Term
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Definition
| controlling the COM relative to the BOS; keeps you from falling |
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Term
| what are limits of stability |
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Definition
| how far COM can move in any direction without loss of balance. Edge of the cone of stability |
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Term
| what is the cone of stability |
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Definition
| limits of stability are shaped like a cone |
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Term
| what determines the size of the cone of stability in standing? |
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Definition
| base of support (feet), joint ROM, muscle strength, sensory information |
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Term
| describe the CNS representation of the cone of stability |
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Definition
| the CNS has an internal representation of the cone of stability that it uses to determine how to move to maintain equilibrium. |
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Term
| what happens to older adults with balance disorders and their CNS representation of the cone of stability |
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Definition
| the cone of stability is very small or their central neural representations of that cone of stability are distorted, which affects their selection of movement strategies to maintain equilibrium |
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Term
| what is the postural sway envelope |
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Definition
| in standing, the body undergoes constant swaying, with the sway envelope centered with limits of stability/COM |
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Term
| how big is a sway envelope for someone standing with their feet 4 inches apart |
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Definition
| 8 deg forward, 4 deg backward, 8 deg left, 8 deg right |
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Term
| what are the 3 sensory inputs necessary for balance |
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Definition
| somatosensory, visual, vestibular |
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Term
| which sensory input has the fastest mode of transmission? |
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Definition
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Term
| how does sensory input contribute to maintenance of balance |
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Definition
| provides information about orientation of body in space and orientation of body parts to other body parts |
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Term
| what is anticipatory control of balance |
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Definition
| using information about initial conditions and goal to regulate balance during a task |
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Term
| what provides somatosensory information |
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Definition
| tactile and proprioceptive inputs via mechanoreceptors in joint capsule, muscles, skin |
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Term
| when does vestibular sensory come in to play? |
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Definition
| when there is a conflict between somatosensory or vision or when somatosensory/vision are absent |
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Term
| what are motor contributions to maintain balance |
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Definition
| responds to sensory input to adjust body position |
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Term
| what parts of the brain affect motor responses |
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Definition
| basal ganglia and cerebellum regulate responses produced by cerebral cortex (premotor and primary motor cortices) |
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Term
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Definition
| automatic postural response |
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Term
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Definition
| posture as a pre-programmed response |
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Term
| describe medium latency APRs |
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Definition
| brainstem level response that occurs prior to cortical potential, causes stabilizing muscle activation (whole body involved); |
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Term
| describe long latency APRs |
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Definition
| cortical involvement to modify postural response after perturbation: should I step or reach? |
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Term
| what cortical involvements occur in long latency automatic postural response? |
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Definition
| cerebellar-cortical loop: adapts based on prior experience; basal ganglia-cortical loop: optimize response based on current conditions |
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Term
| what is the order of ankle strategy for forward sway (small perturbation) |
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Definition
| gastroc, hamstrings, paraspinals |
|
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Term
| what is the order of ankle strategy for backward sway (small perturbation) |
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Definition
|
|
Term
| what muscles are activated in hip strategy for forward sway |
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Definition
|
|
Term
| what muscles are activated in hip strategy for backward sway |
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Definition
|
|
Term
| does the head and hip move in same or different directions in ankle strategy? |
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Definition
|
|
Term
| does the head and hip move in same or different directions in hip strategy? |
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Definition
|
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Term
| when do you use hip strategy instead of ankle strategy |
|
Definition
| when the perturbation is larger and there is not enough friction between foot and ground. |
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Term
| what are the purposes of APA? |
|
Definition
| constrain displacement of body's COM by generate opposing displacement; permit controlled movement of COM over a changing BOS |
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Term
|
Definition
| movement speed, initial location of COM with respect to BOS, postural support, mass of moving limb, instructional set |
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Term
| is APR feedforward or feedback? |
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Definition
|
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Term
| is APA feedforward or feedback? |
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Definition
|
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Term
| does APR react or anticipate? |
|
Definition
|
|
Term
| does APA react or anticipate? |
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Definition
|
|
Term
| what is the overall purpose of APR |
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Definition
|
|
Term
| what is the overall purpose of APA |
|
Definition
| maintain stability during active movement |
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Term
| is APR dependent on the environment? |
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Definition
|
|
Term
| is APA dependent on the environment? |
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Definition
|
|
Term
| what parts of CNS are required by APA |
|
Definition
| spinal cord, brain stem, cortex |
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Term
| what parts of the brain are required by APR |
|
Definition
| spinal cord, brain stem, cortex |
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Term
| what are important considerations in selection of balance assessments? |
|
Definition
| functional observation, sensory impairments, strategies, other impairments |
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Term
| how to do functional observation with balance assessment |
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Definition
| do standardized assessments: static and dynamic |
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Term
| how to test for sensory impairments in selection of balance assessments |
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Definition
|
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Term
| what are some tests to do for balance dysfunction |
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Definition
| functional reach, Berg, Tinetti, TUG, 4SST, DGI, FGA, HiMAT, Community Balance and Mobility Scale, mini BESTest, Push and Release Test |
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Term
| what are the steps/outline of an intervention plan to address balance problems identified in an assessment |
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Definition
| Address underlying impairments. Practice while systematically varying sensory conditions, feedforward vs feedback, point and method of perturbation, speed demands, and attentional demands. Modify environment to compensate for permanent impairments. provide support and cues as needed. provide extrinsic feedback when needed. allow pt to solve problem with minimal feedback. Use biofeedback or STEPFIT to improve stance |
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Term
| are APR responses present in very young children? |
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Definition
|
|
Term
| at what age is there a regression in APR organization? |
|
Definition
|
|
Term
| at what age is a child's APR similar to an adult's |
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Definition
|
|
Term
| how does APR change in older adults |
|
Definition
| increased TA latencies. Increased co-contraction. Occasional reversals in sequence of leg muscle activation |
|
|
Term
| how does apa change in older adults? |
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Definition
| increased latencies, occasional proximal to distal activation. Increased co-contraction |
|
|
Term
| who generally has increased postural sway? |
|
Definition
| young children, older adults |
|
|
Term
| what is the largest sensory contribution for children |
|
Definition
|
|
Term
| what sensory contribution provides most information to adults to maintain balance |
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Definition
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