1
Q
postural control
A
control of the position of body parts with respect to each other and gravity
2
Q
balance
A
ability to keep COM within BOS; all forces acting on the body are balanced
3
Q
components of postural control and balance
A
- static postural control (stability - sitting and standing)
- dynamic postural control (controlled mobility)
- anticipatory control
- automatic control
4
Q
postural control and balance assessments
A
- Balance Grades
- Berg
- Tinneti
- Clinical Test for Sensory Interaction in Balance (CTSIB)
- TUG
- Functional Reach
5
Q
Balance Grades
A
- cutoff
- population
- general assessment
6
Q
Berg
A
- cutoff
- population
- general assessment
7
Q
Tinnetti
A
- cutoff
- population
- general assessment
8
Q
CTSIB
A
- cutoff
- population
- general assessment
9
Q
TUG
A
- cutoff
- population
- general assessment
10
Q
Functional Reach
A
- cutoff
- population
- general assessment
11
Q
Romberg Test
A
Slide 7
12
Q
motor strategies
A
righting reactions and equilibrium reactions
13
Q
orient the head in space and body in relation to the head and support surface
A
righting reactions
14
Q
equilibrium reactions
A
- protective reactions
- tested in sitting and standing
- ankle, hip, stepping strategies (pg 232)
15
Q
ability to execute smooth, accurate, controlled movements
A
coordination
16
Q
coordination is dependent upon intact neuromuscular system and what 3 inputs
A
somatosensory, vestibular, and vision input
17
Q
why should you do a coordination assessment
A
quality of movement;
initiation, ability to hit a target, control of movement, efficiency of movement
18
Q
what are the main areas of CNS that are involved if coordination impairments are present?
A
cerebellar basal ganglia
19
Q
definitions pg 213-214
A
definitions; indicative of cerebellar vs. basal ganglia pathology?
20
Q
definitions pg 213-214
A
definitions
21
Q
definitions pg 213-214
A
definitions
22
Q
definitions pg 213-214
A
definitions pg 213-214
23
Q
definitions pg 213-214
A
definitions pg 213-214
24
Q
definitions pg 213-214
A
definitions pg 213-214
25
definitions pg 213-214
definitions pg 213-214
26
definitions pg 213-214
definitions pg 213-214
27
definitions pg 213-214
definitions pg 213-214
28
definitions pg 213-214
definitions pg 213-214
29
definitions pg 213-214
definitions pg 213-214
30
definitions pg 213-214
definitions pg 213-214
31
definitions pg 213-214
definitions pg 213-214
32
cerebellar impairments
- hypotonia
- dysmetria (hypometria or hypermetria)
- dysdiadochokinesia
- tremor (intention)
- nystagmus
- rebound phenomenon
33
basal ganglia impairments
- akinesia
- bradykinesia
- rigidity
- tremor (resting)
34
tests for selected coordination
Table 6.3 pg 220
35
tests for selected coordination
Table 6.3 pg 220
36
tests for selected coordination
Table 6.3 pg 220
37
tests for selected coordination
Table 6.3 pg 220
38
tests for selected coordination
Table 6.3 pg 220
39
tests for selected coordination
Table 6.3 pg 220
40
types of assessments for function
performance-based and self-reports including:
- barthel index
- functional independence measure (FIM)
- outcomes and assessment information set (OASIS)
- SF-36 or SF-12
41
performance based assessment of function
- what can the patient do under a certain set of circumstances
- may be standardized or non-standardized
42
barthel index
a
43
functional independence measure (FIM)
b
44
outcomes and assessment information set (OASIS)
required for home health care setting
45
SF-36 or SF-12
d
46
- Bedside evaluation of sitting balance
- evaluates sensory, motor, proactive, reactive, and steady state balance factors
- assesses functional sitting abilities, describe sitting balance dysfunction, focus on interventions, and track changes in sitting balance over time
- provides a form of assessment of lower level patients, especially if other balance tests may be too difficult for the patient
Function in Sitting Test (FIST)
47
FIST description
- 14 functional sitting ability tasks
- designed as bedside clinical measure
- scored PT
- uses a single set of scoring criteria for each of the 14 items
- quick assessment tool (usually completed < 10 mins)
48
FIST population
Best suited for patients with:
- Ability to follow simple directions (verbal or nonverbal)
- Known or suspected sitting balance deficits
- Impulsiveness
- Safety issues in sitting
- Slow movement
- Poor seated motor control
