postural control

Question 1

6 multiple systems required for postural stability and orientation

Answer 1

biomechanical constraints
cognitive processing
movement strategies
control of dynamics
sensory strategies
orientation in space

Question 2

biomechanics constraints

Answer 2

degrees of freedom
strength
limits of stability

Question 3

cognitive processing

Answer 3

attention and learning

Question 4

movement strategies

Answer 4

reactice
anticipatory
voluntary

Question 5

control of dynamics

Answer 5

gait
proactive

Question 6

orientation in space

Answer 6

perception
gravity, surfaces, vision
verticality

Question 7

sensory strategies

Answer 7

sensory integration and sensory reweighting

Question 8

postural control in stroke

Answer 8

83% of pts 2-4 weeks post stroke = balance disability

Question 9

motor control impairments in stroke

Answer 9

slow movements, weakness, fatigue, incoordination, decreased force production, co-contraction

Question 10

what cases motor control impairments in stroke

Answer 10

reduction in # and firing rate of motor units

Question 11

decreased # of FT MU and increased atrophy of type. 2 fibers =

Answer 11

slower muscle contractile properties = decreased speed

Question 12

decreased supra spinal drive and increased recurrent inhibition =

Answer 12

slower MU firing rates = decreased strength

Question 13

increased cocontraction and decreased coordination =

Answer 13

reduced net force = decreased precision

Question 14

3 global impairments in balance

Answer 14

sensation ( to detect or anticipate postural disturbance)
neural processing ( to select appropriate feedback/feedforward postural control)
effective motor output

Question 15

Schematic representation of muscle activation (EMG), center of pressure (COP), and center of mass (COM) displacements during external perturbation (horizontal translation of force platform)

Answer 15

Impairment to the timing, magnitude and sequencing of muscle activation

Question 16

postural control in PD

Answer 16

with ds progression = loss in postural stability, gait dysfunction, frequent falls

Question 17

how does PC present in PD

Answer 17

lack of balance reaction, flexed posture, decreased trunk rotation, difficulty executing simultaneous movements/sequential movements

short shuffling gait, reduced arm swing, rigidity and tremor of extremities and head

Question 18

in later stages of PD..

Answer 18

up to 68% falls

Question 19

postural instability ___ responsive to drug therapy in PD

Answer 19

less

Question 20

the basal ganglia is responsible for

Answer 20

controlling the flexibility of postural tone
scaling up the magnitude of postural movements
selecting postural strategies for environmental context
automatizing postural responses and gait

Question 21

rigidity in PD in caused by what main domain of PC

Answer 21

biomechanics constraints (degrees of freedom, strength, limits of stability)

Question 22

bradykinesia in PD is caused by what domain of PC

Answer 22

control of dynamics (gait, proactive)
movement strategies (reactive, anticipatory, voluntary) and sensory strategies (sensory integration and sensory reweighing)

Question 23

proprioception deficits in PD are caused by what domain of PC

Answer 23

orientation in space (perception, gravity surfaces vision, verticality)

Question 24

non motor symptoms in PD are caused by what domain of PC

Answer 24

cognitive processing (attention and learning)

Question 25

postural control in mTBI

Answer 25

postural instability due to dysfunction in sensory integration deficits in cognition = attention affects postural control

Question 26

one of the most common symptoms of mTBI

Answer 26

balance disorders

Question 27

dizziness reports in mTBI

Answer 27

23-81% report

Question 28

postural control in MS is due to

Answer 28

extensive damage to CNS

Question 29

MS demyelination =

Answer 29

sensorimotor cortex, basal ganglia, cerebellum, spinal pathways

Question 30

motor learning preserved in early phase of MS =

Answer 30

capacity dependent on severity

Question 31

MS Critical deficit: slowed spinal SS conduction =

Answer 31

delayed postural latencies and increased postural sway

Question 32

postural control in SCI

Answer 32

aberrant synapse formation leads to inappropriate muscle recruitment and poor coordination changes in excitability of spinal locomotion networks render some synapses hyperexcitable and some hypoexcitable

Question 33

chronic SCI postural control

Answer 33

progressive deterioration of muscle properties diminished the ability to generate movements

Question 34

vestibular system roles

Answer 34

perception of body position and self motion orientation of trunk to vertical controls COM (postural reactions) stabilize head in space

Question 35

balance evaluation outcome tools for stroke

Answer 35

berg balance scale dynamic gait index functional reach tst TUG

Question 36

balance outcome tools PD

Answer 36

berg dynamic gait index functional gait assessment mini BesTESt TUG

Question 37

balance outcome tools for mTBI

Answer 37

high level mobility assessment HIMAT

Question 39

balance outcome tools MS

Answer 39

berg dizziness handicap TUG w cognitive and manual

Question 40

balance outcome tools SCI

Answer 40

TUG 10.8 seconds

Question 41

balance outcomee tools vestibular disorders

Answer 41

dynamic gait index dizziness handicap inventory functional gait assessment

Question 42

healthy older adults according to research - green

Answer 42

(dose-response relationships of ”balance training” parameters; training period of 11-12 wks, frequency of 3x/week, 31-45 minutes per session, 36-40 total # of sessions)- Variety of training modalities (commonly multimodal exercise-based balance training)-

Question 43

interventions for chronic stroke according to research - green

Answer 43

(balance/wt. shifting and gait training effective)

Question 44

intervention for Parkinson - green

Answer 44

exercise interventions probably reduce rate of falls- mod intensity PRE, 2-3x/wk over 8-10 wks-

Question 45

intervention for MS - yellow

Answer 45

(balance interventions have a medium effect on outcomes; high intensity* & task-specific interventions are associated with better outcomes)-

Question 46

intervention for vestibular disorders - yellow

Answer 46

(moderate evidence for improved postural stability following vestibular rehab exercises)

Question 47

intervention for mTBI

Answer 47

(weak evidence for vestibular rehab exercises, subthreshold aerobic exercise)

Question 48

intervention for incomplete SCI

Answer 48

[weak evidence for BWST (+ stimulation – FES or tDCS), small scale studies on VR-based balance training show promise]

Question 49

example of biomechanical issues

Answer 49

ankle strength/ROM

Question 50

example of stability limits

Answer 50

reaching

Question 51

example of APAs

Answer 51

planned changed of position

Question 52

example of reactive responses

Answer 52

unplanned response - step

Question 53

example of sensory orientation

Answer 53

impact of vision/vestibulat system

Question 54

example of gait

Answer 54

change gait speed or direction or cognitive load

Question 55

6 systems of balance

Answer 55

biomechanics constraints stability limits/verticality anticipatory postural adjustments postural responses sensory orientations stability in gait