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What is balance?
condition in which all forces acting on the body are balanced such that the COM is within the stability limits
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What is coordination?
usage of correct muscles at the correct time with the correct intensity and speed. its the basis of smoth, efficient movement
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What part of the brain does balance and coordination come from?
cerebellum
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What are coordination deficits called?
ataxia
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What are some of the indications for balance training?
arthritis, MS, parkinsons, CVA, prosthetics, gait disorders, vestibular rehab, soft tissue injury, joint injury, cerebellar disorders
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What are the 3 senses that help maintain balance?
- vision (gives us a sight for orientation)
- vestibular (inner ear, where equalibrium is housed)
- proprioception (neurological feedback from soft tissue, jts, etc that gives feedback to where we are)
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What is vertigo?
pt gets dizzy and cant keep balance
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What are some things balance training can improve?
- trunk stability, biomechanical alignment, symmetrical weight
- awareness and control of COM and limits of stability
- musculoskeletal responses necessary for balance including functional ROM, strength, and synergistic patterns
- functional balance during static and dynamic activities
- utilization of sensory systems
- safety awareness and compensatory strategies for effective fall prevention
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What are the first areas we need to focus on improving?
- ROM
- muscle strength
- endurance
- stabilization control
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After we have improved the first focus areas, what can we then focus on?
- manual perturbation
- moveable surfaces that displace the BOS (swiss ball, pillow etc)
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What is manual perturbation?
manual force used to displace COM (push pt around)
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What are some indications for coordination exercises?
parkinsonism, MS, CP, CVA (all effect CNS), post injury/post surgically (effects proprioception and muscle strength/balance)
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What are some of the progressions of coordination exercises?
- increase: speed, # of reps, resistance (gradually), complexity (concentric->eccentric->isokinetic)
- decrease rest production
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What are the balance rankings?
- N-4=normal
- G-3=slight difficulty
- F-2=mod. difficulty
- P-1=severe difficulty
- 0=unable
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Who developed the specific coordination exercises (swiss ball/balance board)?
frenkels
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What is non-equilibrium?
components of mvmt-analyzed when a pts stability is challenged
pillow, foam mat, etc
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What is n assessment when pt is standing or using any stage of development sequence?
equilibrium
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What is gross?
large muscle groups
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What is fine?
small muscle groups
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What is Rhomberg?
pt has inability to maintain balance with eyes closed
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Who developed the balance tests?
berg
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What type of tests did tinetti develop?
balance, gait
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What is the conscious effort to relieve tension in muscles?
relaxation
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How do we provide relaxation locally?
- ROM
- heat
- massage
- biofeedback
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How do we provide relaxation generally?
- Jacobsons (relaxation)
- guided imagery
- progressive muscle relaxation techniques
- deep breathing
- biofeedback
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What is the purpose of relaxation exercises?
- decreased tension and pain
- increase circulation
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What are some indications for using relaxation techniques?
tension, HTN, anxiety, pain, muscle guarding, spasm, hypertonic muscles
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What is the pain cycle? (4)
anxiety -> tension -> strength of contraction -> prolonged muscular contractions
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What are contraindications of relaxation techniques?
- lack of muscle tone
- comatose
- disoriented pt
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Who developed relaxation techniques (tighten and let go)?
jacobson
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