kine 3 (balance, Coordination, Positioning, Wheelchair)

Question 1

define balance?

Answer 1

ability to control the COG over the BOS
together with coordination it maintains static position and carries out functional skills and activities

Question 2

what are the biomechanical components of balance

Answer 2

1. center of gravity ( COG)
   2 Base of support (BOS)
   3Limit of stability (LOS) - the distance a person can lean away from the COG without changing the original BOS

Question 3

components of balance maintenance?

Answer 3

1. Postural strategies
   a - ankle strategy
   b- hip strategy
   c- stepping strategy
   2 protective reactions
   3 equilibrium reaction

Question 4

factors affecting balance?

Answer 4

visual impairments
vestibular control impairments
poor proprioception
muscle imbalance

other:
head injury
medications
infection/bacteria in ear
postural hypertension

Question 5

assessing balance (balance tests)

Answer 5

1. Berg balance test
   2 functional reach test
   3 timed up and got test

Question 6

types of stances?

Answer 6

Bilateral - two legs planted on base
tandem - one foot planted in front of other heel near/against toe
single limb - on leg planted on surface
* progress by closing eyes

Question 7

types of surface progressions?

Answer 7

Noncompliant- firm and hard, doesn’t give in
Compliant - generally a softer surface that gives in or complies to foot
unstable - soft or hard surface that is unstable

Question 8

Balance re education

Answer 8

reduce dependence on assistive devices
bilateral -> single leg stance
surface progression
add increments of height
increase LOS
increase speed of movement
manual resistance
decrease BOS

Question 9

balance re education practical aspects?

Answer 9

Single Leg Balance
Single Leg Balance on unstable
Walking Heel Toe
Ball Under Leg

Question 10

define coordination?

Answer 10

the action of muscles and groups of muscles aimed at bringing about purposeful movements

Question 11

characteristics of coordination?

Answer 11

speed
distance
direction
rhythm
muscle tension

Question 12

name and define the types of coordination?

Answer 12

fine motor skills - coordinated movement of small muscles
gross motor skills - coordination of large muscles or groups of muscles
hand- eye skills - using vision input and then control the hands to perform a task

Question 13

cerebellar syndrome symptoms?

Answer 13

Muscle hypotonia
Intention tremor
Ataxic gait
Dysdiadochokinesia - difficulty performing rapid movements
Dysarthria - speech disorder
Nystagmus - involuntary movement of eye
Dysmetria - cant control range of force

Question 14

coordination assessments tests?

Answer 14

Romberg’s’ test - feet together then open and close eyes
Finger to nose test
Heel to shin test
The rebound phenomenon - able to stop arm moving in desired direction after therapist pulled it

Question 15

Parkinson’s disease symptoms?

Answer 15

TREMOR
RIGIDITY - Due to increase muscle tone.
BRADYKINESIA -Slowness of movement,
HYPOKINESIA -Poverty of movement, postural stability and gait

Question 16

define what the usage Frenkel’s exercises?

Answer 16

a set of exercises developed to treat ataxia, in particular cerebellar ataxia

Question 17

main objectives of Frenkel’s exercises

Answer 17

Concentration of attention-
Precision
Repetition
improve function
To improve safety
To delay loss of independence

Question 18

why is it important to position patients?

Answer 18

• prevent muscle contractures and joint stiffness
• prevent pressure sores
• decrease pain/ pt comfort
• support and stability
• decrease edema
• increase function

Question 19

pressure points in supine?

Answer 19

heels
sacrum
elbow
shoulder blades
back of head

Question 20

pressure points in side lying?

Answer 20

ankle
hip
elbow
ribs
shoulder
ear

Question 21

pressure points in prone?

Answer 21

toes
knees
genitalia
breasts
shoulder
ear/cheek

Question 22

when do we change positions?

Answer 22

every 2 hours
when patient is uncomfortable
when treating a patients

Question 23

standard position in supine?

Answer 23

support under:
- head
- cervical support
- elbows
- popliteal space
- ankles

Question 24

standard position for prone?

Answer 24

support under:
head
lower abdomen
anterior shoulder
pelvis
ankles

Question 25

standard position in side lying?

Answer 25

head trunk and pelvis aligned
flexed hip
pillow between legs (top LL slightly more forward)
pillow under arm

Question 26

semi-fowler position?

Answer 26

head of bed lifted to 30 degrees
pillow under popliteal space

Question 27

complications due to poor posture?

Answer 27

• Contractures and Deformities
• Tissue breakdown
• Masked ability
• Reduced performance and tolerance
• Infection, UTI, respiratory insufficiency
• Fatigue and discomfort

Question 28

types of wheelchairs?

Answer 28

lightweight rigid
lightweight folding
motorized
children’s
rural/off road
standard folding
sports
standing

Question 29

measurement of wheelchair?

Answer 29

measure:
hip to hip
knee to knee
knee to hill
1.25 cm of space between side of seat
c.5cm clearance from knee to seat
footrest 2 cm from floor
4 fingers between back rest and axilla

Question 30

positioning of patient on wheelchair?

Answer 30

pelvis center and level
ankles 90 degrees
hips 100 degrees
knees 105 degrees

Question 31

steps for wheelchair using?

Answer 31

prepare the hands
gripping the wheels
going forwards
going backwards
turning right( hold right wheel stable and use left)
turning left ( hold left wheel stable and use right)
stopping
staying still ( breaks )
going over bumps
step hopping

Question 32

wheelchair exercises?

Answer 32

sitting balance
crossing legs
push ups
from chair to mat(floor) and back using benches or directly