Ch7 Regaining Postural Stability And Balance

Closed

Open

Visual

Vestibular (前庭の)

Somatosensory (体知覚の)

Afferent

Efferent

Ankle

Knee

Hip

Shoulder

Elbow

Neck

Wrist

Determines timing, direction and amplitude of correction based on input

System relies on one sense at a time for orientation

For adults the somatosensory system is relied on primarily

Collection of processes that determine temporal sequencing and distribution of contractile activity

Collection of processes that determine temporal sequencing and distribution of contractile activity

Determines timing, direction and amplitude of correction based on input

System relies on one sense at a time for orientation

For adults the somatosensory system is relied on primarily

Provides information concerning relative position of body parts to support surface and each other

Measures orientation of eyes and head in relation to surrounding objects

Role in maintenance of balance

Provides information dealing with gravitational, linear and angular accelerations of the head with respect to inertial space

Minor role when visual and somatosensory systems are operating correctly

Provides information concerning relative position of body parts to support surface and each other

Measures orientation of eyes and head in relation to surrounding objects

Role in maintenance of balance

Provides information dealing with gravitational, linear and angular accelerations of the head with respect to inertial space

Minor role when visual and somatosensory systems are operating correctly

Provides information dealing with gravitational, linear and angular accelerations of the head with respect to inertial space

Minor role when visual and somatosensory systems are operating correctly

Measures orientation of eyes and head in relation to surrounding objects

Role in maintenance of balance

Provides information concerning relative position of body parts to support surface and each other

Shifts CoG by maintaining feet and rotating body at a rigid mass about the ankle joints

Gastrocnemius or tibialis anterior are responsible for torque production about ankle

Anterior/posterior sway is counteracted by gastrocnemius and tibialis anterior, respectively

Effective for slow CoG movements when base of support is firm and within LOS

Also effective when CoG is offset from center

Relied upon more heavily when somatosensory loss occurs and forward/backward perturbations are imposed or support surface lengths are altered

Aids in control of motion through initiation of large and rapid motions at the hip with anti-phase rotation of ankle

Effective when CoG is near LOS perimeter and when LOS boundaries are contracted by narrower base of support

Effective when CoG is near LOS perimeter and when LOS boundaries are contracted by narrower base of support

Aids in control of motion through initiation of large and rapid motions at the hip with anti-phase rotation of ankle

Relied upon more heavily when somatosensory loss occurs and forward/backward perturbations are imposed or support surface lengths are altered

Shifts CoG by maintaining feet and rotating body at a rigid mass about the ankle joints

Gastrocnemius or tibialis anterior are responsible for torque production about ankle

Anterior/posterior sway is counteracted by gastrocnemius and tibialis anterior, respectively

Effective for slow CoG movements when base of support is firm and within LOS

Also effective when CoG is offset from center

Utilizes three stances

Double, single, tandem on both firm and foam surfaces

Athletes are instructed to remain motionless with hands on hips for 20 seconds

Unnecessary movements and correction of body position are counted as ‘errors’ (max score = 10)

Results are best utilized if compared to baseline data

Functional reach tests

Timed agility tests

Carioca

Hop test

Bass test for dynamic balance

Timed T-band kicks

Timed balance beam walks (eyes open and closed)

Steadiness

Symmetry

Dynamic stability

Utilization of external perturbation

Center of Pressure (CoP)

Center of Balance (CoB)

Center of Vertical Force (CoF)

Symmetry

Dynamic stability

Utilization of external perturbation

Center of Pressure (CoP)

Center of Balance (CoB)

Center of Vertical Force (CoF)

Steadiness

Dynamic stability

Utilization of external perturbation

Center of Pressure (CoP)

Center of Balance (CoB)

Center of Vertical Force (CoF)

Steadiness

Symmetry

Utilization of external perturbation

Center of Pressure (CoP)

Center of Balance (CoB)

Center of Vertical Force (CoF)

Steadiness

Symmetry

Dynamic stability

Center of Pressure (CoP)

Center of Balance (CoB)

Center of Vertical Force (CoF)

Steadiness

Symmetry

Dynamic stability

Utilization of external perturbation

Center of Balance (CoB)

