Posture/Balance/Transfers/Gait Motor Control - E1
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Define balance
The ability to control one’s COM w/respect to the BOS
Define BOS
The area of the body in contact w/the support surface
What is postural stability?
Balance!
What is Center of Pressure
The center of the distribution of total forces applied to the support surface
Define “cone of stability”
The boundaries w/in which the body can maintain stability w/o changing the BOS
What is another word for “cone of stability”
Stability limits
Define 0 balance
Unable to maintain balance or no attempt made
Define poor balance
Able to balance w/ or w/o UE support for 5 seconds or less
Define fair balance
Able to balance w/ or w/o UE support for 15-60s and/or able to hold against slight resistance
Define good balance
Able to hold balance against moderate resistance
List the 4 types of balance
Static Dynamic Protective Functional
List the types of static balance
Static - time as measure (T) Static - resistance as measure (R) Static - anticipatory, feed-forward (AFF)
List the types of dynamic balance
Dynamic - reactive, feedback (RFB) Dynamic - anticipatory, feedforward (AFF)
Static Balance T A) objective or subjective? B) what are you doing?
A) Time is an objective measure B) maintain a position over time
How do you test Static Balance R A) objective or subjective? B) what are you doing?
A) Can be subjective or objective B) Attempt to assume near-normal posture w/w/o BUE support and maintain position against gradual matched manual resistance
What are the Static Balance Basic Procedures - w/Pt in sitting
1) Height-adjustable table 2) Feet flat on floor 3) Hips & knees at 90 4) Max thigh contact on support surface 5) UE supported or unsupported
What is PT force application…. a) positions b) instructions c) duration d) end?
a) anterior - mid sternum posterior - mid upper back R/L - acromion b) Hold, don't let me move you c) Gradual build up 3-4 sec d) End when displaced approx 1 inch
Is the (a/b) reliability high for sitting strength tests a) Intra-rater b) inter-rater
Yes & yes - both are fairly high of ICCs
What is Static Balance AFF
The individual is anticipating or predicting what trunk and proximal mm actions or motor control is necessary to prevent falling due to the progressively increasing weight of the arm during reaching
What is the goal of Static AFF balance?
Stability
What are you doing with Dynamic Balance - RFB
Manually displace the COM toward the edges of BOS to elicit the equilibrium or balance rxns
How do you describe a perturbation?
Based on the direction the patient is moving
What occurs w/lateral displacement? a) head/neck b) trunk c) arms d) legs
a) CL (to displacement) lat flexion b) CL (to displacement) lat flexion, ipsi elongation c) CL (to displacement) d) CL IR (to displacement) and IPSI ER
What are you doing in dynamic balance - AFF
Reach in various directions beyond arm’s length to elicit trunk and arm (sitting) and whole body (standing) balance reaction