Balance Training

balance

dynamic process by which the body’s position is maintained by equilibrium

cog, bos

balance is greatest when body’s _____ is maintained over its _____

cog

vertical projection down from com

limits of stability

sway boundaries in which an individual can maintain equilibrium without changing bos

musculoskeletal system, nervous system, contextual effects

balance control is impacted by (3)

sensory processing, motor response, sensorimotor integration

nervous system balance control includes (3)

vision, vestibular, somatosensation

sensory processing includes (3)

head position, level gaze, direction, speed, movements

visual system processes _____ relative to environment, orientation to maintain _____, _____/_____ of head _____

muscle proprioceptors, muscle length, tension, joint, joint receptors, joint position, movement, stress, anticipatory, unexpected, skin mechanoreceptors, vibration, touch, pressure, stretch

somatosensory system input includes _____ for _____/_____ and provides _____ position sense, _____ for _____/_____/_____ provides _____ postural adjustment and counteract _____ postural disturbances, and _____ for _____/light _____/deep _____/skin _____

head position, movement, angular, fast, linear, position, slow, reflexes

vestibular system provides information about _____/_____ with respect to gravity and inertial forces, semicircular canals for _____ acceleration and _____ head movements, otoliths for _____ acceleration/head _____ and _____ head movements, _____ also involved

firm, open, firm, closed, firm, visual conflict dome, foam, open, foam, closed, foam, visual conflict dome

clinical test of sensory interaction on balance:

condition 1: stand on _____ surface, eyes _____

condition 2: stand on _____ surface, eyes _____

condition 3: stand on _____ surface, with _____

condition 4: stand on _____ surface, eyes _____

condition 5: stand on _____ surface, eyes _____

condition 6: stand on _____ surface, with _____

cerebellum, basal ganglia, supplementary motor area

locations of sensory organization integration and processing (3)

somatosensation, visual, vestibular

processing time fastest to slowest

suppress, remaining

if inaccurate or slow processing, cns will _____ input and combine appropriate input from _____ systems

static balance

maintain stability while at rest

dynamic balance

maintain stability while support surface of body is moving

automatic balance

maintain stability in response to unexpected external perturbation

feedforward

proactive strategy, uses sensory information obtained from experience

feedback

reactive strategy, uses sensory information received during or after movement to monitor and adjust output, make corrections to ongoing or future movement

reflex, automatic postural response, voluntary movement

balance recovery methods (3)

first

reflex is _____ response to external perturbation

prevent falls

automatic postural response is first that can effectively _____

slowest, dependent

voluntary movement is _____ response and _____ on task

ankle, weight shift, suspension, hip, stepping, combined

motor strategies for balance recovery (6)

speed, intensity, support surface, magnitude, com, awareness, posture, experiences

factors influencing selection of balance strategies includes _____ and _____ of displacing forces, characteristics of _____, _____ of displacement of _____, subject’s _____ of disturbance, subject’s _____ at time of perturbation, subject’s prior _____

ankle, body sway

_____ muscles are automatically and selectively activated to counteract _____ in different directions, optimal body alignment allows least amount of energy

internal

_____ perturbed standing by voluntary movement of body

external

_____ perturbed standing by forces applied to body

toward load, momentum, previous experiences

during lifting com is shifted _____, cns estimates amount of _____ necessary for lifting based on _____

location, weight, individual, rom, weakness, injury

considerations for lifting style include load _____, _____, and _____ characteristics (_____ deficits, muscle _____, history of _____)

neutral, slow, positioning, symmetrical, weight

safety factors for lifting include maintaining _____ spine, _____ lifting speed, optimal _____ of load, _____ lifts, reduce load _____

injury, disease, processing

balance impairments result from _____ or _____ to any structures involved in three stages of information _____

sensory, processing, reduced

aging causes declines in all _____ systems, declines in all three stages of information _____, difficulty maintaining balance when sensory inputs from more than one system are greatly _____

slower, hip, magnitude, velocity

response patterns to perturbation with aging show _____ onset, more frequent use of _____ strategy for balance control, limitations in ability to maintain balance when challenged with perturbations of increasing _____/_____

fear of falling, reduced, gait

aging causes _____, perceived stability limits are _____ from actual stability, leads to _____ changes

outcome measures

clinical assessment includes many different _____ for balance

fall history, input, processing, biomechanical, tests, function, environmental, fall risk

evaluation should include _____, assessing sensory _____, sensory _____, and _____ impairments, _____ to determine balance control and impact on _____, _____ assessments to determine _____ hazards

static, dynamic, anticipatory, reactive, sensory organization, functional, safety

categories of balance assessment include (7)

musculoskeletal, challenge, perturb, loss of balance

balance training program should address _____ deficits and _____ impairments identified with enough to _____ balance but avoid total _____

external

_____ focus of attention has performer attending to external environment

internal

_____ focus of attention has performer attending to body movements or positions

external

_____ focus of attention is more beneficial for functional carryover

safety

should always consider _____ when performing balance training

2-3/week, enough to perturb balance but avoid total loss of balance/moderate to high, 2 hours/week, postures/dynamic movements/postural muscles/reducing sensory input/sequencing whole body

balance FITT principle: F _____, I _____, T _____, T _____

vision, sensory, medications

health and environmental factors include _____ deficit, _____ loss, and _____

fall prevention

therapeutic exercise is an effective tool in _____