OT 504 Week 5 LG 2: Balance and Physical Activity in Older Adulthood Flashcards

What systems are involved in maintaining balance?

Vision, vestibular system, proprioception/kinesthesia, tactile (somatosensory) input, cognition, strength, and flexibility.

What cognitive components contribute to balance?

Coordination, motor planning, processing speed (reaction time), and attention.

What is static balance?

The ability to maintain a stable position while motionless.

What is dynamic balance?

Maintaining stability while the body is moving.

What is reactive balance?

The ability to recover stability after an unexpected disturbance.

What sensory changes can affect balance in older adults

Changes in vision, vestibular function, proprioception, and touch sensation.

What is sarcopenia?

Age-related muscular atrophy and loss of muscle mass.

How can hyperkyphosis affect balance?

It alters posture and center of gravity, increasing fall risk.

How do reaction times change with aging?

They become slower, reducing the ability to respond to balance challenges.

What gait changes commonly occur with aging?

Decreased step length, decreased stride length, slower speed, decreased cadence, and increased double-stance time.

what is cadence?

The number of steps taken per minute while walking.

What is double-stance time?

The portion of gait when both feet are on the ground.

Name common medical conditions that can affect balance.

Dehydration, malnourishment, orthostatic hypotension, BPPV, COPD, CHF, and extrapyramidal dysfunction.

What is orthostatic hypotension?

A drop in blood pressure when changing positions, often causing dizziness and falls.

What does BPPV stand for?

Benign Paroxysmal Positional Vertigo.

What causes BPPV?

Small calcium particles (canaliths) become displaced and float in the semicircular canals.

What symptoms are associated with BPPV?

Vertigo, dizziness, and balance problems.and Nystagmus.

What sensation do individuals with BPPV commonly experience?

A spinning sensation of themselves or their surroundings.

what is the epley maneuver?

A treatment for BPPV that involves sequential movements to reposition dislodged canaliths back into their proper location in the inner ear.

when does nystagmus occur in the BPPV?

immediately after changing head or body position

what does COPD stand for?

Chronic Obstructive Pulmonary Disease

What is COPD?

A progressive lung condition that happens when airflow is blocked.

two types of COPD

are chronic bronchitis and emphysema.

Difference between chronic bronchitis and emphysema?

Chronic bronchitis is characterized by a persistent cough and mucus production due to inflammation of the bronchial tubes, while emphysema involves the destruction of the alveoli, leading to reduced gas exchange and breathlessness.

what is chronic bronchitis?

Chronic bronchitis is a long-term condition marked by a persistent cough, production of mucus, and inflammation of the bronchial tubes, often caused by smoking or exposure to irritants.

what is emphysema?

Emphysema is a progressive lung disease characterized by the destruction of the alveoli, resulting in decreased elastic recoil, difficulty breathing, and inadequate oxygen exchange.

What causes airflow limitation in COPD?

Swelling, irritation, mucus production, and loss of elasticity in airways and air sacs.

What are common symptoms of COPD?

Breathlessness, wheezing, chest tightness, cough, and barrel-shaped chest.

Why does COPD increase fall risk?

Reduced oxygenation and activity tolerance can impair balance and mobility.

what does CHF stand for?

Congestive Heart Failure

What is CHF?

 A long-term condition that happens when heart cannot pump blood well enough to supply the body with what it needs.

What are common symptoms of CHF?

Chest pain, heart palpitations, hypotension, shortness of breath, fatigue, nausea, loss of appetite, swelling, and nocturia.

what is nocturia?

Nocturia is the condition of waking during the night to urinate, which can disrupt sleep and be a symptom of underlying health issues.

why can nocturia occur?

Nocturia can occur due to various factors including age-related changes in bladder capacity, hormonal changes affecting urine production, or underlying health conditions such as CHF, diabetes, or urinary tract infections.

Why can CHF affect balance and mobility?

fatigue, hypotension, and shortness of breath reduce activity tolerance and increase fall risk.

what doe EPD stand for?

Extrapyramidal Dysfunction

What is extrapyramidal dysfunction (EPD)?

Group of movement disorders that affect the involuntary motor system controlling posture, muscle tone, and automatic movements.

What neurological structures are commonly involved in EPD?

The basal ganglia and cerebral cortex

What conditions may cause EPD?

Brain injury, stroke, Parkinson's disease, and Lewy Body Dementia.

What is dystonia?

Continuous muscle spasms and contractions.

What is rigidity?

Increased muscle stiffness and resistance to movement.

What is bradykinesia?

Slowness of movement.

What is tardive dyskinesia?

Involuntary, irregular jerky movements

What are OT goals related to balance and physical activity?

Improve or maintain quality of life, occupational performance, strength, ROM, activity tolerance, and balance.

What occupational areas are commonly addressed?

ADLs, IADLs, and functional mobility.

What does OT aim to prevent?

Declines in ADL/IADL performance, ROM, strength, activity tolerance, cognitive function, and falls.

