Carol LamhutBianca Nemes

Joanne RearickJason VanDuyne

Carol and the Adventurers!

Objectives:● Definition● Systems that help to maintain balance● Normal effects of aging with balance● Functional balance assessment● Ways to improve balance● Interventions

Improving Balance in Elderly Populations

-The state of having your weight spread equally so that you do not fall-The ability to move or to remain in a posture without losing control or falling-Static or dynamic environment

Definition

Maintaining balance requires coordination of input from three systems● Somatosensory

○ Proprioception○ Kinesthesia

● Visual● Vestibular

Systems that maintain balance

Sarcopenia- Degenerative loss of skeletal muscleReaction time- Speed decreases to increase accuracyRange of motion- Degenerative changes in collagenPostural changes- Forward head, lordotic curveLimits of stability- Decreased awareness of abilities

Normal effects of aging

Berg Balance Scale● A 14-item objective measuredesigned to assess static balanceand fall risk● Item-level scores range from 0-4● Item scores are summed● Maximum score = 56

Functional Balance Assessments

●Romberg Stance● Head Movements● Close Eyes- 20-30 second hold● Head Movements with Eyes Closed

●Tandem Stance● Head movements● Close Eyes● Head movements with eyes closed

Balance Intervention

Single Leg

● Repeat Progression● Head Movements● With Eyes Closed

Balance Intervention ProgressionUn-Level Surface

● Foam Cushion● Stability Ball

When working with an elderly patient, are we…

the normal effects of aging?

Reversing the effects of aging

Delaying or are we

Improving

- VOR (Vestibulo-Ocular Reflex)- The purpose of these exercises is to improve one’s central or brain’s compensation for injuries or abnormalities within the vestibular or balance system.

- Gaze stabilization- Smooth pursuit- Head and eye direction (same, opposite)

Vestibular Exercises S

-Assessed the short-term effectiveness of vestibular rehabilitation therapy in reducing fall risk in an at-risk population-70 patients older than 50 years of age-Berg balance test scores:● Pre-therapy = 36.8● Post-therapy = 46.4-Referring diagnosis, age, and gender had no impact on outcome

Efficacy of Vestibular RehabilitationTherapy in Reducing Falls

By: John D. Macias, MD, Shelly Massingale, PT, Richard D. Gerkin, MD

Thank you

1. The role of visual, vestibular, and somatosensory systems in postural balance by Mary Grace Gaerlan (University of Nevada Las Vegashttp://digitalscholarship.unlv.edu/cgi/viewcontent.cgi?article=1382&context=thesesdissertationse

2. Shaffer, S. W., & Harrison, A. L. (2007). Aging of the somatosensory system: A translational perspective. Physical Therapy, 87(2), 193-207. Retrieved fromhttp://search.proquest.com/docview/223114898?accountid=40611?accountid=40611

3. Wulf, G. ( 2013 ). Attentional focus and motor learning: A review of 15 years. International Review of Sport and Exercise Psychology , 6, 77 - 104.http://www.neuropt.org/docs/csm-2014-handouts/dd-sig--changing-patients-focus-of-attention-to-enhance-motor-performance-and-learning.pdf?sfvrsn=2

4. Anemaet, W., & Moffa-Trotter, M. (1999). Functional tools for assessing balance and gait impairments. Topics In GeriatricRehabilitation, 15(1), 66-83.

5. Macias JD, Massingale S, Gerkin RD. Efficacy of vestibular rehabilitation therapy in reducing falls.http://www.ncbi.nlm.nih.gov/pubmed/16143174

References