and attent to appropriate sensory inputs pts likely complain of dizziness or visual motion sensitivity
43
Measurement tools for screening fall risk
STEADI Stay independent questionnaire TUG FRAST
44
PT exam - history
``` function in diff environments fall hx and fear of falling adaptive equipment meds medical testing family, social, work hx ```
45
PT exam - vestibular
``` Dizzy - have them define it Details of their sx Exam - 1 smooth pursuit 2 VOR cancellation 3 VOR 4 Saccades 5 Hallpike 6 Determine if periph or centr vertigo ```
46
PT exam - static balance tests
``` Romberg Single leg stance Postural stress test Perturbations Functional reach LOS on force plate ```
47
PT exam - dynamic balance tests
Fukuda FSST Mini BEST Fregly Gabriel Quantitative Ataxia Test Battery
48
Mini BESTest addresses what 4 systems
Anticipatory postural adjustments Postural responses Sensory orientation Gait stability
49
What other 2 does the long BESTest add
Biomechanical | Stability limits/verticality
50
Berg - what is inc fall risk
less than 45 out of 56
51
TUG - what is abnormal
more than 30 seconds
52
Tinetti POMA - what is increased fall risk
Less than 23 out of 28
53
Five times sit to stand - what is abnormal
scores greater than 15 sec | measures strength
54
LImitations of Funtional balance measures
might not predict balance in complex environemtns most dont measure all 3 aspects of postural control (steady state, reactive, anticipatory) No measure of the quality of mvmnt
55
Sensory manupualtion tests
clinical test for sensory integration and balance (foam) equi-test = surround on movable force plate vestibular tests
56
Participation exam tools
(all questionnaires) Fall efficacy scale Activities specific balance confidence scale UIC fear of falling scale
57
Comprehensive fall risk assessment - if in community
multidisciplinary with medical review, medications, physical exam, gait/balance exam, home assessment
58
Comprehensive fall risk assessment - if in hospital
mental status, medications, toileting, other dx, footwear
59
Goals for interventions
``` pt ed improve balance reduce motion provoked sx improve coordination dec disability, improve function dec falls - be careful with this one ```
60
Interventions - need to consider if
restorative or compensatory
61
Interventions - CVA
aerobic is beneficial
62
Interventions - PD
need to use block practice and lots of repititions
63
Intervetnions - Guillain Barre, polio, ALS, MS
Risk of fatigue or overworking the motor units
64
six dimensions of mvmvnt
``` flexibility strength accuracy speed adaptability endurance ```
65
What mode of balance exercise is effective
should be done in stance | progressive program that has strength and abalnce is best
66
Not effective in balance exercise
strength, stretching, walking as single interventions are not effective inconclusive on perturbation and compensatory stepping training
67
Factors to manipulate for Rx
``` Surface Speed of mvmnt Cognitive demands Sensory input Task - objects to manipulate Time to complete tasks ```
68
Dosage (this is all balance)
1 to 3 times a week | Min of 50 hours over 3 to 6 months (best if over 10 week time frame)
69
PT supervision vs. Can they stay at home
Monitor safety, vitals, fatigue Progressions - do they need assistance or can they do them Cognition Upside to home - a lot more to practice that we can't simulate in clinic
70
Evidence based exercise programs for balance
Otago Stepping On Tai Chi
71
Otago
Home based 17 exercises to be done for a year with levels of progression Highly effective for those over 80 35% fall and injury reduction
72
Stepping on
7 sessions for 2 hours over 2 months Focuses on adoption of safety strategies 31% fall reduction in community adults
73
Tai Chi
reduce fall risk by 47.5%
74
Intervention for older adults
``` hip protector pads Vit D vibrating insoles grab bars, assistive devices exercise program for balance, gait, strength ```

Semester 5 PMNM Exam 3 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions