Posture And Balance

Front 1

POSTURE

general definition?

Back 1

a position or attitude or the body
The relative arrangement of body parts for a specific activity
A characteristic manner of bearing one’s body

Front 2

POSTURE

how is it assesed?

Back 2

Posture is assessed in anatomic position, with hands relaxed at sides

Front 3

POSTURE

where do they gravitational force lines fall?

Back 3

The gravitational force line falls through the center of mass.
Behind the hip joint
In front of the knee joint
In front of the ankle joint

Front 4

POSTURE

in general, where is the center of gravity?

Back 4

The center or gravity (COG) is about S2.
Varies between individuals and body types.

Front 5

POSTURE

why is the center of gravity different for men?

Back 5

Men- increased upper body mass- higher COG

Front 6

POSTURE

why is the center of gravity different for women?

Back 6

Women- increased lower body mass- lower COG

Front 7

Factors that cause us to move out of a posture

JOINT COMPRESSION

main idea?

Back 7

spine, decreased height of discs

Front 8

Factors that cause us to move out of a posture

LIGAMENTOUS TENSION

main idea?

Back 8

leaning on Y lig

Front 9

Factors that cause us to move out of a posture

CONTINUOUS MUSCLE CONTRACTION

main idea?

Back 9

fatigue

Front 10

Factors that cause us to move out of a posture

CIRCULATION

main idea?

Back 10

pooling of blood in legs or insufficient sensation causing tissue damage

Front 11

Materials Required when assessing posture

PLUMBLINE

use?

Back 11

string hanging from ceiling, weight on the end

Front 12

Materials Required when assessing posture

WALL GRID

main idea?

Back 12

clear film with gridlines, hanging from ceiling

Front 13

Posture

STATIC POSTURE

main idea?

Back 13

Static- assume and hold posture

Front 14

Posture

DYNAMIC POSTURE

main idea?

Back 14

movement patterns to change from one position to another

Front 15

Posture

should it be assessed in both sitting and standing positions?

Back 15

Assess posture of spine and pelvis in standing and sitting- LE length may play a role in posture

Front 16

Posture

how many planes should it be assessed in?

Back 16

Asses posture in 2 planes

Frontal- front and back halves
Sagittal- side to side, comparing bony prominences

Front 17

Procedure- frontal plane

where should patient be instructed to stand?

Back 17

Have pt stand on opposite side of plumbline- centered or greatest mass

Front 18

Procedure- frontal plane

what should be measured?

Back 18

Measure out of norms for all spinal curves and joints

Front 19

Procedure- sagittal plane

where should patient be instructed to stand?

Back 19

Pt standing on opposite side of the plumbline

Front 20

Procedure- sagittal plane


what should be assessed?

Back 20

Assess bilateral bony landmarks, spinal scoliosis, and head righting

Front 21

SCOLIOSIS

what is the difference between FUNCTION and STRUCTURAL

Back 21

Functional or Structural- Have pt bend forward
If functional- curve is flexible and disappears
If structural- vertebrae deviate laterally from midline and rotate, causing ribs to rotate and vert and ribs to protrude

Front 22

SCOLIOSIS

what can be concluded if when sitting there is no scoliosis?

Back 22

If no scoliosis then curve is functional and due to leg length discrepancy

Front 23

Naming the Curve with Scoliosis

how is it named?

Back 23

to the side of their convexity (right of left)
with the vertebrae number

Front 24

Naming the Curve with Scoliosis

when forward bending, what side will the ribs protrude on?

Back 24

Ribs will protrude on the side of the convexity in forward bending.

Front 25

Naming the Curve with Scoliosis

is determining if COMPENSATED or UNCOMPENSATED the same as naming the curve?

Back 25

May be compensated or uncompensated but this is not a NAME

Front 26

Protective Shift

is this considered Scoliosis?

Back 26

Not a scoliosis

Front 27

Protective Shift

what is this due to?

Back 27

Due to protective shortening on one side of paraspinals and reactive lengthening on the other side

Front 28

Protective Shift

are these patients considered ACUTE?

Back 28

These pts are very acute

Front 29

Protective Shift

what is this the possible result of?

Back 29

Could be result of pulled muscle or HNP to keep disc off nerve root
Shift hips toward PT and check for increased pain level

Front 30

Leg Length

when is this kind of testing used?

Back 30

Leg Length testing is used when an asymmetry occurs during postural examination.

Front 31

Leg Length

what might cause a leg length asymmetry?

Back 31

Leg length asymmetry may be caused by actual bony asymmetry or may be caused by pelvic obliquity or muscular imbalances.

Front 32

Leg Length

what are the 3 common tests for assessing leg length discrepancy?

Back 32

True leg length discrepancy
Apparent leg length discrepancy
Leg pull test

Front 33

True Leg Length Procedure

how is the patient positioned?

Back 33

Pt in supine
Place legs in similar positions

Front 34

True Leg Length Procedure

how measured?

Back 34

Measure from ASIS to medial malleoli
Distal ASIS border to proximal med mall

Front 35

True Leg Length Procedure

what might cause asymmetry?

Back 35

If unequal, may be due to femur or tibia
Bend knees to 90 degrees, compare height

Front 36

Apparent Leg Length Procedure

how is pt positioned?

Back 36

Pt in supine
Place legs in similar positions

Front 37

Apparent Leg Length Procedure

how measured?

Back 37

Measure from umbilicus to medial malleoli

Front 38

Apparent Leg Length Procedure

if unequal, what might this indicate?

Back 38

Uneven measures could indicate:
Pelvic obliquity
Adductor or flexion deformity of the hip

Front 39

Leg Pull Procedure

how is pt positioned?

Back 39

Pt in supine
Place legs in similar positions

Front 40

Leg Pull Procedure

how measured?

Back 40

Grasp pts legs at the malleoli with thumbs at the most proximal part of the med mall
Flex pts hips and then pull legs while lowering
Visually compare thumb level

Front 41

Leg Pull Procedure

what additional pt positions should this be tested in and how does rotation affect this test?

Back 41

Test in supine, long sit and full sit
ER will lengthen leg, IR will shorten

Front 42

Narrative notes

in what kinds of facilities are these mostly utilized?

Back 42

Mostly used in rehab centers where progress will be slower

Front 43

Narrative notes

how often are they written and how is the grammar/usage different?

Back 43

Can be written once per day, per week
Complete sentences vs fragments

Front 44

Narrative notes

what kind of motion is emphasized and how written?

Back 44

Quality of movement stressed more than quantity
Must be organized, concise and direct
Written in paragraph form

Front 45

Balance

definition?

Back 45

the ability to control center of gravity over a base of support in a given sensory environment

Front 46

Balance

how determined?

Back 46

Determined by sensory input and motor output

Front 47

Sensory Input

combination of what systems?

Back 47

vision
proprioceptive
vesibular
somatosensory

Front 48

Sensory Input

what does VISION include?

Back 48

eyes, age, clarity

Front 49

Sensory Input

what does PROPRIOCEPTION include?

Back 49

positioning of body in space, affected by decreased sensation

Front 50

Sensory Input

what does the VESTIBULAR system resolve conflict from?

Back 50

resolves conflicts from other 2
Semicircular canals-measure speed & acceleration
Vestibular nuclei- vestibulospinal tract

Front 51

Sensory Input

what does SOMATOSENSORY refer to?

Back 51

self to object

Front 52

Motor Output

Postural Synergy

learned or automatic?

Back 52

Automatic Response
Can I correct this movement of COG inside BOS, or do I have to step? Use of a Balance Strategy- small movements of joints

Front 53

Motor Output

Program Strategy

automatic or learned?

Back 53

Learned Response

Front 54

Motor Output

Program Strategy

what kind of mechanism is at work?

