Neuro Quiz #5 - Assessing Balance and Coordination in Medicine

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78 Terms

1
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True or False: Balance, equilibrium, and postural stability are interchangeable.

TRUE

2
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Balance is ____.

ability to maintain stability in an upright posture against gravity

3
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____ is the maximal distance of intentional displacement of COM in each direction without LOB.

limits of stability (LOS)

4
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____ balance is when they are not moving and ____ balance is when they are reaching out of BOS or during gait.

static; dynamic

5
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The postural control system includes _____, _____, _____, and _____.

biomechanical; sensory; motor; central procession

6
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The biomechanical control system considers _____.

forces applied and mechanical factors that contribute to body and joint/segment stability

7
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COP and COG are (sensory, biomechanical, motor, central procession) postural control.

biomechanical

8
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_____ is all incoming information and used to monitor equilibrium status and adjust upright posture.

sensory

9
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The primary sensory systems involved in balance are ____, _____, and ____.

vision, somatosensory, vestibular

10
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The motor postural control system is ____.

all parts of the neuromuscular system that help carry out postural adjustments and equilibrium reactions

11
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Reflexive postural reactions include ____.

righting reactions (head on body, body on body)

protective reactions

balance strategies (ankle, hip, stepping)

12
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Central processing receives ____ info, _____ it, and _____ a response.

sensory, processes, implements

13
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True or False: Balance is not a critical component of independence.

FALSE

14
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Skilled activities requires ____.

balance

15
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Loss of stability can have a profound impact on daily life of individuals with neurologic pathology due to _____

lack of independence, risk of injury

16
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When asking a patient's history of falls, it is important determine _____ vs _____ factors.

intrinsic; extrinsic

17
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When examining balance, you usually start in ____ and progress to ____.

sitting; standing

18
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When choosing tests and measures to assess balance, we want to make sure the _____ matches the tool used.

degree of impairment

19
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Self reported scales for balance include:

Falls efficacy scale (FES), Activities Specific Balance Confidence Scale (ABC Scale)

20
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Performance based measures of balance include:

TUG

Functional Reach

POMA

Berg

DGI

BESTest

Gait velocity

Balance and Dual-Tasking

21
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Balance Grading Scales are ____.

ordinal

22
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Absent

Patient unable to maintain balance

23
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Patient able to maintain balance with handhold support, may require some minimal assistance, accepts minimal challenge, can maintain balance while turning head/trunk.

Fair

24
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Poor

Patient requires handhold support, moderate to maximal assistance to maintain position, cannot accept challenge or move without loss of balance

25
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Patient able to maintain balance without handhold support, limited postural sway, accepts moderate challenge, can maintain balance while picking object off floor.

Good

26
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Normal

Patient able to maintain steady balance without handhold support, accepts maximal challenge and can weight shift easily within full range of LOS in all directions

27
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Which tests are used to assess steady-state postural control?

Romberg/Sharpened Romberg

28
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Ankle/hip/stepping strategies are used for (anticipatory/steady-state/reactive) postural control.

reactive

29
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Vision gives info about _____.

the environment; dynamic movement

30
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Somatosensation gives info about _____.

cutaneous touch and pressure, proprioception

31
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____gives info about head in relation to gravity/space and helps with VOR.

vestibular

32
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The Clinical Test for Sensory Interaction and Balance (CTSIB) is used to assess ____.

postural control under changing sensory conditions

33
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Conditions 1-3 on CTSIB differ from conditions 4-6 because _____.

1-3 are on ground, 4-6 are on foam

34
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Conditions 2 and 6 both have ____.

eyes closed

35
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The effect of the loss of one sense depends on:

availability of other senses to detect position in space

ability to use orientation cues in the environment

ability to correctly interpret and select sensory information for orientation

36
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Therapy objectives for improving balance include:

educate patient on safety and fall prevention

maximally remediate/correct impairments

teach compensatory strategies when remediation unsuccessful

IMPROVE PATIENT CONFIDENCE

return to PLOF

37
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True or False: There is a progressive decline in balance, increase in falls and injuries from falls as we get older.

TRUE

38
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Specific changes in ____, ____, and ____ contribute to balance decline.

visual, vestibular, musculoskeletal

39
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Safety first! So we need to:

guard, put gait belt on, challenge impaired systems

40
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Impairments that can be corrected in relation to balance are ____.

strength, ROM, alignment

41
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_____, _____, and ____ strategies can help improve postural control.

movement, sensory, and cognitive

42
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True or False: We should work on balance before having the patient properly align themselves.

