balance lab

What balance strategy is primarily used for small perturbations on a firm surface?

Ankle strategy

What balance strategy is primarily used for moderate perturbations or standing on a narrow base of support?

Hip strategy

What balance strategy is primarily used when the COM moves outside the BOS?

Stepping strategy

What balance strategy lowers the COM during extreme instability?

Suspensory strategy

What is steady-state balance?

Maintaining the COM within the BOS during quiet standing or stable conditions

What balance test assesses functional balance through 14 tasks?

Berg Balance Scale (BBS)

What balance test examines sensory contributions to balance?

Modified CTSIB (M-CTSIB)

What percentage of balance input comes from somatosensation on a firm surface?

70%

What percentage of balance input comes from vestibular input on a firm surface?

20%

What percentage of balance input comes from vision on a firm surface?

10%

What percentage of balance input comes from vestibular input on an unstable surface?

60%

What percentage of balance input comes from vision on an unstable surface?

30%

What percentage of balance input comes from somatosensation on an unstable surface?

10%

How can visual input be reduced during a balance activity?

Eyes closed, prism glasses, or moving eyes/head during the task

How can somatosensory input be reduced during a balance activity?

Narrow BOS, foam surface, or incline board

A patient loses balance significantly when eyes are closed but performs well with eyes open. What sensory system are they relying on heavily?

Vision

A patient loses balance on foam but performs well on firm ground. What sensory system may be impaired?

Vestibular system

What is anticipatory balance control?

Postural adjustments that occur before an expected movement or perturbation

What type of postural control occurs before sensory systems can respond?

Anticipatory postural adjustments (APAs)

Give three common examples of anticipatory balance activities.

Standing on one foot, reaching forward, rising onto tiptoes

What test measures limits of stability through forward reaching?

Functional Reach Test (FRT)

What does the Functional Reach Test primarily assess?

Anticipatory balance and limits of stability

How is the Functional Reach Test performed?

Reach forward as far as possible without stepping

What is a regression for the Functional Reach Test?

Seated reach or shorter reach distance

What is a progression for the Functional Reach Test?

Narrow BOS, foam surface, or multidirectional reaching

What balance test assesses dynamic balance with reaching in multiple directions?

Star Excursion Balance Test (SEBT)

What are the three primary reach directions in the Y-Balance Test?

Anterior, posteromedial, and posterolateral

What is a progression for the Y-Balance Test?

Greater reach distance, unstable surface, or dual tasking

What is a regression for the Y-Balance Test?

Shorter reach distance or supported reaching

What type of balance is challenged when catching a ball?

Anticipatory balance

What type of balance is challenged when lifting a box of known weight?

Anticipatory balance

What type of focus should be encouraged during anticipatory balance activities?

External focus

What is an example of an external focus cue during a reaching activity?

“Touch the target lightly.”

What is an example of an external focus cue during ball kicking?

“Kick the ball far.”

What is reactive balance?

Balance responses that occur after an unexpected perturbation

What type of postural control occurs after a perturbation has already happened?

Reactive balance control

What test may be used to assess reactive balance?

Push-and-Release Test

What test may be used to assess reactive balance by pulling the patient backward?

Pull Test

Why are perturbation exercises used in reactive balance training?

To improve recovery responses following unexpected balance loss

A patient takes a step after a therapist-induced perturbation. What balance strategy was used?

Stepping strategy

A patient sways at the ankles without stepping after a small perturbation. What strategy was used?

Ankle strategy

A patient rapidly bends at the hips after a perturbation but does not step. What strategy was used?

Hip strategy

How should reactive balance activities initially be regressed?

Predictable perturbations, firm surface, wider BOS

How can reactive balance activities be progressed?

Unpredictable perturbations, narrow BOS, unstable surfaces, dual tasks

What movement analysis construct describes equal movement or weight bearing?

Symmetry

What movement analysis construct describes the amount of movement or sway?

Amplitude

What movement analysis construct describes body position relative to gravity?

Alignment

What movement analysis construct describes the ability to orient the body relative to gravity?

Verticality

What movement analysis construct describes control of the COM?

Stability

What movement analysis construct describes fluid, non-jerky movement?

Smoothness

What movement analysis construct describes performing movement components in the correct order?

Sequencing

What movement analysis construct describes appropriate response timing?

Timing

What movement analysis construct describes how accurately a task is completed?

Accuracy

What movement analysis construct assesses pain, dizziness, or symptom increase during movement?

Symptom provocation

A patient stands with feet together for 30 seconds on firm ground. What balance category is being challenged?

Static/steady-state balance

A patient stands on foam with eyes closed. Which sensory system is being challenged most?

Vestibular system

A patient reaches for an object while standing without moving their feet. What balance category is being challenged?

Anticipatory balance

A patient recovers from an unexpected shove by stepping backward. What balance category is being challenged?

Reactive balance

What is the easiest progression level in the balance hierarchy?

Wide BOS

What comes after wide BOS in the balance progression hierarchy?

Narrow BOS

What comes after narrow BOS in the balance progression hierarchy?

Tandem stance

What comes after tandem stance in the balance progression hierarchy?

Single-leg stance

What comes after single-leg stance in the balance progression hierarchy?

Eyes closed

What comes after eyes closed in the balance progression hierarchy?

Foam surface

What comes after foam surface in the balance progression hierarchy?

Foam with eyes closed

What comes after foam with eyes closed in the balance progression hierarchy?

Dual-task activities

What comes after dual-task activities in the balance progression hierarchy?

External perturbations

What is the highest level in the balance progression hierarchy?

Unpredictable perturbations

A patient can maintain tandem stance but loses balance during single-leg stance. What is an appropriate progression?

Practice single-leg stance with guarding

A patient cannot maintain balance during tandem stance. What is an appropriate regression?

Narrow BOS stance

A patient demonstrates excessive sway on foam with eyes closed. What should the therapist do first?

Regress by opening the eyes or returning to a firm surface

What safety equipment should be used during balance training in lab?

Gait belt

What should always be practiced during balance activities?

Proper guarding techniques

A patient loses balance only when head movements are added. Which balance system is likely being challenged?

Vestibular system

A patient performs well during static standing but struggles while reaching for objects. Which balance system should be emphasized?

Anticipatory balance control

A patient performs well during reaching tasks but cannot recover from unexpected perturbations. Which balance system should be emphasized?

Reactive balance control

A therapist wants to specifically train ankle strategy. What exercise is most appropriate?

Single-leg stance with upright trunk

A therapist wants to specifically train hip strategy. What exercise is most appropriate?

Tandem stance with trunk bending

A therapist wants to specifically train stepping strategy. What exercise is most appropriate?

Crossover stepping or stepping onto a stool

A patient catches balls of varying weights while standing. Which balance category is primarily challenged?

Anticipatory balance

A patient standing on a treadmill experiences sudden speed changes. Which balance category is primarily challenged?

Reactive balance

What dosage is commonly used for static balance holds?

20–30 seconds for 2–3 sets

What dosage is commonly used for anticipatory balance activities?

2–3 sets of 5–10 repetitions or 30–60 second bouts

What dosage is commonly used for reactive perturbation training?

2–3 sets of 5–10 perturbations from multiple directions