Busy. Please wait.
Log in with Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password

Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.

Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
Didn't know it?
click below
Knew it?
click below
Don't Know
Remaining cards (0)
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

therex test 2

210: exercise for impaired balance

Balance or Postural Stability - A term used to describe the dynamic process by which the body's position is maintained in equilibrium - Center of gravity is maintained over the base of support
center of mass perfect equilibrium
center of gravity vertical projection of COM to the ground
base of support perimeter of contact area between body and it's support surface
limits of stability sway boundary within ability to maintain equilibrium. 8 deg fwd, 4 deg bwd for normal sway. 8 degrees each side/side
ground reaction forces and center of pressure push back from the ground. Newton's law (for every action, there is an equal and opposite reaction)
In normal people the ____ is situated over the _____ (feet). In a person with abnormal COG—they must employ a strategy to maintain balance COG, BOS
where is center of mass in human body S2
systems of the body that maintain balance vestibular, proprioceptive/somatosensory, visual
Visual system provides information about - position of head relative to environment - Orientation of head to maintain level gaze - Direction and speed of head movements
Somatosensory (Proprioceptive) system provides information about - Position and motion of body and body parts relative to each other and support surface - Information from muscle spindles and GTO, mechanoreceptors
when is somatosensory (proprioceptive) system used? when surface is firm, flat, and fixed.
vestibular system provides information about - position and movement of head with respect to gravity and inertial forces
what part of vestibular system detects fast acceleration of the head? (rotational, angular movements - walking or during fall) semi circular canals
what part of vestibular system detects acceleration and head position in relationship to gravity (linear movements)slow, postural sway otoliths
Vestibular system gives no information about ______ by itself—must have information from _____ and ____ system body position, somatosensory, visual
what system is dominant when there is a conflict between proprioceptive and visual cues and for postural stability during ambulation vestibular
sensory organization vision, vestibular, somatosensory
sway referenced vision when the visual field moves with sway (wall moves—should see small adjustments here, i.e. ankle strategy)
swat referenced support support surface moves with sway
tests for sensory integration/balance - Foam and Dome, Romberg Test - Additional Tests: Reach test, Berg Balance, Tinetti, TUG
the ____ suppresses inaccurate information CNS
what system is primary for upright postural control visual
what system contributes mostly to normal quiet stance somatosensory
types of balance control - static - dynamic - automatic
static balance control Maintain an antigravity position at rest - standing and sitting
dynamic balance control Stabilize the body when a support surface is moving OR when the body is moving on a stable surface (sit to stand, transfers)
automatic postural reactions Maintain balance in response to unexpected perturbations
ankle strategy - Small perturbations, quiet stance
weight shift strategy - Medial/lateral perturbations
where does weight shift strategy often occur - Primarily occurs at hips
suspension strategy - Lowers COM quickly flexing hip and knees - Can be combined with ankle, weight shift
hip strategy - Large perturbations or COG near limits of stability - Rapid hip flexion/extension
how would you train hip strategy incorporate perturbations, stepping over/around objects, stepping off of a moving surface onto a non moving surface, train according to the environment
stepping strategy COM beyond limits of stability a step is taken to enlarge BOS
Patient must have adequate ROM and strength to employ ____ , and ____ strategies hip, stepping
3 things that can cause impaired balance - deficits with aging - deficits with medications - vision
aging balance deficits - Declines in all three sensory systems - Difficulty when relying solely on vestibular system
what medications can cause balance deficits - Hypnotics - Sedatives - Anti depressants
Increased fall risk with decreased ____ strength (below grade 4) LE
what posture increases risk of falls forward head
Increased falls with decreased ankle ___ DF
Increased falls with decreased ____ strength quad
Increased falls with decreased ____ strength, especially reaching tasks PF
reasons for senior falls pushing something, pulling something, turning, grabbing an object
Balance _____ is better than with non-slip socks barefoot (maybe—but regular socks definitely decreases balance)
one study showed ____ can improve balance OTS (off the shelf orthotics)
Fear of ____ may negate gains made through rehab falling (don't use fear based tactics- sell independence)
vit ____ is very important for preventing falls D - bone integrity
balance training to improve static balance control Sitting, ½ kneeling, Tall kneeling, Standing on firm surfaces, Tandem, single leg stance. Can do each EO or EC
be very ____ about how you want patients to their balance exercises at home specific (do you want them in corner, does someone need to supervise them?)
how can we train dynamic balance control Maintain balance control on moving or unstable surfaces
progression for dynamic balance exercises Progress by shifting bodyweight, moving UEs, LEs, head, excursion of extremities to further away from body, from double leg to single leg
is single or bilateral UE moving more disturbing to balance bilateral
Internal Perturbation Voluntary movement of the body
External Perturbation Forces applied to the body
Both internal and external perturbation require activation of _____ but some are anticipatory (internal) or reactive (external) mm synergies
how can we train anticipatory balance control Reach in all directions, Use different postures for variation and progression i.e., sitting, kneeling, standing, Use different heights of reach, Vary speeds
anticipatory balance is a feed ____ system forward
why is marching a good balance exercise for elderly pts forces them to weight shift and increases single leg stance time
what does gait look like when someone is afraid of falling smaller steps, shuffle, grab onto stuff, decreased arm swing, slower gait speed, decreased foot clearance (everything smaller)
how can we train reactive balance control Emphasize ankle, hip, stepping strategy, etc; Add anticipated and unanticipated external forces
reactive balance ability to respond effectively and prevent a fall following a loss of balance; the loss of balance could be cause by an external source (e.g., hit or bump) or by a failure to control balance during voluntary movement (i.e., an "internal perturbation)
Perturbations need to be _____ to be most effective randomized
overall principles for progressing balance training Move from stable to unstable, Move from wide BOS to narrow BOS
Challenge balance by taking vision away (reliance on _____ and ______) vestibular, somatosensory
how can you challenge the vestibular system? head tilt manuvers
Tai Chi for Balance many studies show it can help improve balance, whole body movements performed in a slow, relaxed manner with an emphasis on awareness of posture alignment and synchronized breathing
what does OTIS stand for oscillating technique for isometric stabilization
purpose of OTIS train peripheral mechanoreceptor input and process signals to efferent responses
Without good training, the time it takes to ____ is greater than the time it takes from ____ loading to rupture react, ligament
____ ms between ligament loading and rupture 80-90
____ ms between ligament loading and initiation of ligamento-muscular reflex 40-80
____ ms between ligament loading and the initiation of volitional muscle contraction (at cortex level) 150
motor responses occur at the spinal cord (joint receptors), brain stem (integrates visual and vestibular information)
what is the role of cerebral cortex in balance process proprioceptive info
safety for balance training gait belt, use parallel bars or near railing, stay away from other equipment, get help with high risk pts, guard pt getting on and off equipment
evidence based balance programs OTAGO, SAIL, Matter of Balance, Tai Ji Quan: Movement for Better Balance, Tai Chi for Arthritis for Fall Prevention
Created by: bdavis53102
Popular Physical Therapy sets




Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
restart all cards