Deck 8: Exercise for Impaired Balance
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Deck 8: Exercise for Impaired Balance
1
The vestibular system provides which of the following types of sensory information for balance control?
A) Muscle tension and length
B) Joint movement and position
C) Position of the head and body with respect to inertial forces
D) Position of the head relative to the environment
A) Muscle tension and length
B) Joint movement and position
C) Position of the head and body with respect to inertial forces
D) Position of the head relative to the environment
C
2
The semicircular canals of the vestibular system would contribute the most to balance control during which of the following activities?
A) Standing and quickly turning the head to look at a person
B) Sitting in a chair reading a newspaper
C) Standing on a bus that suddenly accelerates forward
D) Standing on an elevator that suddenly accelerates downward
A) Standing and quickly turning the head to look at a person
B) Sitting in a chair reading a newspaper
C) Standing on a bus that suddenly accelerates forward
D) Standing on an elevator that suddenly accelerates downward
A
3
When a hip strategy is used for balance control in response to a posterior displacement of the support surface,which muscle groups are activated and in what sequence?
A) Abdominals followed by the quadriceps
B) Quadriceps followed by the abdominals
C) Hamstrings followed by the paraspinals
D) Paraspinals followed by the hamstrings
A) Abdominals followed by the quadriceps
B) Quadriceps followed by the abdominals
C) Hamstrings followed by the paraspinals
D) Paraspinals followed by the hamstrings
A
4
An 82-year-old woman is referred to physical therapy with a history of two falls in the past month.The patient lives alone and relies on her daughter for transportation.The best choice of an exercise program for this person is:
A) Otago Exercise Program.
B) Nitz and Choy Circuit Exercise Program.
C) Tai Chi Exercise Program.
D) Group Balance Exercise Program by Means and colleagues.
A) Otago Exercise Program.
B) Nitz and Choy Circuit Exercise Program.
C) Tai Chi Exercise Program.
D) Group Balance Exercise Program by Means and colleagues.
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5
Mrs.S is a 65-year-old woman with a history of falling due to episodic loss of balance.The medical diagnosis is "balance disorder." Which of the following tests is the best choice to administer to determine if Mrs.S has a fear of falling?
A) Activities-Specific Balance Confidence Scale
B) Tinetti Mobility Test
C) Berg Balance Scale
D) Functional Reach Test
A) Activities-Specific Balance Confidence Scale
B) Tinetti Mobility Test
C) Berg Balance Scale
D) Functional Reach Test
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6
To prevent falls and maximize safety while lifting heavy objects from the floor,an elderly patient is instructed to:
A) Bend at the knees as far as possible,keeping the back straight and placing the load between the legs.
B) Keep the knees straight,bend at the hips,keep the back straight,and pick up the load quickly.
C) Bend at the knees partially while keeping her back straight and pick up the load slowly.
D) Bend the knees partially and rotate and laterally bend the back to lift the load to one side of the hips.
A) Bend at the knees as far as possible,keeping the back straight and placing the load between the legs.
B) Keep the knees straight,bend at the hips,keep the back straight,and pick up the load quickly.
C) Bend at the knees partially while keeping her back straight and pick up the load slowly.
D) Bend the knees partially and rotate and laterally bend the back to lift the load to one side of the hips.
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7
As part of the treatment program to improve a patient's balance,you decide to utilize a balance training program recommended by Nitz and Choy.The components of this program include:
A) Group exercises that consist of practicing standing postures and walking and perturbation training.
B) Individual and group exercises emphasizing dynamic and multisensory activities delivered in a circuit mode.
C) Group exercises consisting of stretching,strengthening,and coordination exercises;body mechanics;survival training;and walking.
D) Home program consisting of lower and upper extremity exercises in sitting and standing positions.
A) Group exercises that consist of practicing standing postures and walking and perturbation training.
B) Individual and group exercises emphasizing dynamic and multisensory activities delivered in a circuit mode.
C) Group exercises consisting of stretching,strengthening,and coordination exercises;body mechanics;survival training;and walking.
D) Home program consisting of lower and upper extremity exercises in sitting and standing positions.
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8
A 76-year-old community-dwelling man is referred to physical therapy for balance training.He reports no previous falls.His Timed Up and Go (TUG)score is 15 seconds.The best setting for him to receive training is in:
A) An individual or community-based group exercise program.
B) A community-based group exercise program with individual supervision provided by trained staff.
C) A clinic with physical therapist or physical therapist assistant supervision.
D) At home with physical therapist or physical therapist assistant supervision.
A) An individual or community-based group exercise program.
B) A community-based group exercise program with individual supervision provided by trained staff.
C) A clinic with physical therapist or physical therapist assistant supervision.
D) At home with physical therapist or physical therapist assistant supervision.
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9
While testing a patient's balance,you have the patient perform a series of activities,starting with those that require a low level of balance control and progressing to more difficult tasks.Of the following,the task that requires the greatest amount of balance control is:
A) Catching and throwing a ball while sitting.
B) Raising the opposite arm and leg while in the quadruped position.
C) Walking with one foot placed in front of the other.
D) While standing,balancing on one leg for 10 seconds.
A) Catching and throwing a ball while sitting.
B) Raising the opposite arm and leg while in the quadruped position.
C) Walking with one foot placed in front of the other.
D) While standing,balancing on one leg for 10 seconds.