Back 54

feed forward mechanism, I have been through this before, and _____ is what I did then and it worked. Let’s try it again.
Roller coaster loop- lean backwards of forwards?

Front 55

Motor Coordination

this is the process of deciding _____?

Back 55

Process of deciding motor output

Front 56

Motor Coordination

what is the goal of MOTOR COORDINATION?

Back 56

maintain COG within BOS- Stability

Front 57

Motor Coordination

what is FEEDBACK CONTROL?

Back 57

automatic responses triggered by stimulation

Front 58

Motor Coordination

what is FEED FORWARD CONTROL?

Back 58

control- prior experience and current environmental conditions determine movement strategy

Front 59

Motor Coordination

how is NORMAL CONTROL?

Back 59

Normal control is automatic and subconscious

Front 60

Balance Strategies

what is the CONE OF STABILITY?

Back 60

elliptical pattern around the COG
Forward Sway- 8 degrees
Backward Sway- 4 degrees

Front 61

Balance Strategies

ANKLE STRATEGY

where is the sway? how is the muscle action?

Back 61

Sway about the ankles
Muscle action it distal to proximal

Front 62

Balance Strategies

ANKLE STRATEGY

what muscles active forward and backwards?

Back 62

Forward= gastroc- hamstrings- paraspinals
Backward=ant tib- quads- abdominals

Front 63

Balance Strategies

HIP STRATEGY

how is it typified and where is the muscle action?

Back 63

Sway about the hips
Muscle action is proximal to distal

Front 64

Balance Strategies

HIP STRATEGY

what muscles active during forward and backward motion?

Back 64

Forward= abdominals- quads- ant tib
Backward= paraspinals- hamstrings- gastroc

Front 65

Balance Strategies

how effective is the SHEARING STRATEGY

Back 65

Strategy-Not very effective on slippery surfaces, will cause a fall

Front 66

Balance Strategies

STEPPING STRATEGY

when is this used?

Back 66

Use when movement is too fast or too far to stay within cone of stability

Front 67

Balance Strategies

STEPPING STRATEGY

what is this a combination of?

Back 67

Combination of muscle reactions between both legs brings the feet back under the body when the COG has exceeded the BOS

Front 68

how should strategy, sequence, and timing be assessed in older and diseased patients?

Back 68

Assess with:
Eyes open and closed
Firm and soft surfaces
perturbation

Front 69

Treatments

if there are SENSORY DEFECITS, what should be worked on?

Back 69

work on boosting other systems

Front 70

Treatments

if there are STRATEGY DEFECITS, what should be worked on?

Back 70

work on other hip or ankle strategies

Front 71

Treatments

if there are SEQUENCING DEFICITS, what should be worked on?

Back 71

practice slowly and increase speed, could add FES for training

Front 72

Treatments

if there are ORGANIC PROBLEMS, will treatment always be successful?

Back 72

If organic problems- severing of tracts or obliteration of nuclei, treatment may not be successful

Front 73

Tinetti Balance Assessment

what does it measure?

Back 73

Measures different postures and gait

Front 74

Tinetti Balance Assessment

is it subjective or objective?

Back 74

Objective for documentation, improving numbers

Front 75

Tinetti Balance Assessment

has its reliability and validity been established?

Back 75

Reliability and Validity proven

Front 76

Tinetti Balance Assessment

what does it asses and what are its levels?

Back 76

Assess’ pts risk of falling
19 and lower, pt at HIGH risk
19-24, could fall but not high risk
Validation for PT for balance training

Front 77

Vertigo

what do CAWTHORNE'S EXERCISES accomplish?

Back 77

reproduces vertigo and thereby desensitizes deficient area.

Front 78

Vertigo

what does the HALL-PIKE POSITION accomplish?

Back 78

45 degree reclined, may increase vertigo due to semi circular canals fluid levels all even.

Front 79

Vertigo

what kind of postures to begin with, and how should it progress?

Back 79

Begin with static postures and progress as dizziness decreases