Balance scenario 6

• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • Main Analysis Findings
  • high level balance - medium BOS in standing - swaying in tandem stance
  • high level balance - small BOS in standing - can single leg stand for 10 seconds
  • physical - high level balance - needs to put foot down in external perturbation (nudge) - stepping strategy
  • physical - medium level balance - unable teach outside BOS in single leg stand

  
• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • Further tests/investigations you would like to do
  • check sensory systems e.g. does vision affect ability, does surface of floor affect ability
  • quads and hamstrings strength/endurance test
  • equal line of gravity?
• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • A suitable outcome measure
  • functional mobility assessment
  • berg balance scale
  • quads and hamstring strength/endurance
  • reassess line of gravity
• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • Justification for selection of treatment
  • start in single leg stand, stabilising with safety bar with both hands whilst being nudged
  • quads and hamstring strengthening/endurance
• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • progression:
  • single leg stand, being nudged with one hand stabilising
  • start to reach outside base of support whilst stabilising one hand - e.g. aim to put a sticker on the mirror, then increase the distance between the pts and the mirror, then make it more realistic
• Increased sway in tandem stance. Able to single leg stand on affected leg for at least 10 but needing to put foot down with nudge test. Unable to reach beyond base of support on affected side when in single leg stand

  • Justification of approaches to facilitated learning
  • refer to balance scenario 1