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10
Individuals with somatosensory deficits in the lower extremities,such as peripheral polyneuropathies,tend to use which of the following motor strategies in response to balance disturbances?
A) Ankle strategy
B) Hip strategy
C) Stepping strategy
D) Suspensory strategy
A) Ankle strategy
B) Hip strategy
C) Stepping strategy
D) Suspensory strategy
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11
Individuals who become unstable or fall in condition 5 (standing on foam with eyes closed)and condition 6 (standing on foam wearing a dome)during the Clinical Test of Sensory Integration on Balance most likely have deficits in:
A) Proprioception.
B) Somatosensation.
C) Vestibular function.
D) Vision.
A) Proprioception.
B) Somatosensation.
C) Vestibular function.
D) Vision.
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12
The center of gravity (COG)in most adult humans is located slightly:
A) Posterior to the L2 vertebra.
B) Posterior to the S2 vertebra.
C) Anterior to the L2 vertebra.
D) Anterior to the S2 vertebra.
A) Posterior to the L2 vertebra.
B) Posterior to the S2 vertebra.
C) Anterior to the L2 vertebra.
D) Anterior to the S2 vertebra.
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13
Which of the following terms is defined as "the sway boundaries in which an individual can maintain equilibrium without changing his/her base of support"?
A) Center of mass
B) Limits of stability
C) Limits of pressure
D) Center of gravity
A) Center of mass
B) Limits of stability
C) Limits of pressure
D) Center of gravity
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14
During an examination of a patient who has a history of episodic falls,you observe the patient performing functional tasks to determine how she loses her balance.You note that the patient becomes unsteady whenever she picks up objects from the floor or reaches for objects in a kitchen cupboard.These findings most likely indicate a control deficit in:
A) Anticipatory balance.
B) Reactive balance.
C) Static balance.
D) Sensory organization.
A) Anticipatory balance.
B) Reactive balance.
C) Static balance.
D) Sensory organization.
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15
To improve a patient's dynamic postural control using visual and vestibular inputs,the most appropriate activity for the patient to perform is:
A) Standing on a foam surface with feet apart and eyes open.
B) Marching in place on a firm surface with the eyes open.
C) Walking with a narrowed base of support on foam with eyes open.
D) Walking with a narrowed base of support on a firm surface with eyes closed.
A) Standing on a foam surface with feet apart and eyes open.
B) Marching in place on a firm surface with the eyes open.
C) Walking with a narrowed base of support on foam with eyes open.
D) Walking with a narrowed base of support on a firm surface with eyes closed.
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16
To maintain balance in condition 3 (standing on a firm surface wearing a dome)of the Clinical Test of Sensory Integration on Balance,a person must rely solely on:
A) Somatosensory and vestibular information.
B) Vestibular information.
C) Visual and somatosensory information.
D) Visual and vestibular information.
A) Somatosensory and vestibular information.
B) Vestibular information.
C) Visual and somatosensory information.
D) Visual and vestibular information.
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17
The typical pattern of muscle activation associated with an ankle strategy to correct forward body sway is:
A) Gastrocnemius and hamstrings are activated simultaneously,followed by the paraspinals.
B) Gastrocnemius is activated first,then the hamstrings,followed by the paraspinals.
C) Paraspinals are activated first,then hamstrings,followed by the gastrocnemius.
D) Hamstrings,gastrocnemius,and paraspinals are activated simultaneously.
A) Gastrocnemius and hamstrings are activated simultaneously,followed by the paraspinals.
B) Gastrocnemius is activated first,then the hamstrings,followed by the paraspinals.
C) Paraspinals are activated first,then hamstrings,followed by the gastrocnemius.
D) Hamstrings,gastrocnemius,and paraspinals are activated simultaneously.
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18
As part of a patient's balance training program,you have her walk across a balance beam or on a line drawn on the floor.The motor strategy this patient is most likely retraining is the:
A) Ankle strategy.
B) Suspensory strategy.
C) Stepping strategy.
D) Hip strategy.
A) Ankle strategy.
B) Suspensory strategy.
C) Stepping strategy.
D) Hip strategy.
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19
A balance test that can reliably detect deficits in individuals with chronic ankle instability is the:
A) Functional Reach Test.
B) Multi-Directional Reach Test.
C) Star Excursion Test.
D) Postural Stress Test.
A) Functional Reach Test.
B) Multi-Directional Reach Test.
C) Star Excursion Test.
D) Postural Stress Test.
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20
The most important neural structures for the integration and processing of sensory information for balance control are:
A) Basal ganglia,primary motor area,and cerebellum.
B) Basal ganglia,thalamus,and supplementary motor area.
C) Supplementary motor area,cerebellum,and basal ganglia.
D) Supplementary motor area,cerebellum,and thalamus.
A) Basal ganglia,primary motor area,and cerebellum.
B) Basal ganglia,thalamus,and supplementary motor area.
C) Supplementary motor area,cerebellum,and basal ganglia.
D) Supplementary motor area,cerebellum,and thalamus.
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21
The outcome measure developed specifically to measure balance control during gait in people with vestibular disorders is the:
A) Timed Up and Go Test.
B) Tinetti Performance-Oriented Mobility Assessment.
C) Functional Gait Assessment.
D) Dynamic Gait Index.
A) Timed Up and Go Test.
B) Tinetti Performance-Oriented Mobility Assessment.
C) Functional Gait Assessment.
D) Dynamic Gait Index.
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