Lecture 6: Exam and Treatment for Balance

Question 1

What two kinds of balance must be tested?

Answer 1

1. static and dynamic sitting

2. static an dynamic standing

Question 2

Are balance exams a standardized outcome measure?

Answer 2

no only a screening tool

Question 3

What is the Romberg test?

Answer 3

a clinical test used for balance although not very functional, therefore useful as a scrren

Question 4

What are parts of Romberg?

Answer 4

pts stand with feet together and arms crossed, do eyes open and closed and max time is 30 seconds

Question 5

What is a positive romberg?

Answer 5

loss of balance with eyes closed

Question 6

What is a sharpened Romberg?

Answer 6

standing in tandem stance same procedure

Question 7

What is another test similar to the Romberg?

Answer 7

SLS

Question 8

What are two standardized measures for static and dynamic sitting balance?

Answer 8

Trunk Impairment Scale (TIS)

Function in sitting test (FIST)

Question 9

What is the FIST?

Answer 9

14 items, with scored as 0 (complete assist) to 4 (ind.)

Question 10

What are examples of static and dynamic standing balance?

Answer 10

ABC scale, CTSIB, FRT, Berg, TUG, DGI, BESTest

Question 11

What is the ABC scale?

Answer 11

self report of confidence with maintaining balance

Question 12

What is score on ABC that indicates fall risk?

Answer 12

under 67% (84% accuracy)

bench marks established for people with history of CVA, PD

Question 13

What is the CTSIB?

Answer 13

clinical test for sensory interaction in balance

“foam and dome” test

indicates where functional deficit is coming from (sensory modality)

Question 14

How many different conditions are tested in the CTSIB?

Answer 14

6, firm and foam with eyes open/closed/dome

Question 15

What is the functional reach test testing?

Answer 15

ability to reach forward in bilateral stance = internal pert and test of proactive balance

Question 16

What is cut off score for Berg Balance?

Answer 16

45 (max is 56) indicates greater fall risk

Question 17

What does 5 time sit to stand measure?

Answer 17

LE strength and fall risk

Question 18

What is the DGI?

Answer 18

dynamic gait index, assess individual ability to modify balance while walking in the presence of external demands

Question 19

What is FGA?

Answer 19

functional gait assessment, assess postural stability during various walking tasks

Question 20

Why is the BESTest so good?

Answer 20

it allows clinicians to differentiate balance into 6 underlying systems that may constrain balance and in turn design more effective treatments

Question 21

What are 6 different areas of BESTest?

Answer 21

1. biomechanical constraints
2. Stability limits
3. APA
4. postural responses
5. sensory orientation
6. Stability in Gait

Question 22

What kind of perturbation is reaching?

Answer 22

internal bc patient must brace themselves for movement

Question 23

What is general cut off score for BESTest?

Answer 23

69% (sensitivity 0.86)

Question 24

What areas are tested in the Mini BESTest?

Answer 24

1. APA
2. reactive postural control
3. sensory orientation
4. dynamic gait

Question 25

For the Brief BESTest what areas of 6 original areas are tested?

Answer 25

1. Biomechanical- hip strength 2. stability limits- reach forward 3. APA- stand on one limb 4. postural responses- compensatory stepping each leg 5. Sensory orientation- stance on foam eyes closed 6. stability in gait: get up and go test

Question 26

How can you train vision to help balance?

Answer 26

visual fixation, VOR exercises, scanning the environment

Question 27

How can you train somatosensation?

Answer 27

unstable surface training, if promoting recovery use exercises to appertain sensory input

Question 28

How can you train the vestibular system?

Answer 28

functional activities with head turns, habituation, VOR exercises

Question 29

What are examples of training internal perturbations?

Answer 29

head turns, weight shifts, reaching, sit to stand, walking, stairs, obstacle courses

Question 30

How can a PT train ankle or hip strategies?

Answer 30

large supporting surface with slow and low amplitude external perturbations

Question 31

How can a PT train stepping strategies?

Answer 31

small supporting surface with large fast perts

Question 32

What are other ways to train external pertubations?

Answer 32

moving surfaces, walking in crowded hallway, catching a ball thrown in unpredictable directions