Balance Lecture
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Transcript of Balance Lecture
Possible causes of Balance deficits
The Dynamic Balance Walking Kinetic Chain
Running transfers force of the foot hitting the ground up the kinetic chain to the knee, hip, pelvic region, lower back and to the upper back and cervical region
Abnormal and inefficient movement can cause balance deficits, injury to joints and soft tissue facilitating adaptation to movement and loss of performance-loss of balance
Gait Analysis
Kinetic Chain When the foot hit the
ground force is transmitted up the leg to the trunk
Distribution of forces is critical to safe and effective walking
Abnormal balance to the forces leads to injuries
Rehabilitation of the Ankle-Foot Complex
Forces at the foot For proper balance
the Therapist must first assess the position of the foot and provide the proper:
Flexibility Mobility Strength Strength and control
to the upper leg and trunk
Rehabilitation of the Knee
Knee Joint Middle joint of the kinetic
chain High level of three
dimensional forces Requires high level of
ligaments and muscular support
Patella position and smooth movement is critical to proper function
Position of knee (posture) is essential to acquire both static and dynamic balance
Strength deficits at hip or ankle can affect the stress on knee joint
Rehabilitation of Pelvic Injuries
Force transmitted to the Sacral Joint and lumbar region
Three dimension forces on joint
Key Stone of lower trunk core stability
Low back imbalance can present radiculopathy that can mask true problem
Key is core stabilization to improve trunk control with balance requirement
A strong foundation will allow for improved adaptation to balance issues
Rehabilitation of Hip Injuries
Hip joint Ball and socket joint High level of
stability Limited mobility Critical for straight
hip control Balance of
musculature flexibility and strength is essential
Balance System: Schematic of System
Vestibular
Visual
Somatosensory
Sensory-specific Input
Vestibular
Nuclear
Primary Processor
Central Integrator
Vestibulo-ocular Reflex Eye Mvmt
Vestibulo-Collic reflex (neck movement)
Vestibulo-spinal Reflex
Postural Mvmt
Muscular Output
Adaptive
Cerebellum
Adaptive Feedback
Balance System
Three systems work in harmony to allow us to maintain an upright and functioning posture Vision Inner Ear (vestibular System) Muscles (of the entire body)
Balance System
The system usually works well but it can become deficient if we become sick, injured or from the treatment with some particular medications
If this happens our brains adapt to utilize the system that is still operational and neglect the system that has been affected
This leads to reduced function and fear of falling
Overall quality of life is reduce and leads to dependency to individual
Balance Adaptations
What typically happens is that a person will start to utilize their eyes to be the primary sensory to keep them upright Typical situation
Steps become smaller Feet further apart (waddle when you walk) Steps are shallow and short Eyes become focused on the ground Arm swing is reduced
Results of changes in walking pattern
Falls occur Falls are leading cause of fatal and non
fatal injury for older Americans Nearly 20,000 older Americans die from
fall-related injuries every year One in three seniors over the age of 65
will fall at least once this year Falls threaten seniors’ safety and
independence
How do we prevent falls
Falls are among the most preventable cause of high medical treatment costs among older adults
What is needed is: Education Screening Exercise/Physical Activity (if you don’t
use it you will loose it) Physical Therapy (Only if necessary)