balance is the ability to maintain cog within the bos. basically when someone pushes you still keep standing that means that you got some good balancing abilities. so a physiotherapist assess your static and dynamic balance in various positions. this helps him improve your ability to move about more easily.

1. BALANCE
DR.SUSAN JOSE (PT)

2. DEFINITION
• Balance is defined as the condition in which all the forces acting
on the body are balanced and that the center of mass (COM) is
within base of support (BOS) and the limits of stability(LOS).

3. BOS

4. LOS IN STANDING AND SITTING

5. MOTOR
SENSORY
COGNITIVE
BALANCE
WHAT SYSTEM WORKS TO MAINATIN BALANCE ?

6. • MOTOR –
• Muscle quality
• Ability to activate the muscles
• SENSORY-
• Visual system
• Vestibular system
• Somatosensory system- proprioception and tactile system
• COGNITIVE-
• Attentional ability

7. ASSESSMENT
STATIC BALANCE -
• BOS
• SYMMETRY OF WEIGHT BEARING
• COM POSITION AND SWAY

8. SWAY METER

9. DYNAMIC BALANCE
• REACTIVE CONTROL is the ability to maintain balance in response to
external destabilizing forces on the body.
TO ASSESS :
• Perturbations
• Move the surface where the patient is sitting or standing
• Ex- moveable platform, therapy ball
• OBSERVE- Postural strategies

12. • PROACTIVE CONTROL is the ability to maintain balance in response to an internally
generated destabilizing forces.
• EX- leaning forward, dancing

14. SAFETY OF THE PATIENT IS KEY
QUALITATIVE GRADING

15. MOTOR
SENSOR
Y
COGNITIVE
BALANCE
WHAT SYSTEM WORKS TO MAINATIN BALANCE ?

16. SENSORY SYSTEM ORGANISATION
• CLINICAL TEST OF SENSORY INTEGRATION AND BALANCE

17. ASSESSING THE EFFECT OF COGNATION ON BALANCE
DUAL-TASKING -
While talking while standing, reading while walking, or pour water into a glass

18. QUANTITATIVE ASSESSMENT
1. BERG BALANCE SCALE
• BBS assess both the static and dynamic balance.
• Scores of 45 or below =High risk of recurrent or multiple falls

19. 2.REACH TESTS
MULTI DIRECTIONAL REACH TEST
direction Normative value
forward 25 ±8.14 cm
lateral 19.7 ±5.70 cm
back 11.6+/- 3.07 in

20. TIMED GET UP AND GO TEST
• It is a quick measure of dynamic balance and mobility.
Healthy adults - less than 10 seconds.

21. THANKYOU

22. REFERENCES
• O’ SULLIVAN 6TH EDITION PHYSICAL REHABILITATION