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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
What is coordination?
usage of correct muscles at the correct time with the correct intensity and speed. its the basis of smoth, efficient movement
What part of the brain does balance and coordination come from?
What are coordination deficits called?
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
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)
What is vertigo?
pt gets dizzy and cant keep balance
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
What are the first areas we need to focus on improving?
- muscle strength
- stabilization control
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)
What is manual perturbation?
manual force used to displace COM (push pt around)
What are some indications for coordination exercises?
parkinsonism, MS, CP, CVA (all effect CNS), post injury/post surgically (effects proprioception and muscle strength/balance)
What are some of the progressions of coordination exercises?
- increase: speed, # of reps, resistance (gradually), complexity (concentric->eccentric->isokinetic)
- decrease rest production
What are the balance rankings?
- G-3=slight difficulty
- F-2=mod. difficulty
- P-1=severe difficulty
Who developed the specific coordination exercises (swiss ball/balance board)?
What is non-equilibrium?
components of mvmt-analyzed when a pts stability is challenged
pillow, foam mat, etc
What is n assessment when pt is standing or using any stage of development sequence?
What is gross?
large muscle groups
What is fine?
small muscle groups
What is Rhomberg?
pt has inability to maintain balance with eyes closed
Who developed the balance tests?
What type of tests did tinetti develop?
What is the conscious effort to relieve tension in muscles?
How do we provide relaxation locally?
How do we provide relaxation generally?
- Jacobsons (relaxation)
- guided imagery
- progressive muscle relaxation techniques
- deep breathing
What is the purpose of relaxation exercises?
- decreased tension and pain
- increase circulation
What are some indications for using relaxation techniques?
tension, HTN, anxiety, pain, muscle guarding, spasm, hypertonic muscles
What is the pain cycle? (4)
anxiety -> tension -> strength of contraction -> prolonged muscular contractions
What are contraindications of relaxation techniques?
- lack of muscle tone
- disoriented pt
Who developed relaxation techniques (tighten and let go)?