The ability to control the center of gravity over the base of support in a given sensory environment. In another word is the ability to maintain normal alignment relationships between the various body segments and between the body and environment. Balance is the condition in which all the forces acting on the body are balanced such that the center of mass is within the stability limits, the bound-Aries of the base of support.
Functional balance tests
Functional tests of balance focus on the maintenance of posture (static balance), balance during weight shifting or voluntary movement (dynamic balance),balance response to manual perturbations, and functional mobility (gait)examples of static balance tasks in standing include double limb stance, single limb stance, tandem stance, and the Romberg test.
Dynamic balance tasks include sit to stand and sit down, reaching movements; turning, and step-ups. Walking tasks include timed walking, walking with commands to turn direction (180 or 360 turns), turn the head (side to side or up and down), or stop and start. Scoring can vary from a simple subjective scale (impaired or intact) to a scale with specific criterion description for successful performance. The objectivity of measurement can be used to document time in balance during a 30 second trail of a single limb stance.
Romberg test
Is used to determine proprioceptive contributions to upright balance. The patient is instructed to stand with feet together, eye open unaided for 20 to 30 seconds. If patient falls with eyes open, the test is over. The patient is then asked to stand with eyes closed. In a negative test these is only minimal sway. If the test is positive, the patient is able to stand eyes open but demonstrates increased instability or falls with eyes closed.
It is important to tell the patient you are prepared to catch him or her in event of a fall. Positive Romberg test is indicative of a loss of proprioception that can occur with posterior column lesions in the spinal cord and peripheral neuropathy. In the sharpened Romberg test, the feet are placed in tandem (heel-toe position) and the eyes open to eyes close condition imposed.
Multidirectional reach
In this we can measures how far an individual can reach in the forward, backward, and lateral directions. For forward beyond arm’s length while maintaining a fixed base of support in the standing position. The test uses level yard stick mounted on the wall and positioned at the height of the patient’s acromion. The patient stands sidewards next to the wall( without touching) feet normal stance width and weight equally distributed on both feet, the shoulder is flexed to 90 and elbow extended with the hand fisted.
An initial measurement is made of the position of the 3rd metacarpal along the yard stick for forward, the patient is instructed to lean as far forward as possible without losing balance or taking a step. For lateral reach, the patient faces away from the wall and reaches sideways to the right as far as possible. The therapist records functional reach in inches for all three trials and then averages the three trials.
Berg balance scale
The scale consists of 14 functional task commonly performed in everyday life. The item range from sitting or standing unsupported, to movement transition, variations in standing position, feet together, forward reach, retrieving an object from the floor, turning standing on one foot to placing the foot on a stool. The first five items are considered basic balance items while the last nine items are considered more advanced balance tasks.
Efficacy scale
Is a self report measure that examines how confident an individual feels while performing items of daily functional mobility and ADL tasks both with or without assistance (household).
Functional tests of balance focus on the maintenance of posture (static balance), balance during weight shifting or voluntary movement (dynamic balance),balance response to manual perturbations, and functional mobility (gait)examples of static balance tasks in standing include double limb stance, single limb stance, tandem stance, and the Romberg test.
Dynamic balance tasks include sit to stand and sit down, reaching movements; turning, and step-ups. Walking tasks include timed walking, walking with commands to turn direction (180 or 360 turns), turn the head (side to side or up and down), or stop and start. Scoring can vary from a simple subjective scale (impaired or intact) to a scale with specific criterion description for successful performance. The objectivity of measurement can be used to document time in balance during a 30 second trail of a single limb stance.
Romberg test
Is used to determine proprioceptive contributions to upright balance. The patient is instructed to stand with feet together, eye open unaided for 20 to 30 seconds. If patient falls with eyes open, the test is over. The patient is then asked to stand with eyes closed. In a negative test these is only minimal sway. If the test is positive, the patient is able to stand eyes open but demonstrates increased instability or falls with eyes closed.
It is important to tell the patient you are prepared to catch him or her in event of a fall. Positive Romberg test is indicative of a loss of proprioception that can occur with posterior column lesions in the spinal cord and peripheral neuropathy. In the sharpened Romberg test, the feet are placed in tandem (heel-toe position) and the eyes open to eyes close condition imposed.
Multidirectional reach
In this we can measures how far an individual can reach in the forward, backward, and lateral directions. For forward beyond arm’s length while maintaining a fixed base of support in the standing position. The test uses level yard stick mounted on the wall and positioned at the height of the patient’s acromion. The patient stands sidewards next to the wall( without touching) feet normal stance width and weight equally distributed on both feet, the shoulder is flexed to 90 and elbow extended with the hand fisted.
An initial measurement is made of the position of the 3rd metacarpal along the yard stick for forward, the patient is instructed to lean as far forward as possible without losing balance or taking a step. For lateral reach, the patient faces away from the wall and reaches sideways to the right as far as possible. The therapist records functional reach in inches for all three trials and then averages the three trials.
Berg balance scale
The scale consists of 14 functional task commonly performed in everyday life. The item range from sitting or standing unsupported, to movement transition, variations in standing position, feet together, forward reach, retrieving an object from the floor, turning standing on one foot to placing the foot on a stool. The first five items are considered basic balance items while the last nine items are considered more advanced balance tasks.
Efficacy scale
Is a self report measure that examines how confident an individual feels while performing items of daily functional mobility and ADL tasks both with or without assistance (household).
