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In biomechanicsbalance is an ability to maintain the line of gravity vertical line from centre of mass of a body within the base of support with minimal postural sway. A certain amount of sway is essential and inevitable due to small perturbations within the body e. An increase in sway is not necessarily an indicator of dysfunctional balance so much as it is an indicator of decreased sensorimotor control. Maintaining balance requires coordination of input from multiple sensory systems including the vestibularsomatosensoryand visual systems.
The senses must detect changes of spatial orientation with respect to the base of support, regardless of whether the body moves or the base is altered. There are environmental factors that can affect balance such as light conditions, floor surface changes, alcoholdrugsand ear infection. There are balance impairments associated with aging. Age-related decline in the ability of the above systems to receive and integrate sensory information contributes to poor balance in older adults.
In fact, one in three adults aged 65 and over will fall each year. In the case of an individual standing quietly upright, the limit of stability is defined as the amount of postural sway at which balance is lost and corrective action is required. Body sway can occur in all planes of motion, which make it an increasingly difficult ability to rehabilitate. There is strong evidence in research showing that deficits in postural balance is related to the control of medial-lateral stability and an increased risk of falling.
To remain balanced, a person standing must be able to keep the vertical projection of their center of mass within their base of support, resulting in little medial-lateral or anterior-posterior sway.
Ankle sprains are one of the most frequently occurring injuries among athletes and physically active people. The most common residual disability post ankle sprain is instability along with body sway. Mechanical instability includes insufficient stabilizing structures and mobility that exceed physiological limits.
Functional instability involves recurrent sprains or a feeling of giving way of the ankle. Individuals with muscular weakness, occult instability, and decreased postural control are more susceptible to ankle injury than those with better postural control.
Balance can be severely affected in individuals with neurological conditions. People who suffer a stroke or spinal cord injury for example, can struggle with this ability. Impaired balance is strongly associated balanfe future function and recovery after a stroke, and is the strongest predictor of falls. Another population where balance is severely affected is Parkinson’s disease patients. A study done by Nardone and Schieppati showed that individuals with Parkinson’s disease problems in balance have been related to a reduced mehalurgico of stability and an impaired production of anticipatory motor strategies and abnormal calibration.
Balance can also be negatively affected in a normal population through fatigue in the musculature surrounding the ankles, knees, and hips. Studies have found, however, that muscle fatigue around the hips gluteals and lumbar extensors and knees have a greater effect on postural stability sway.
As a result, proprioception and kinesthetic feedback from joints are altered so that conscious joint awareness may be negatively effected.
Since balance is a key predictor of recovery and is required in so many of our activities of daily livingit is often introduced into treatment plans by physiotherapists and occupational therapists when dealing with geriatrics, patients with neurological conditions, or others whom they have determined it to be beneficial. Balance training in stroke patients has been supported in the literature.
Some types of exercise gait, balance, co-ordination and functional tasks; strengthening exercise; 3D exercise and multiple exercise types improve clinical balance outcomes in older people, and are seemingly safe.
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Some functional balance tests that are available are:. Concussion or mild traumatic brain injury have been associated with imbalance among sports participants and military personnel.
Some of the standard balance tests may be too easy or time-consuming for application to these high-functioning groups, s. Expert recommendations have been gathered concerning balance assessments appropriate to military service-members. Due to recent technological advances, a growing trend in balance assessments has become the monitoring of center of pressure terrestrial locomotion CoPthe reaction vector of center of mass on the ground, path length for a specified duration.
Laboratory-grade force plates are considered the “gold-standard” of measuring CoP. These different assessments range from the sensory organization test looking at the different systems that contribute through sensory receptor input to the limits of stability test observing a participant’s ankle range of motion, velocity, and reaction time.
Within the past 5 years research has headed toward inexpensive and portable devices capable of measuring CoP accurately. Other inexpensive, custom-built force plates are being integrated into this new dynamic to create a growing field of research and clinical assessment that will benefit many populations.
The complexity of balance allows for many confounding variables to effect a person’s ability to stay upright.
Fatigue medicalcausing central nervous system CNS dysfunction, can indirectly result in the inability to remain upright. This is seen repeatedly in clinical populations e. Parkinson’s disease, multiple sclerosis. Another major concern regarding fatigue’s effect on balance is in the athletic population. Balance testing has become a standard measure to help diagnose concussions in athletes, but due to the fact that athletes can be extremely fatigued has made it hard for clinicians to accurately determine how long the athletes need to rest before fatigue is gone, and they can measure balance to determine if the athlete is concussed.
This can have devastating effects when looking at college and professional games where the athlete is depended upon by a community. So far, researchers have only been able to estimate that athletes need anywhere from 8—20 minutes of rest before testing balance    That can be a huge difference depending on the circumstances. Age, gender, [ how?
Height also influences body sway in that as height increases, functional reach typically decreases. However, this test is only a measure of anterior and posterior sway.
This is done to create a repeatable and reliable clinical balance assessment tool. Tai Chi] and combinations of these can help improve balance in older adults. However, there was no or limited evidence on the effectiveness balande general physical activities, metalugico as walking and cycling, computer-based balance games and vibration plates.
While balance is mostly an automatic process, voluntary control is common. Active control usually takes place when a person is in a situation where balance is compromised. This can have the counter-intuitive effect of increasing postural sway during basic activities such as standing.
One explanation for this effect is that conscious control results in over-correcting an instability and “may inadvertently disrupt relatively automatic control processes. Supra-postural tasks are those activities that rely on postural control while completing another behavioral goal, such as walking or creating a text message while standing upright.
Research has demonstrated that postural stability operates to permit the achievement of other activities.
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In a healthy individual, it is believed that postural control acts to minimize the amount of effort required not necessarily to minimize swaywhile successfully accomplishing the supra-postural task.
This results from the use of more automatic and reflexive control processes. Externally focusing attention improves postural stability, despite increasing postural sway at times. From Wikipedia, the free encyclopedia. For other things called “balance”, see Balance disambiguation.
European Journal metalurgio Applied Physiology. Archives of Physical Medicine and Rehabilitation. Physical Rehabilitation 5th ed. Centers for Disease Control and Prevention. Retrieved 15 May Halance Sci Sports Exerc. Journal of Orthopedic and Sports Physical Therapy. Journal of Neurologic Physical Therapy. Research Quarterly for Exercise and Sport. Journal of Athletic Training. The Cochrane Database of Systematic Reviews Physical Rehabilitation Fifth ed.
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