What three rehabilitation approaches are highlighted in the lecture?

Restore, rehabilitate, and habilitate.

What fall-related question should OTs ask during the occupational profile?

"Have you had any falls in the last 6 months? What happened?"

What mobility-related question should OTs ask?

"Do you have any problems with strength, ROM, balance, walking, or breathing that prevent you from doing what you want or need to do?"

Why ask about future concerns?

To identify prevention opportunities and meaningful goals.

What is one of the best ways to assess physical activity and balance concerns?

Observing the client performing occupations.

What should an OT observe during occupational performance?

Activities that are difficult, easy, require compensation, or affect endurance and balance.

What areas are commonly assessed?

ROM, strength, endurance/activity tolerance, and balance

What does Modified Independent mean?

The client is independent but may use a mobility aid.

What mobility aids might a Modified Independent client use?

Cane, walker, or rollator.

What does Supervision mean?

The client requires cueing for safe movement.

What types of cueing may be used?

Visual, verbal, or tactile cues.

What does Contact Guard Assist mean?

The client requires a gait belt and close guarding for safety.

What do Min Assist, Mod Assist, and Max Assist indicate?

Increasing levels of physical support needed for mobility.

Why is ROM assessed before strength?

To identify pain, rigidity, instability, compensatory movements, and determine if MMT can be safely performed.

What may indicate that ROM testing should stop?

Pain, rigidity, instability, or inability to perform the movement safely.

Why are compensatory movements important to identify?

They may mask impairments and affect function.

What is MMT?

A method used to evaluate muscle strength and function.

What are the types of muscle testing?

Manual resistance, dynamometer testing, and functional testing.

What factors can affect MMT results?

Fatigue, pain, fear, communication, recent sutures, and testing position.

What precautions should be considered before MMT?

Inflammation, pain, healing tissue, environmental factors, and cardiovascular conditions.

What is proximal stability?

Stabilizing a body segment to prevent compensatory movement during testing.

How should resistance be applied during MMT?

Opposite the muscle's pull and gradually increased over 2–3 seconds.

What is the MMT grading scale?

0–5.

What does Grade 0 indicate?

No muscle contraction.

What does Grade 1 indicate?

Trace, contraction can be felt, when palpated

What does Grade 2 indicate?

poor, person can move though complete range of motion without gravity(gravity eliminated)

What does Grade 3 indicate?

Fair, person can move through complete range of motion against gravity & hold position against gravity

what setting does grade 3 happen in?

most adult day care, assisted living facilities, or rehabilitation centers and PACE

What does Grade 4 indicate?

Good, person can move through complete range of motion against gravity and can hold position against moderate resistance.

What does Grade 5 indicate?

Normal, person can hold body part against strong pressure/resistane

what is important thing to remember from the lecture from the MMT?

Most of the well community dwelling older adults will be greater than 3

What are the three common aerobic assessments discussed in OT practice?

Vital signs, METS, and Borg rating of perceived exertion scale

What are the four vital signs commonly assessed during aerobic activity?

blood pressure, heart rate, respiratory rate, and SpO₂.

Why are vital signs monitored during exercise?

To assess cardiovascular and respiratory response to activity and ensure safety.

What does SpO₂ measure?

Peripheral oxygen saturation, or the percentage of oxygen carried by hemoglobin in the blood.

What vital sign reflects how many times the heart beats per minute?

Heart rate.

What vital sign measures the force of blood against arterial walls?

Blood pressure.

What vital sign measures breathing frequency?

Respiratory rate.

What does MET stand for?

Metabolic Equivalent of Task.

What do METs measure?

The energy cost of physical activities.

What does 1 MET represent?

Energy expenditure at rest.

Why are METs useful in rehabilitation?

They help determine the intensity of activities and a client's functional capacity.

How can OTs use METs?

To grade activities, monitor endurance, and develop safe activity programs.

What is the Borg Rating of Perceived Exertion Scale?

scale used to monitor and guide exercise intensity based on how hard a person feels they are working

What does RPE stand for?

Rating of Perceived Exertion.

What is the range of the original Borg Scale?

6–20.

What is the range of the Modified Borg Dyspnoea Scale?

0–10.

What does the Borg Scale measure?

A person's perceived level of physical exertion during activity.

What does the Modified Borg Dyspnoea Scale primarily measure?

Breathlessness (dyspnea).

Which Borg Scale is more commonly used to measure breathlessness?

The Modified Borg Dyspnoea Scale (0–10).

Why is the Borg Scale useful in clinical practice?

It helps clinicians monitor exercise intensity and activity tolerance.

What OT performance area can the Borg Scale help assess?

Activity tolerance/endurance.

When might an OT use the Borg Scale?

During exercise, functional mobility, endurance training, or cardiopulmonary rehabilitation.

A client reports a Borg Dyspnoea rating of 8/10 during activity. What does this indicate?

The client is experiencing a very high level of perceived breathlessness and may need activity modification, rest, or monitoring.