Functional Balance and Coordination Scales.pptx
- 1. Functional Balance And Coordination Scales Presenred By Dr. Manisha Yadav ( PT) MPT (Neuro )
- 2. Balance Perform assessment of balance during functional activities, with or without the use of assistive, adaptive, orthotic, & prosthetic devices Assess static & dynamic balance Balance Assess Static Balance Assess Dynamic Balance Assess
- 3. Static and Dynamic Balance Scale Static balance tests Dynamic balance tests Romberg Test Functional Reach Test Tandem (Sharpened) Romberg Test Multidirectional Reach Test One-Legged Stance Test Berg Balance Scale Timed Get Up and Go Test CTSIB
- 5. Romberg Test • Patient stands with feet together & eyes opened for 20 sec. • Patient stands with feet together & eyes closed for 20 sec. • Positive (indicating balance problems) if patient sways excessively, takes astep or falls.
- 6. Tandem (Sharpened) Romberg Test • Patient stands with one foot in front of the other in a heel- to-toe position with eyes open for 30 sec. • Patient then stands with one foot infront of the other in a heel-to-toe position with eyes closed for 60 sec . • Positive (indicating balance problems) if patient sways excessively, takes astep or falls
- 7. One-Legged Stance Test • With arms over chest, patient lifts one leg & holds it with hip in neutral & knee flexed to 90°for 30 sec (lifted leg may not press into stance leg). • Patient then repeats test with other leg. • Examiner stops timing if patient’s legs touch each other or foot touches the floor.
- 9. Functional Reach • Patient reaches forward as far as possible from a comfortable standing position. • Using a yardstick placed on the wall at shoulder level, examiner measures(in inches) the excursion of arm reachfrom start to finish.
- 10. Multidirectional Reach Test • From a comfortable standing position, patient reaches forwardas far as possible without moving feet or taking a step, leans as far back as possible & reaches sideways (to either side) asfar as possible. • Using a yardstick fixed on a tripod or attached to the wall at shoulder level, examiner measures the starting & ending positions of the index finger of the patient’s outstretched hand.
- 11. Berg Balance Scale This scale Measure Balance in Older Adults GENERAL INSTRUCTIONS Please document each task and/or give instructions as written. When scoring, please record the lowest response category that applies for each item. Equipment: • Yardstick • One standard chair with arm rests One standard chair without arm rests Footstool/step • Stopwatch or wristwatch • 15 foot walkway
- 12. Scoring: A five-point scale, a range of 0-4. 0 = lowest level of function 4 = highest level of function. Highest possible score = 56 Score of < 45 indicates a greater risk of falling • 41-56 = low fall risk • 21-40 = medium fall risk • 0 –20 = high fall risk
- 13. Category Itemes Score Sitting balance Sitting unsupported 0-4 Standing balance Standing unsupported 0-4 Standing with eyes closed 0-4
- 14. Standing with Feet together 0-4 Standing on one foot 0-4 Turning to look behind 0-4
- 15. Retrieving object from floor 0-4 Tandem standing 0-4 Reaching forward while standing 0-4
- 16. Dynamic Balance Sitting to Standing 0-4 Standing to Sitting 0-4 Transfer 0-4 Turning 360 degree 0-4
- 18. Timed Get Up and Go Test { TUG } • Patient sits comfortably in a firm chair with back resting against backrest • Patient stands, walks 10 ft toward a target at normal walking speed, turns around without touching the target, walks back to the chair, turns around & sits down • Examiner times performance with a stop watch beginning with the verbal instruction “go” & ending when the patient returns to starting position.
- 19. • Patient gets one practice & two test trials • Examiner records test trial average (in sec) • Most healthy adults can complete the test in 10 sec • 10 to 20 seconds is acceptable for the frail elderly or patients with disabilities
- 20. Clinical Test for Sensory Interaction in Balance (CTSIB) (for children 4 years and up, and adults) • Instruct the patient to stand with arms folded across the chest & with feet shoulder width apart. • The patient should be able to maintain balance in each condition for 30 seconds & is allowed three trials. • Two or more falls are considered to be indicative of deficits of sensory information required for standing balance. A condition is failed if the person steps, unfolds arms, or opens eyes (in eyes closed conditions).
- 21. Observation of sway in each condition is graded as: Grades Category 1 Minimal Sway 2 Mild Sway 3 Moderate Sway 4 Fall
- 22. Scale for the assessment and rating of ataxia (SARA) SARA is an 8-item performance based scale, yielding a total score of o (no ataxia) to 40 (most severe ataxia). EQUIPMENT REQUIRED • Stopwatch • 10 meter walkway • Examination table
- 23. SCORES The score ranges from o (no ataxia) to 40 (severe ataxia). The individual item scores are as follows: • Gait (o to 8) • Stance (o to 6) • Sitting (o to 4) • Speech disturbance(o to 6) • Finger chase (o to 4) • Nose-finger test (o to 4) • Fast alternating hand movements (o to 4) • Heel-shin slide (o to 4) • Limb kinetic functions (items 5 to 8) are rated independently for both body sides, and its arithmetic mean is included in total score.
- 24. S. no. Items Score 1 Gait 0 Normal, 1 Slight difficulties 2 Clearly abnormal 3 Considerable staggering, difficulties in half-turn 4 Marked staggering, intermittent support of the wall required 5 Need assisted Device 6 Need Minior Assistance 7 Need Major Assistance 8 Unable 2 Stance 0 Normal, 1 Able to stand with feet together without sway 2 Able to stand with feet togetherwith sway 3 Able to stand but not with feet together 4 Able to stand for with intermittent support 5 Able to stand with constant support of one arm 6 Unable to stand 3 Sitting 0 Normal, 1 Slight difficulties, 2 Constant sway, but able to sit without support 3 Able to sit for with intermittent support 4 Unable to sit for
- 25. 4 Speech disturbance 0 Normal 1 Suggestion of speech disturbance 2 Impaired speech, but easy to understand 3 Occasional words difficult to understand 4 Many words difficult to understand 5 Only single words understandable 6 anarthria 5 Finger chase 0 No dysmetria 1 Dysmetria, under/ overshooting target <5 cm 2 Dysmetria, under/ overshooting target < 15 cm 3 Dysmetria, under/ overshooting target > 15 cm 4 Unable to performs 6 Nose-finger test 0 No tremor 1 Tremor with an amplitude < 2 cm 2 Tremor with an amplitude < 5 cm 3 Tremor with an amplitude > 5 cm 4 Unable to perform 5 pointing movements
- 26. 7 Fast alternating hand movements 0 Normal, no irregularities (performs <10s) 1 Slightly irregular (performs <10s) 2 Clearly irregular, single movements difficultto distinguish or relevant interruptions, butperforms <10s8 3 Very irregular, single movements difficultto distinguish or relevant interruptions,performs >10s 4 Unable to complete 10 cycles 8 Heel-shin slide 0 Normal 1 Slightly abnormal, contact to shin maintained 2Clearly abnormal, goes off shin up to 3 timesduring 3 cycles3Severely abnormal, goes off shin 4 or more timesduring 3 cycles4 Unable to perform the task
- 27. THANK YOU