Postural Control

Question 1

What is postural control?

Answer 1

The control of body position in space for stability and orientation.

Question 2

What is postural stability?

Answer 2

The ability to control the center of mass (COM) relative to the base of support (BOS).

Question 3

What is postural orientation?

Answer 3

The ability to maintain appropriate alignment between body segments and with the environment for a task.

Question 4

Is balance the same as postural control?

Answer 4

Yes, balance is synonymous with postural control and equilibrium.

Question 5

Why is postural control important?

Answer 5

It’s critical for independence, efficiency, and safety in functional tasks and ADLs.

Question 6

What are consequences of impaired postural control?

Answer 6

Loss of independence, difficulty with ADLs, and increased fall risk.

Question 7

What three systems interact to produce balance?

Answer 7

Sensory/perceptual systems, CNS integration, and motor systems.

Question 8

Name the three sensory systems for balance.

Answer 8

Vision, vestibular, and somatosensory.

Question 9

What does the CNS do with sensory input for balance?

Answer 9

It integrates the input and produces an appropriate motor response.

Question 10

What are the three key types of balance control?

Answer 10

Steady state, anticipatory (proactive), and reactive control.

Question 11

What is steady state postural control?

Answer 11

Ability to maintain COM within BOS in predictable, non-perturbed conditions.

Question 12

What are examples of steady state postural control?

Answer 12

Sitting or standing quietly, sometimes called static balance.

Question 13

What contributes to steady state postural control?

Answer 13

Body alignment, muscle tone, postural tone, and movement strategies.

Question 14

What is anticipatory postural control?

Answer 14

Activation of postural adjustments in preparation for voluntary movement.

Question 15

What does anticipatory control rely on?

Answer 15

Prior experience and learning using feedforward mechanisms.

Question 16

Give an example of anticipatory postural control.

Answer 16

Activating left leg muscles before lifting the right leg onto a curb.

Question 17

Name five examples of tasks using anticipatory control.

Answer 17

Sit-to-stand, walking, raising arms, catching a ball, lifting objects.

Question 18

What are limits of stability (LOS)?

Answer 18

The maximum distance one can move without losing balance or changing BOS.

Question 19

Are LOS present in both sitting and standing?

Answer 19

Yes, both positions have defined limits of stability.

Question 20

What is reactive postural control?

Answer 20

The ability to recover balance after unexpected external perturbation.

Question 21

What type of feedback does reactive control rely on?

Answer 21

Sensory feedback after the disturbance.

Question 22

Give two examples of when reactive control is used.

Answer 22

Tripping while walking or being bumped in a crowd.

Question 23

What is the ankle strategy?

Answer 23

Fixed support strategy for small, slow perturbations; muscles activate distal to proximal.

Question 24

Which muscles activate first during forward sway in ankle strategy?

Answer 24

Gastrocnemius, then hamstrings and paraspinals.

Question 25

Which muscles activate first during backward sway in ankle strategy?

Answer 25

Anterior tibialis, then quads and abdominals.

Question 26

What is the hip strategy?

Answer 26

Fixed support strategy for faster, larger COM shifts using proximal to distal activation.

Question 27

When is the hip strategy used?

Answer 27

During fast sway, large perturbations, or on narrow surfaces.

Question 28

What muscles activate during forward sway in the hip strategy?

Answer 28

Abdominals, then quads.

Question 29

What muscles activate during backward sway in the hip strategy?

Answer 29

Paraspinals, then hamstrings.

Question 30

What is a change-in-support strategy?

Answer 30

Balance strategy involving stepping or using arms to widen the BOS.

Question 31

When is a stepping strategy used?

Answer 31

When perturbation is too large for ankle or hip strategy.

Question 32

What is sensory reweighting?

Answer 32

CNS shifts reliance to more accurate sensory inputs when one system is compromised.

Question 33

What happens if the CNS fails to reweight sensory inputs?

Answer 33

It can lead to imbalance and falls.

Question 34

What is the tripod model of sensory input for balance?

Answer 34

Vision, vestibular, and somatosensory systems all contribute equally.

Question 35

What happens when one sensory system is inaccurate?

