Balance Lecture
- 2. The Balance
- 3. 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
- 4. 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
- 5. 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
- 6. Pronation of the Foot
- 7. How mal-alignment affect the entire body and therefore balance deficits
- 8. 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
- 9. 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
- 10. 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
- 11. 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
- 12. Outer, Middle and Inner Ear Outer Ear Inner Ear Middle Ear
- 13. 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)
- 14. 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
- 15. 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
- 16. 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
- 17. 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)
- 18. Questions Dr. Charles Curtis DPT, Cert. MDT Vestibular Competency