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O Balance/Coord
notes
| Term | Definition |
|---|---|
| ____ out of 5 hip fx pt dies w/in yr of injury | 1 |
| common causes of balance impairment | injury, surgery, immobilization, sedentary lifestyle, normal aging, TBI, CVA, Parkinson, BBPV(Benign Paroxysmal Positional Vertigo) |
| COG | in adult just anterior to S2 |
| BOS | perimeter of contact |
| LOS | sway boundary |
| dynamic balance | stability during movement |
| static balance | stability at rest |
| sensory systems and balance control | visual system, somatosensory system, vestibular system |
| vision | position of head in space, head movements are compared to visual perception (VOR) |
| somatosensory | proprioceptors such as mm spindles & GTO's, joint receptors (Ruffini receptors and Pacinian corpuscles), mechanoreceptors in skin |
| vestibular system | receptors in the inner ear detect acceleration and head movement when the pull of gravity is compared to motion of head, associated with CN 8 |
| sensory integration | term used to describe the accurate processing and evaluation of all sensory data to develop an integrated unconscious perception of balance |
| error/conflicts between the sensory systems result in... | dizziness, disorientation and loss of balance and falls |
| visual system can... | compensate for nearly any vestibular or somatosensory disorder |
| 3 systems for controlling balance | reflex, automatic, voluntary |
| reflex | stretch reflexes in spinal cord- a very fast system |
| automatic | brain stem elicits posture mm control- longer loop involves delay- delay may be long enough to result in fall |
| voluntary | purposeful movements-very slow- almost never quick enough to stop a fall (120 ms) |
| motor strategies for balance control | ankle, hip, stepping |
| ankle strategy | (anteroposterior plane)- small perturbations |
| hip strategy | larger perturbations |
| stepping strategy | large forces displaces stability |
| health and environmental factors | low vision, sensory loss, medications |
| exam & eval of impaired balance | TUG, functional reach test, Tinettis, Berg, perturbation test, Romberg |
| TUG | timed up and go test- ask pt to quickly get up, walk 12 ft, turn and return to chair. graded in seconds |
| functional reach | stand & reach fwd. measure excursion of hand. should be about 13 in on men and 11 in on women |
| normal balance grade | 5-pt maintains position with therapist maximally disturbing balance. can shift weight in all directions |
| good balance grade | 4-pt maintains balance with moderate disturbance. can shift wt but limitations are evident |
| fair balance grade | 3-pt maintains balance for short periods unsupported. unable to sit on unlevel surface. cannot be left unattended. cannot shift weight or tolerate challenge |
| poor balance grade | 2-pt needs assistance to maintain sitting. will fall over. |
| zero balance grade | 1-pt requires max support to maintain balance |
| BAPS | biomechanical ankle platform system |
| high level drills-agility | double-leg squats, fwd/bwd gait, sidestepping, heel-to-toe walking, braiding steps, hopping, minitramp, hip, knee, or ankle injury, single-leg or double-leg standing or hopping with eyes closed |
Created by:
jessigirrl4
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