Answer 35

The CNS down-weights it and relies more on the remaining accurate ones.

Question 36

What musculoskeletal factors influence postural control?

Answer 36

Strength, ROM, alignment, tone, and coordination.

Question 37

What neuromotor factors affect balance?

Answer 37

Tone abnormalities, paresis, coordination issues.

Question 38

What cognitive factors affect postural control?

Answer 38

Attention, executive function, and judgment.

Question 39

What is impaired steady state balance?

Answer 39

Difficulty maintaining stable sitting or standing posture.

Question 40

What are functional implications of impaired steady state balance?

Answer 40

Increased reliance on UEs, reduced function, increased fall risk.

Question 41

Name three reasons for impaired steady state balance.

Answer 41

Altered alignment, disrupted sensory input, increased postural sway.

Question 42

What causes altered alignment?

Answer 42

Tone changes, flexibility issues, weakness, sensory/perceptual impairments.

Question 43

How does altered alignment affect stability?

Answer 43

It reduces the functional limits of stability and increases fall risk.

Question 44

What is increased postural sway?

Answer 44

Larger, faster body oscillations during quiet stance due to poor control.

Question 45

Name conditions associated with increased postural sway.

Answer 45

Parkinson’s disease, cerebellar pathology, some strokes, cerebral palsy.

Question 46

What is impaired anticipatory balance?

Answer 46

Inability to pre-activate postural muscles before movement.

Question 47

Why is anticipatory control important?

Answer 47

It ensures safe and efficient task performance.

Question 48

What can cause loss of anticipatory control?

Answer 48

Deficits along motor or sensory pathways, depending on pathology.

Question 49

What patients are likely to have anticipatory control problems?

Answer 49

Nearly all with neurological disorders.

Question 50

What is impaired reactive balance?

Answer 50

Difficulty recovering from unexpected perturbations due to CNS or motor issues.

Question 51

What motor problems cause reactive balance deficits?

Answer 51

Sequencing, delay, poor adaptation, and scaling of responses.

Question 52

What is a sequencing problem?

Answer 52

Incorrect order of muscle activation in response to balance disturbance.

Question 53

What is a delay problem?

Answer 53

Late muscle activation after a perturbation.

Question 54

What is an adaptation problem?

Answer 54

Inability to adjust strategies for different tasks or environments.

Question 55

What is a scaling problem in balance?

Answer 55

Inappropriate amplitude of postural response to perturbation size.

Question 56

What sensory issue affects reactive balance?

Answer 56

Reduced or absent sensory input prevents appropriate motor reaction.

Question 57

What is the result of poor sensory feedback during perturbation?

Answer 57

The body cannot respond effectively to restore balance.

Question 58

Why is balance training essential in neuro rehab?

Answer 58

To improve postural control and reduce fall risk in daily activities.

Question 59

How can PTs address impaired steady state balance?

Answer 59

Improve alignment, strength, sensory input, and sway control.

Question 60

How can PTs address anticipatory control deficits?

Answer 60

Train tasks that require postural pre-activation, like reaching or stepping.

Question 61

How can PTs address reactive control deficits?

Answer 61

Practice recovery strategies like stepping, reaching, and perturbation training.

Question 62

How do balance deficits affect function?

Answer 62

They reduce independence and increase risk for falls and injury.

Question 63

What tools are used to evaluate balance?

Answer 63

Observation, LOS testing, functional tasks, and perturbation responses.

Question 64

What strategy is used first in mild sway?

Answer 64

Ankle strategy.

Question 65

What strategy is used on narrow surfaces or fast sway?

Answer 65

Hip strategy.

Question 66

What strategy is used when balance is lost?

Answer 66

Stepping or reach-and-grasp strategy.

Question 67

How do somatosensory inputs affect balance?

Answer 67

They help detect body position, movement, and support surface.

Question 68

How does vision contribute to balance?

Answer 68

Provides reference to verticality and motion of environment.

Question 69

How does the vestibular system contribute to balance?

Answer 69

Detects head movement and orientation in space.

Question 70

What happens in sensory conflict situations?

Answer 70

CNS must reweight inputs to determine the most reliable source.