- cannot tolerate other balance tests (low level pts)
- are unable to stand or ambulate without excessive assistance or devices (low level pts)
49
measures motor impairment of the trunk after a stroke (or other neurological injury or condition) through the evaluation of static and dynamic sitting balance as well as coordination of trunk movement
Trunk Impairment Scale
50
Trunk Impairment Scale description
- 17-item
- 20-minute test
- contains three sub-scales: static sitting balance, dynamic sitting balance and coordination
51
Trunk Impairment Scale population
people with neurological conditions such as stroke, PD and other non-specific populations (MS, TBI, CP)
52
aimed to develop a measure to screen older adults for balance and gait impairments that was feasible for use, reliable and sensitive to significant changes, and reflected position changes and gait maneuvers used during daily activities (tests gait and balance abilities in older adults and determines level of fall risk)
Tinetti Performance Oriented Mobility Assessment
53
Tinetti Performance Oriented Mobility Assessment description
- 16 tasks: 9 balance and 7 gait
- Ordinal scale from 0-2 (0 = most impaired, 2 = independent)
- Total possible balance score of 16 points
- Total possible gait score of 12 points
- Total possible test score of 28 points
- 10-15 minutes
- Consists of standing and seated tasks
- Some tasks have patients eyes closed/open
54
Tinetti minimal detectable change
Older adults: 4 points
55
Tinetti cut off scores
Total score out of 28
| < 19 = High fall risk
56
Objective measure used to assess balance and fall risk in adult population; limitations = high ceiling effect for higher level patients and doesn’t assess gait
Berg Balance Scale
57
Berg Balance Scale description
14 item scale testing balance with transfers, static and dynamic activity
58
Berg Balance Scale minimal detectable change
Elderly population change of 4 points
59
Berg Balance Scale cut off scores
21-40 medium fall risk
| <20 = high fall risk
60
Assesses mobility, balance, walking ability, and fall risk in older adults; pt sits in chair with his/her back against the chair back, on “go” pt rises from chair, walks 3 meters at a comfortable and safe pace, turns around at the line, walks back to the chair and sits down, timing begins at “go” and stops when pt is seated, must use the same AD each time he/she is tested to be able to compare scores
Timed Up and Go (TUG)
61
TUG cut off scores
Community dwelling adults: >13.5
62
assesses pt's dynamic stability by measuring the maximum distance an individual can reach forward while standing (modified – sitting) in a fixed position
Functional Reach Test and Modified Functional Reach Test
63
- pt instructed to stand close to (not touching) a wall and position the arm that is closer to the wall at 90 degrees of shoulder flexion with a closed fist
- PT records the starting position at the 3rd metacarpal head on the yardstick
- Instruct the pt to “Reach as far as you can forward without taking a step”
- location of the 3rd metacarpal is recorded
- difference between the start and end position is the reach distance, usually measured in inches
- test allows for 4 total trials: 1 practice trial, followed by 3 "test" trials; distances of the last 3 trials are averaged to obtain the patient's score
Functional Reach Test and Modified Functional Reach Test
- Modified Functional Reach Test is with them in sitting with back against the wall, hips, knees and ankles flexed to 90, leaning forward and laterally each direction. Once they lean mark the position of their fifth finger. If cannot lift arm, movement of the acromion is measured.
64
Functional Reach Test cut off scores
Community Dwelling Elderly: FRT < 7 inches
65
assesses the likelihood of falls in older adults; designed to test 8 facets of gait; performed with a marked distance of 20 feet
- Can be performed with or without an AD
- Scores are based on a 4-point scale:
- Highest possible score is 24 points
- Tasks include: Steady state walking, Walking with changing speeds, Walking with head turns both horizontally and vertically, Walking while stepping over and around obstacles, Pivoting while walking, Stair climbing
Dynamic Gait Index
66
Dynamic Gait Index cut off scores
< 19 = High risk of falls in the elderly
| > 22 = Safe ambulator
NEUROMOTOR
flashcards
Decks in class (4)
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