Center of Vertical Force (CoF)

Steadiness

Symmetry

Dynamic stability

Utilization of external perturbation

Center of Pressure (CoP)

Center of Vertical Force (CoF)

Steadiness

Symmetry

Dynamic stability

Utilization of external perturbation

Center of Pressure (CoP)

Center of Balance (CoB)

Static

Semi-dynamic

Dynamic

Functional

Static

Semi-dynamic

Dynamic

Functional

Static

Semi-dynamic

Dynamic

Functional

Static

Semi-dynamic

Dynamic

Functional

Non-ballistic types of drills

Static balance training

Bilateral to unilateral on both involved and uninvolved sides

Utilize multiple surfaces to safely challenge athlete and maintaining motivation

With and without arms/counterbalance

Eyes open and closed

Alterations in various sensory information

ATC can add perturbations

Incorporation of multiaxial devices

Train reflex stabilization and postural orientation

Transition from static to dynamic

Running, jumping and cutting – activities that require the athlete to repetitively lose and gain balance in order to perform activity

Incorporate when sufficient healing has occurred

Semi-dynamic exercised should be introduced in the transition

Involve displacement or perturbation of CoG

Bilateral, unilateral stances or weight transfers involved

Sit-stand exercises, focus on postural

Dynamic and functional types of exercise

Slow to fast, low to high force, controlled to uncontrolled

Dependent on sport athlete is involved in

Start with bilateral jumping drills – straight plane jumping patterns

Advance to diagonal jumping patterns

Increase length and sequences of patterns

Progress to unilateral drills

Pain and fatigue should not be much of a factor

Can also add a vertical component to the drills

Addition of implements

Tubing, foam roll

Final step = functional activity with subconscious dynamic control/balance

Non-ballistic types of drills

Static balance training

Bilateral to unilateral on both involved and uninvolved sides

Utilize multiple surfaces to safely challenge athlete and maintaining motivation

With and without arms/counterbalance

Eyes open and closed

Alterations in various sensory information

ATC can add perturbations

Incorporation of multiaxial devices

Train reflex stabilization and postural orientation

Transition from static to dynamic

Running, jumping and cutting – activities that require the athlete to repetitively lose and gain balance in order to perform activity

Incorporate when sufficient healing has occurred

Semi-dynamic exercised should be introduced in the transition

Involve displacement or perturbation of CoG

Bilateral, unilateral stances or weight transfers involved

Sit-stand exercises, focus on postural

Dynamic and functional types of exercise

Slow to fast, low to high force, controlled to uncontrolled

Dependent on sport athlete is involved in

Start with bilateral jumping drills – straight plane jumping patterns

Advance to diagonal jumping patterns

Increase length and sequences of patterns

Progress to unilateral drills

Pain and fatigue should not be much of a factor

Can also add a vertical component to the drills

Addition of implements

Tubing, foam roll

Final step = functional activity with subconscious dynamic control/balance

Non-ballistic types of drills

Static balance training

Bilateral to unilateral on both involved and uninvolved sides

Utilize multiple surfaces to safely challenge athlete and maintaining motivation

With and without arms/counterbalance

Eyes open and closed

Alterations in various sensory information

ATC can add perturbations

Incorporation of multiaxial devices

Train reflex stabilization and postural orientation

Transition from static to dynamic

Running, jumping and cutting – activities that require the athlete to repetitively lose and gain balance in order to perform activity

Incorporate when sufficient healing has occurred

Semi-dynamic exercised should be introduced in the transition

Involve displacement or perturbation of CoG

Bilateral, unilateral stances or weight transfers involved

Sit-stand exercises, focus on postural

Dynamic and functional types of exercise

Slow to fast, low to high force, controlled to uncontrolled

Dependent on sport athlete is involved in

Start with bilateral jumping drills – straight plane jumping patterns

Advance to diagonal jumping patterns

Increase length and sequences of patterns

Progress to unilateral drills

Pain and fatigue should not be much of a factor

Can also add a vertical component to the drills

Addition of implements

Tubing, foam roll

Final step = functional activity with subconscious dynamic control/balance