Balance Lab (9/20a) [Examination] Flashcards Preview

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Why do we test balance

Assess safety, fall risk

Postural control involved in all activities

Documentation about impairment to base standard for their improvement (we get paid)


Usual performance

how they perform day to day

We want to see their worst to understand what we can work on


Best performance

how they perform under optimal conditions


Dual task paradigm

Doing two tasks at the same time

we may introduce a second task to distract pt to see how they perform when they aren’t solely concentrating on doing the activity at their best


Two popular threshold tests for fall risks

Mini BESTest ***
Berg Balance Test


Problems with balance threshold tests

We treat fall risk as if it’s a pass/fail activity, but it truly isn’t

We should be least confident when someone is around the middle/threshold

Test values make no clinical sense, but they are used for insurance properties


Sensory systems affected by aging




perception or awareness of the position and movement of the body

not affected by aging -- affected by diseases


Can we restore diminished proprioception


No evidence that proprioception can be restored


4 Main Categories of Mini BESTest

Reactive postural control
Sensory orientation
Dynamic gait


Two quick proprioception tests

***Moving the big toe with eyes closed→ is toe up or down?

Eyes closed, move one arm into a position → ask them to match with other arm


Big toe proprioception - interpretation

pt should be able to quickly tell whether toe is up or down

any hesitation at all indicates something is abnormal → may need to refer out


Functional Reach test

<6" is at increased fall risk

hold yard stick vertically at shoulder height
pt stands perpendicular to stick
middle finger of fist aligns with edge of stick
pt reaches, measure farthest distance


Short Physical Performance Battery (SPPB) test

1) Balance tests - side by side stand, semi tandem stand, tandem stand

2) Gait speed test - 4 meter walk

3) Chair stand test - pretest (able to stand from chair with arms crossed), test (time to repeat 5 times)


Timed Up and Go (TUG) test

Time to get up from chair, walk 3 m (or 10 ft), and sit back in chair

1) Instruct patient
2) On the word "go" begin timing
3) Stop timing when patient sits back down
4) Record time


To really test a patient's balance you have to

make them be unstable by:
changing speed
changing intensity
changing surface
remove some sensory information
introduce dual task