FALSE; we want to patient to be symmetrically vertical and then perform balance interventions

43
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With movement strategies, we want to work on strategies that ____.

are not intact

44
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Ways to challenge the system that is impaired are by ____.

decreasing visual input

using unstable surface

walk on uneven surface

implement head turns with activities

45
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Additional considerations for balance training are _____.

cardiopulmonary conditioning, mental practice, gradually withdrawing assistance

46
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____ is the ability to execute smooth, accurate controlled movement.

coordination

47
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Coordinated movements are characterized by _____.

speed, distance, direction, timing, and muscular activation

48
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With coordination, you need to consider ____ and ____.

dexterity and agility

49
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Changes in coordination with age include:

impaired balance

decreased strength (sarcopenia)

slowed reaction time

loss of flexibility

faulty posture

50
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We need to assess ____, ____, ___, and ___ before assessing coordination.

lack of strength, ROM, sensation, and muscular imbalance

51
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What conditions can cause ataxia?

MS, sarcoidosis, celiac disease

infections (chicken pox) -- will resolve over time

paraneoplastic syndrome

tumor on cerebellum

side effects of medications

Vitamin E deficiency

52
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With cerebellar dysfunction, balance testing will be hard under which conditions?

ALL, eyes open and closed

53
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With somatosensory issues, patients might have problems with ____.

their eyes closed because relying on purely somatosensation.

54
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True or False: you should test bilaterally even if a patient has a hemi side.

TRUE

55
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Examples of cerebellar pathology are _____.

dysdiadochokinesia, dysarthria, dysmetria, dyssynergia

56
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Examples of basal ganglia pathology are ____.

akinesia, athetosis, bradykinesia, chorea, dystonia, rigidity

57
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Intention and postural tremors are ____ pathology, whereas resting tremors are ____ pathology.

cerebellar; basal ganglia

58
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Standardized coordination tests include ____ for pediatric populations, and ____, ____, and ____ for others.

BOT-2; 9 hole peg test, bocks and blocks, Minnesota Manual Dexterity test

59
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Sample tests for dysdiadochokinesia:

finger-to-nose

alternate nose-to-finger

pronation/supination

knee flex/ext

60
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Pointing and past pointing, drawing a circle or figure 8, heel on shin are examples of tests for ____.

dysmetria

61
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Hypotonia is tested by _____.

passive motion, deep tendon reflexes

62
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Asthenia can be tested by ____.

fixation or position holding, applying manual resistance

63
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Intervention strategies for coordination include:

addressing impairments

using sensorimotor systems to enhance motor performance

train motor coordination - accuracy and speed

compensate with other systems or equipment

64
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Interventions for cerebellar disorders include:

core/proximal stability for distal mobility

increase body awareness

train VOR

65
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Stability is developed in ____ postures, including _____.

weight bearing; prone on elbows, quadruped, sitting, kneeling, standing, modified plantargrade

66
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True or False: if possible, add limb movements in weight bearing positions to improve ataxia and building stability.

TRUE

67
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In sitting, you can work on _____.

holding with alternating isometrics or rhythmic stabilization

68
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Slow reversals with stepping movements can be completed in ____.

modified plantargrade

69
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Using the pool or a gait training _____ a patient.

unweights

70
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After strengthening proximally, we can work on ____, ____, and ____.

gait, fine motor, higher level coordination

71
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We can increase body awareness through _____, ____, and ____.

tactile input; approximation to increase proprioception; visual input

72
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Tactile input can be through _____.

hinged AFOs, manual contact

73
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Approximation to increase proprioception can be increased with ____.

weighted vests/belts

74
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You can use mirrors to increase _____.

visual input

75
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With chorea, athetosis, or dystonia, patients will have most success when the UE and LE are ____ to control ____.

weightbearing; involuntary movements

76
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The restorative approach for improving coordination includes _____.

aerobic activity, core, balance, gait

77
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True or False: you should train aerobic activity in isolation for those with coordination impairments.

FALSE in conjunction with other exercises

78
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Using bracing, AD, taping/compression, and adaptive equipment are examples of _____.

general compensatory approaches