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69 Cards in this Set
- Front
- Back
DEFINE posture
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the alignment of body segments with respect to one another and to the surrounding environment
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DEFINE "balance" or "equilibrium"
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the control of postural alignment
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DEFINE Newton's Third Law
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A state of equilibrium exists when the sum of the forces acting on a body is balanced
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When does a fall result?
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when the body is unable to combat a challenge to its center of gravity by means of a postural control response, resulting in a loss of upright position, and consequently experiences an impact on a lower surface
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DEFINE risk for falling
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Research shows that we can predict whether one person is more likely to fall than another
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Who is at risk for falling?
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*a person who has fallen in the last 6 mos
*those w/ impaired sensory input: vision, vestibular, somatosensory *ppl with impaired posture *pple with loss of use of one or more limbs *ppl who have pain w/ movement *ppl with diminished ROM *ppl with weakness of the hip extensors, hip abductors, and dorsiflexors *ppl with impaired neurological systems *ppl w/ cardiovascular problems *ppl w/ GI problems *ppl w/ genitourinary problems *ppl with impaired cognistion *ppl w/ hip, distal radius, or vertebral body fractures *ppl w/ depression *ppl with impaired memory *ppl who are afraid of falling *ppl who perform tasks w/ high attentional demands *ppl who take 4+ medications or any psychoactive medication |
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What are some diseases that can impair sensory input?
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diabetes
CVA low vision vertigo Total joint athroplasty |
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What are some diseases that can cause impaired posture?
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Parkinson's Disease
Osteoporosis |
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What are some diseases that can cause the loss of use of one or more limbs?
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CVA
amputation SCI |
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What diseases can cause diminished ROM?
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OA, RA, post traumatic stiffness
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What diseases cause impaired neurological systems?
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CVI, TIA, Parkinson's, delirium
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What diseases are included under cardiovascular problems?
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myocardial infarction, cardiac arrhythmias, postural hypotension
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What diseases are included under GI problems?
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bleeding, diarrhea, defacation syncope, post prandial syncope
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What diseases are included under genitourinary problems?
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incontinence, nocturia
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What is considered "impaired cognition"?
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A score of less than 24 on the Folstein MMSE
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What is considered "depressed"?
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score of less than 5 on the geriatric depression scale
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What does the OT practice framework identify balance as?
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Performance skil, specifically a motor skill related to maintenance of posture
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DEFINE motor skills
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skills in moving and interacting w/ task, objects, and environment
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What is included under motor skills in the OT practice framework?
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Posture
mobility coordination strength energy |
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What does the OT practice framework suggest developing your intervention on?
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occupational profile
occupational performance |
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What is Pattern A of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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Primary prevention/risk reduction for loss of balance and falling
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What is Pattern B of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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Impaired neuromotor development
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What is Pattern C of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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Impaired motor fx and SI associated w/ nonprogressive disorders of the CNS: congenital or acquired in infancy or childhood
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Which pattern of the Neuromuscular preferred practice pattern is most seen in the clinic?>
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pattern A
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What is Pattern D of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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impaired motor fx and SI associated with nonprogressive disorders of the CNS: acquired in adolescence or adulthood
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What is Pattern E of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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Impaired motor fx and SI associated w/ progressive disorders of the CNS
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What is Pattern G of the Neuromuscular preferred practice pattern in the Guide to PT practice?
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impaired motor fx and SI associated w/ acute or chronic polyneuropathies
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What is Pattern B of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired posture
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What is Pattern C of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired muscular performance
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What is Pattern D of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility, motor fx, mm performance, and ROM associated w/ lovalized inflammation
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What is Pattern F of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility motor fx, mm performance, and ROM associated w/ spinal disorders
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What is Pattern G of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility motor fx, mm performance, and ROM associated w/ fracture
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What is Pattern H of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility motor fx, mm performance, and ROM associated w/ joint arthroplasty
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What is Pattern I of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility motor fx, mm performance, and ROM associated w/ bony or soft tissue surgery
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What is Pattern J of the Musculoskeletal Preferred Practice Pattern in the Guide to PT practice?
