Exam 3 Review Questions PDF

6 Domains of Balance 1.​ If your patient is visually impaired, what conditions of the CTSIB will be especially difficult? ​ Balancing on a foam pad - conditions 4, 5 and 6 2.​ How about if your patient has peripheral neuropathy? Bilateral vestibular loss? ​ Peripheral Neuropa...

6 Domains of Balance 1.​ If your patient is visually impaired, what conditions of the CTSIB will be especially difficult? ​ Balancing on a foam pad - conditions 4, 5 and 6 2.​ How about if your patient has peripheral neuropathy? Bilateral vestibular loss? ​ Peripheral Neuropathy: ​ Condition 2 - eyes closed on firm surface ​ Condition 3 - visual conflict on firm surface ​ Condition 5 - eye closed on foam surface ​ Condition 6 - visual conflict on foam surface ​ Bilateral Vestibular Loss: ​ Condition 4 - eye open on firm surface ​ Condition 5 - eyes closed on foam surface ​ Condition 6 - visual conflict on foam surface 3.​ Using the categories of the postural control model covered in class, what categories would you ​ be sure to assess if your patient reported the following: (think of the components involved in ​ each task) ​ a.​ falling inside her home ​ ​ Biomechanical restraints, stability during gait, limits of stability ​ b.​ falling while shopping at the Shoppes at Grand Prairie ​ ​ Stability during gait, sensory orientation, cognitive influences ​ c.​ losing balance while doing her laundry ​ ​ Anticipatory postural adjustments, reactive postural responses, biomechanical constraints ​ d.​ falling while hanging her laundry on the clothesline ​ ​ Limits of stability, anticipatory postural adjustments, sensory orientation 4.​ What would be an appropriate balance assessment tool (not including the BESTest) for the ​ following scenarios? ​ a.​ you are screening every resident of a large retirement community for fall risk ​ ​ TUG ​ b.​ your patient (3wks s/p R CVA) is being discharged from rehab to a skilled nursing facility ​ ​ ​ for continued PT and you need to document changes in balance ​ ​ Berg Balance Scale ​ c.​ you are assessing a patient in home health—you want to get an idea of her safety with ​ ​ ​ ADLs and activities within her home. ​ ​ Tinetti ​ d.​ you are assessing an outpatient who has sustained a couple of falls in the community. ​ ​ FGA 5.​ If your patient uses a hip or stepping strategy for a very small perturbation, what areas will you ​ assess? ​ Ankle strength and ROM, somatosensation, reactions/postural response 6.​ How will you determine whether your patient’s balance is negatively affected by dual tasking? ​ TUG Cognitive - count backwards from a random number 20-100 ​ TUG Manual - carrying a glass of whatever 7.​ What questions will you ask your patient regarding her symptoms to determine if her ​ unsteadiness and/or falls is due to a PT problem or a medical problem? ​ Any falls in the past 6 months? ​ Would you describe it as dizziness or lightheadedness? ​ Do you feel weak? ​ Any changes in medication? ​ Any changes in sensation? ​ Any changes in vision or hearing? ​ Any recent illnesses? ​ Any incontinence? ​ Any recent surgeries? 8.​ What type of reactive postural response might you see in an individual with PD? How might it look different than in a person with ataxic MS or with Down Syndrome? ​ PD - present but lacking in amplitude, often resorts to stepping response over ankle/hip strategy ​ MS - large and exaggerated ​ DS - delayed 9.​ If your patient is unable to complete the entire 30 second trial of standing on foam with eyes closed of the CTSIB, what could this indicate? ​ Impaired vestibular system 10. If your patient scores a 55/56 on the Berg Balance scale, but complains of instability and loss of balance, how would you interpret this? How would you proceed with your assessment? ​ Explore specific systems: ​ Dynamic stability - FGA/cognitive TUG ​ Fear of falling - ABC ​ Reactive postural responses - perturbations ​ Prioception and vestibular - CTSIB 11. If your patient has impairments in Anticipatory postural adjustments, what types of activities might be problematic or cause loss of balance? ​ Lifting objects ​ Step initiation ​ Pushing or pulling doors ​ Standing from a chair 12. If during the seated lateral reach with eyes close, your patient falls over and has to catch himself, what balance domain is impaired? What if they overshoot when returning themselves to upright from the lateral lean position? ​ Falling Over - sensory orientation ​ Overshooting - reactive postural control 13. Your patient scores a 6/24 on the DGI. How would you interpret this? ​ High fall risk; cut-off score is