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Balance

Balance. Wael Alasaq PT. Ph.D. PT Department Kuwait University. Balance. What is Balance? Balance involves the regulation of movement of linked body segments over supporting joints & base of support (Mackinnon & Winter 1993) What is postural control?

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Balance

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  1. Balance Wael Alasaq PT. Ph.D. PT Department Kuwait University

  2. Balance What is Balance? • Balance involves the regulation of movement of linked body segments over supporting joints & base of support (Mackinnon & Winter 1993) What is postural control? The regulation of the body’s position in space for the dual purposes of stability & orientation. (Shumway-Cook & Woollacott). Wael Alasaq PT.Ph.D

  3. Balance Cont. Postural adjustments have 3 goals: • Support body against gravity & other external forces. • Maintain the center of body mass (CBM) within the base of support (BOS). • To stabilize parts of the body while moving other parts. Wael Alasaq PT.Ph.D

  4. Balance Cont. • How balance is regained (postural adjustments)? • Muscle activation • Segments movement Wael Alasaq PT.Ph.D

  5. Systems participating in postural control are: 1- Sensory System • Vision: Provide information about our orientation to the environment & help in predicting upcoming perturbation. • Somatosensory including joints receptors, muscle proprioceptors, cutaneous, & pressure receptors • Vestibular 2- Musculoskeletal 3- Wael Alasaq PT.Ph.D

  6. It was often referred to postural adjustments as: postural reaction postural reflexes or equilibrium reactions. Old vs. new terms & their effects on ttt Wael Alasaq PT.Ph.D

  7. Biomechanical Description • Balancing during motor action in standing • Balancing during motor action in sitting • Balancing during body transport Wael Alasaq PT.Ph.D

  8. Balancing during motor action in standing • Postural sway: Postural sway • Balance is affected by the task & environment • Postural responses to unexpected perturbation Wael Alasaq PT.Ph.D

  9. Balancing during motor action in setting • BOS • CBM is closer to the BOS • Moving or reaching in setting requires postural adjustments as well. • Lower limb muscles are involved in anticipatory, ongoing and reactive postural adjustments. Wael Alasaq PT.Ph.D

  10. Balancing during motor action in setting Cont. • Trunk muscles act as postural stabilizers, especially when upper limbs are used and for reaching. • When reaching side ways destabilization occurs faster than forward reach. • When feet are unsupported the limits of stability is reached much earlier, such as setting over the side of the bed Wael Alasaq PT.Ph.D

  11. Balancing during body transport • Walking • Standing up & Sitting down Wael Alasaq PT.Ph.D

  12. Walking • Balance is affected by both task & environment. • Control of balance in walking vs. in standing. • Loss of balance may occur due to many factors: Find them in your book Wael Alasaq PT.Ph.D

  13. Standing up & sitting down • The movt. in the sagital plane • Demands control of linear momentum & Muscle activations • Healthy elderly decrease speed of standing up • Falls in these activities are common in elderly Wael Alasaq PT.Ph.D

  14. Standing up & sitting down Cont. • Stroke pts experience difficulties with balance throughout standing. • Muscles which are important in controlling the standing up are…………. & those controlling sitting down are ………. Wael Alasaq PT.Ph.D

  15. Age-related changes • Postural instability in elderly and tendency to fall can be attributed to many factors. Go and find them! • Are @ high risk of pathologies accelerating degeneration in neuromusculoskeletal systems • Biomechanical factors (musculoskeletal flexibility & MM strength) • 30-80 yrs decrease of 40% UL & 30% LL strength Wael Alasaq PT.Ph.D

  16. Age-related changes Wael Alasaq PT.Ph.D

  17. Observational analysis & Guidelines for balance training • In trios read and practice the activities in Carr & Shepard book pp50-71. Wael Alasaq PT.Ph.D

  18. Functional Tests • Functional reach test • Step Test • TUGT • BBS Wael Alasaq PT.Ph.D

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