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impaired joint mobility motor fx, mm performance, and ROM associated w/ amputation
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DEFINE balance
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the control of postural alignment
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DEFINE posture
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relates to the stabilizing and aligning of one's body while moving in relation to task objects w/ which one must deal
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DEFINE stabilizes
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maintains trunk control and blance while interacting w/ task objects such that there is no evidence of transient (quickly passing) propping or loss of balance that affects task performance
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DEFINE aligns
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maintains an upright sitting or standing position, w/out evidence of a need to persistently prop during task performance
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DEFINE positions
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positions body, arms, or wheelchair in relation to task objects in a manner that promotes the use of efficient arm movements during task performance
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What are the 5 aspects of the dynamic system of balance?
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environment
motor output sensory input cognition task |
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What are the different bodily components that maintain postural control?
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musculoskeletal components
internal representations adaptive mechanisms anticipatory mechanisms tasks individual sensory system neuromuscular synergies |
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What is included under "tasks"?
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ADL, IADL, education, work, play, leisure, roles and contextws
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What is included under "anticipatory mech"?
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vision, cognition, judgement, decision making, mapping
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What is included under "adaptive mech"?
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problem solving
organizing recall |
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What is included under "internal representations"?
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processing
habits and routines |
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What is included under "neuromuscular synergies"?
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coordination
tone movement synergies |
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What are some basic principles of the biomechanics of balance?
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COG and Base of support
sway |
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What sensory systems are involved in maintaining balance?
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visual
somatosensory (proprioception) vestibular |
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How does the visual system help maintain balance?
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*determine verticality by assessing vertically aligned objects in the environment
*proactive postural control *children under 3 use vision as their primary source of sensory info for balance |
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How does the somatosensory system help maintain balance?
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*proprioceptors in ligs and joint capsules
*stretch receptors (muscle spindles) in mm *pressure receptors (primarily in soles of feet) *longus coli mm |
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How does the body solve conflicts between one or more systems involved with balance?
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the vestibular system is the tie-breaker (what it is telling the body goes)
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What are 2 technological tests to assess sensory organization?
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neurocom smart balance master (high tech)
sensory organization test (aka the "foam and dome" test) (low tech) |
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How does the Sensory organization test work?
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provides a combination of standing on flat surface vs. foam, eyes open vs. eyes closed, visual conflict dome vs no dome
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What are the 2 outcomes for each of the 6 tests in the sensory organization tests?
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no change from normal (eyes open on flat surface) or increase sway
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How many reactions do humans have to a disruption to balance?
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3
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What percentage of all balnce strategies are proactive in nature?
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80-90%
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DEFINE proactive balance strategy
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therapist strive to help pts aviod falls by being proactive, rather than reactive
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What are 3 reactive balance strategies?
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postural strategies (ankle strategy, hip strategy, stepping strategy
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DEFINE ankle strategy
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pt sways forward-->backwards.
*sway is slow, small, and near midline *distal to proximal contraction of mm on the contralateral side of sway |
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DEFINE hip strategy
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pt sways forward-->backwards while bending at the hip
*COG movement is large, fast, and nearing the limit of stability *proximal to distal mm contraction ipsilateral to the direction for COG displacement (the way the person is bending) |
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DEFINE stepping strategy
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COG is displaced very rapidly or is displaced beyond the limit of stability
*involves stepping w/ the feet or reaching w/ the arms in an attempt to establish a new BOS |
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What reactive strategies are most commonly used?
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ankle and stepping strategies
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What is an exercise that uses the ankle strategy?
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wall lean exercise
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What is an exercise that uses the stepping strategy?
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floor clock exercise
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What are common balance assessment test/tools?
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*the university of oklahoma balance assessment tool
*sesnory organization *berg balance scale *functional reach test *university of oklahom hazard assessment form |
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What are 3 rules of thumb for balance assessment?
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*screen for balance dysfunction/falls risk in you intake and history
*screen in your PE using the functional reach *in functional reach indicates risk for falling, administer berg balance scale |
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What information should you get from a patient with risk of falling/history of falling?
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*when was your last fall?
*develop a history of falling for the pt *understand the patient's "typical day" *pt's desired outcome *medication |
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What should be recorded with a person w/ a history of falling?
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Symptoms before the fall
Previous falls Location of the fall Activity at the time of fall Time of day when the fall occurred Trauma acquired from the fall (SPLATT) |