what are some standardized balance tests that can be used to set goals and document fall risk
- activities-specific balance confidence scale (ABCs)
- Timed up and go (TUG)
- Berg balance scale (BBS)
tests that overlap dynamic balance activities and qualitative analysis of movement
- 10 meter walk
- 6 minute walk
- 5x STS
- 30 second chair rise
- stair climb
what are ways to change a task to create a dynamic balance test
- add surface challenge
- add movement in place
- add U.E activity
- change BOS
function of spinal preparation
- tonically active for postural orientation
function of brainstem level contributions to posture
circuits for automatic postural synergies (ankle, hip, stepping)
function of basal ganglia/ cerebellum level contributions to posture
modify postural muscle in response to environmental condition (cerebellum)
ability to quickly change muscle patterns in response to changing task (basal ganglia)
postural orientation
ability to maintain relationship between body segments and between body + environment for task
what are the three postural control strategies
- steady state
- proactive/anticipatory
- reactive
what are the 5 determinants of postural control
- sensory processing
- balance confidence
- multi-task ability
- postural movement strategies
- perception of verticality
define sensory processing
selection, weighting, and integration of sensory info (vision, somatosensory, vestibular) by CNS to develop accurate + meaningful perception of the body and environment
define balance confidence
certainty in ability to remain stable in predictable environments
define multi-task ability
ability to maintain postural control while also performing secondary motor task, cognitive task, and/or busy environment
postural movement strategies
use of muscle synergies for postural control (U.E protective responses and L.E stepping, ankle, hip strategies)
perception of verticality
orientation of body in relation to line of gravity on perception of body + environment
what are questionnaires related to balance
- ABCs
- FES (falls efficacy scale)
what postural control strategies are questioned using the ABCs
all three (and dynamic gait activities)
what ICF model relates to the ABCs questionaire
activity + participation
what does a higher score on the ABCs mean
higher function
what ICF model is related to falls efficacy scale
activity + participation
what postural control strategies are questioned in the Falls Efficacy scale (FES)
anticipatory (also dynamic gait BUT this is not really a postural control strategy)
what does a higher score on the FES mean
worse outcome - greater fear of falling or increased risk
what does a 15 second 5xSTS predict
recurrent fallers
what score is increased fall risk for BERG
45
what setting is the postural assessment in stroke scale usually used
inpatient - looking at more steady state balance
