Chapter 19: Balance Laboratory

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Click here to view the Neurologic Lab Manual Video Balance Testing.

OUTLINE

Objectives:

The student will appropriately:

1. Practice hip, ankle, and stepping balance strategies to gain an appreciation of normal postural responses.

2. Effectively and safely administer balance tests to a client (classmate) with an impairment. The student will describe appropriate modifications/precautions for each test depending on the impairments presented.

3. Accurately demonstrate balance treatment techniques with a client (classmate) based on case studies using appropriate guarding.

4. Generate an appropriate plan of care including two short-term goals, two long-term goals, a treatment plan, a 60-minute treatment session, and a home exercise program based on a case study.

Prelab

Students read and review four cases, and come up with one short and long-term goal and a few initial interventions for each case.

Activity 1. Normal Postural Control

Students perform various activities in pairs and observe normal responses to postural perturbations.

Activity 2. Examination

Students practice in pairs administering various clinical balance tests under altered visual and musculoskeletal conditions and observe how the alterations impact their partner’s balance performance.

Activity 3. Case Studies and Treatment

Students develop a treatment plan and home exercise program and practice them on each other for a paper client with balance impairments.

Activity 4. Demonstrations

Students present their selected treatment goals, treatment interventions with demonstration of one intervention, and home program to the entire class. They must explain their rationale for selecting each intervention in their treatment plan.

WORKSHEET

Prelab: Prior to attending, lab students are to read and review each of the cases, and come up with two short-term goals and one long-term goal for each case that relates to participation and is individualized to the client. Identify a few initial intervention ideas for each.

Case Study 1

S.R. is a 62-year-old woman with left-sided hemiplegia, referred for evaluation of balance 5 weeks following her stroke. After her middle cerebral artery infarct, she spent 4 days in acute care and 3 weeks in rehabilitation before being discharged home. The client reports two falls since returning home, once while walking in the dark, and once while attempting to hang up a flower pot that was heavier than she expected. She also reports that she loses her balance two to three times per day, often when reaching for objects or when getting up from chair and walking. The client reports that she uses a quad cane for ambulation. She wants to be safe with gardening.