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PT-415 Motor Control > Impairment: Balance Dysfunction > Flashcards

Impairment: Balance Dysfunction Flashcards

1
Q

Postural Control: Definition

A

Controlling the body’s position in space for the purpose of STABILITY and ORIENTATION

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2
Q

Postural Control: Types

A
  • Reactive (compensatory)
  • Proactive (anticipatory)
  • Adaptive
  • Tilting Reactions
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3
Q

Reactive (compensatory)

A

Reaction to external force

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4
Q

Proactive (anticipatory)

A

Responses that occur in anticipation (feedforward)

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5
Q

Adaptive

A

Appropriately modify via sensory and motor

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6
Q

Tilting Reactions

A

Reposition COM within BOS for changing surface

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7
Q

Postural Orientation (POSTURE) definition

A

Ability to maintain appropriate relationship between:

  • Body segments
  • Body and environment for a given task
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8
Q

Balance (Postural Stability) definition

A
  • State of PHYSICAL EQUILIBRIUM involving stabilizing and destabilizing forces
  • CONTROLLING COM OVER BOS
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9
Q

COM

A
  • Located at approximately S2
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10
Q

COG

A
  • Vertical Projection of the COM
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11
Q

BOS

A

Area that is in contact w/ support surface

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12
Q

Static POSTURE/BALANCE:

A
  • COG falls within BOS

- maintains particular posture agains gravity

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13
Q

Postural Fixation Reactions

A

Stabilize the body against thrust force

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14
Q

Dynamic POSTURE/BALANCE

A
  • COG falls outside BOS
  • maintaining stability during movements of body and body segments
  • changing surface (walking)
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15
Q

Functional Task Analysis (list)

A
  • Mobility
  • Stability
  • Controlled Mobility
  • Skill
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16
Q

Mobility

A

Ability to move from one position to another safely

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17
Q

Stability

A
  • (static postural control)

- COM over BOS

18
Q

Controlled Mobility

A
  • (dynamic postural control)
  • maintain postural stability while moving w/ COM over BOS
  • WEIGHT SHIFTING
19
Q

Skill

A
  • Ability to consistently perform “coordinated movement” for purposes of INVESTIGATION/INTERACTION w/ environment
20
Q

Line of Gravity (LOG): Definition

A

Ideal posture, where body segment axes should fall

21
Q

LOG “ideal” position:

A
  • slightly anterior to ankle and knee joints
  • slightly posterior to hip joint
  • thru midline of trunk
  • anterior to shoulder
  • thru external auditory meatus
22
Q

Center of Pressure (COP)

A
  • Both VERTICAL and HORIZONTAL shear forces
    - within foot unilaterally
    - between foot bilaterally
  • LOG and COP constantly change b/c postural sway
23
Q

Center of Force (COF)

A

Only vertical forces

24
Q

Postural Sway

A
  • shifts from SIDE to SIDE and HEEL to TOE
  • STEADINESS:
    - holding given posture w/ least amount of movement
    - increased sway = increased unsteadiness
25
Q

Limits of Stability (LOS)

A

Maximum angle from vertical that can be tolerated w/o loss of balance

   - static standing = 12 degrees of motion in sagittal plane
   - static standing = 16 degrees of motion in frontal plane
26
Q

Sensory Processes for Balance Control

A
  • Visual System
  • Somatosensory Inputs
  • Vestibular System
27
Q

Visual System w/ Balance:

A
  • Helps perceive movements via VISUAL PROPRIOCEPTION
  • Exam:
    - Focal Vision: central vision
    - Ambient Vision: peripheral vision
28
Q

CN Visual Deficits:

A
  • CN II: depth perception, visual acuity
  • CN III: lid droop, outward eye, dbl vision, decrease depth perception
  • CN IV: head tilt, downward dbl vision, trouble w/ stairs (tripping)
  • CN VI: inward eye posture, turns head towards affected eye
29
Q

Somatosensory Inputs:

A
  • Cutaneous and Pressure sensations

- Muscle and Joint Proprioceptors

30
Q

Sensory Input: Examination

A
  • Romberg Test: assesses DORSAL COLUMN (eyes open/closed)

- Sensory Testing:

31
Q

Vestibular System:

A
  • vestibulo-ocular reflex (VOR)
  • vestibulospinal reflex (VSR) (“no” walking)
  • labyrinthine righting reactions (LRR)
32
Q

Vestibular System: Examination

A
  • Ocular Fixation
  • Smooth Pursuits
  • Saccadic Eye Movements
  • Convergence
  • VOR
33
Q

Vestibular System: Treatment

A
  • Canalith Repositioning Treatment (CRT)
    - rapid repositioning of head to move crystals (periph def)
  • Habituation Exercises
    - repeated positioning of pt in positions to elicit symptoms
  • Gaze Stability Exercises
  • Postural Stability
34
Q

Motor Processes: Automatic Postural Synergies

A
  • Ankle (Romberg)
  • Hip
  • Stepping (reaching/grasp) (nudge)
  • Suspension (crouching down)
35
Q

3 movement systems CNS uses to regain balance

A
  • Stretch Reflex (ankle, hip, step strategies)
  • Automatic Postural Reactions (righting/equilibrium)
  • Voluntary Responses (cortical)
36
Q

Static Tests:

A
  • Single Limb Stance (SLS or OLST)
  • Romberg Test
  • Tandem Romberg Test
37
Q

Dynamic Tests

A
  • Functional Reach Test (FR)

- Multidirectional Reach Test

38
Q

Berg Balance Scale (BBS)

A
  • originally for stroke pts
  • static and dynamic tests (14 functional tasks)
  • 5-point ordinal scale ; 56 total points
  • fall predictor
    - 54 to 36, each 1 point = 7% increase fall risk
    - <45 = high fall risk. <36=100% fall risk
39
Q

Berg Balance Scale: functional tests (14)

A

1: sitting to stand in
2: standing unsupported
3: sitting unsupported feet on floor
4: standing to sitting
5: transfers
6: standing unsupported w/ EC
7: standing unsupported w/ feet together
8: reaching forward w/ outstretched arm
9: pick up object from floor
10: turning to look behind L and R shoulders
11: turn 360 degrees
12: alternating step stool touches
13: standing unsupported, one foot in front
14: standing on one leg

40
Q

Fullerton Advanced Balance Scale (FAB)

A
  • for higher functioning older adults who pass BBT

- 10 items, scored 0-40 (0-bad, 40-good)

41
Q

BESTest

A
  • tests multiple aspects of postural control
  • 36 items in 6 groups:
    Biomechanics constraints
    Stability limits
    Anticipatory transitions
    Postural responses
    Sensory orientation
    Dynamic gait

PT-415 Motor Control (4 decks)

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