balance

Question 1

balance

Answer 1

• physical equilibrium
• integration of vision, somatosensory, and vestibular systems

Question 2

balance reflexes

Answer 2

• vestibuloocular reflex (VOR) - head/eye movement coordination, supports gaze stabilization through eye movement counter to movement of head, maintains stable image on retina during movement
• vestibulospinal reflex (VSR) - attempts to stabilize body and control movement, assists with stability while head is moving and coordination of trunk during upright postures

Question 3

automatic postural strategies

Answer 3

• automatic motor responses that are used to maintain COG over BOS
• ankle strategy - somatosensory, distal to prox
• hip strategy - hips move opposite head, prox to distal, vestibular
• suspensory strategy - crouching, squatting, lower COG for better control, for when mobility and stability are required (surfing)
• stepping strategy - from unexpected challenges

Question 4

peripheral vertigo

Answer 4

• characteristics
• episodic and short duration
• autonomic symptoms present - sweat, pallor, N/V
• preciptating factor
• auditory fullness, tinnitus
• etiology
• BPPV
• meniere’s
• infection
• trauma/tumor
• DM
• etoh use

Question 4

central vertigo

Answer 4

• characteristics
• less autonomic symptoms
• LOC can occur
• neurologic symptoms - diplopia, hemianopsia, weakness, numbness, ataxia, dysarthria
• etiology
• meningitis
• migraine HA
• complications s/p ear infxn
• cerebellar degenertaion disorders (etoh)
• MS

Question 5

benign paroxysmal positional vertigo

Answer 5

• repeated vertigo subsequent to change in head position, only lasts a few seconds, noted in recumbent position (posterior canal)
• otoconia (canalith) loosens and travels into canal

seen treatment card for more details

Question 6

nystagmus

Answer 6

• abnormal eye movement of nonvolitional, nonrhythmic oscillation of eyes, speed fast in on direction

Question 7

central vs peripheral nystagmus

Answer 7

• central
• direction: bidirectional or unidirectional
• visual fixation: no inhibition with fixatoin
• vertigo: mild
• symptom length: may be chronic
• etiology: demyelinatio of nerves, vascular lesions, cancer/tumor
• peripheral
• direction: unidirection with fast segment indicating opposite of lesion
• visual fixation: will inhibit nystagmus and vertigo
• vertigo: significant
• symptom length: minutes, days, week, recurrent but finite period of time
• etiology: MEniere’s, vascular disorderes, trauma, toxicity, inner ear infection

Question 8

berg balance scale

Answer 8

• 14 tasks, 0-4 ordinal
• assesses fall risk
• has static activities, transitional movements, dyanimca activities in sitting and standing
• 0 to 56, higher scores indicting better balance

Question 9

fregly-graybiel ataxia test battery

Answer 9

• assess and treat balance dysfunction
• 8 test conditions - each leg measured on two accounts
• EO, EC balance conditions - sharpened rhomberg, one leg, on a rail, walking rail, walking floor
• pass/fail
• good for patients with high level skills

Question 10

fugl-meyer sesnsorimotor assessment of balance performance battery

Answer 10

• assess balance for patients with hemiplegia
• 7 items 0-2 scores

Question 11

functional reach

Answer 11

• assess standing balance and risk of falling
• 3 trials averaged for score – measure at 3rd metacarpal
• 20-40 years: 14.5-17 in
• 41-69 years: 13.5-15 inc
• 70-87 years: 10.5-13.5 inc

Question 12

TUG

Answer 12

• functional performance for mobility and balance
• score based on amount of postural sway, excessive movements, reaching for support, side steeping, other signs of LOB
• 5 point scale - 1 is normal
• < 10s indep
• > 30s high risk for fall

Question 13

tinetti performance oriented mobility assessment

Answer 13

• screens pt and IDs inc risk for falling
• sit<->stand w/ armless chair, turning
• gait assessment normal and fast
• 28 points, < 19 indicates high risk