Mini-Bestest Evaluation

Five participants with acute stroke and unilateral hemiparesis (Age 51 ± 17 years; Height 1.7 ± 0.1m; Weight 81.6 ± 3.6kg; LOS 36 ± 24.6 days; 3 males, 2 females; 2 with right hemiplegia) were recruited for RE gait training during inpatient rehabilitation in conjunction with traditional therapy. Participant inclusion requirements: have a medical clearance, upright standing tolerance (≥30 min), intact skin, physically fit into the device, have joint range of motion within normal functional limits for ambulation, have had stroke with its onset >1 week and 0.05). This may suggest that the RE was limited to rehabilitate muscles during the IDS and swing phases as seen in figures (6-8).

Exercises and physical activity have been associated with numerous health benefits including reducing incidences of falls and injuries among the elderly and the geriatric population. Appropriately exercise programs and cardiovascular fitness in older people improve strength and balance. The interventions included strengthening, endurance, balance, flexibility exercises, Tai Chi, stand up/step down procedure and walking exercises. In the first research, the findings were that program targeting balance, leg strength, and freezing gait were only effective in people with milder illnesses, as opposed to more serious disorders like Parkinson’s disease. The study was done for a period of 2 years. In the second research, the findings showed that a multi-component enhanced physical performance of the community indwelling adults but did not translate to psychological outcomes or reduced rates of falling.

A group of student collaborated in a study for patient with Multiple Sclerosis that presented with a balance deficit. The purpose of the study was to compare Berg Balance Scale and Mini-BESTest and the ability of both balance measures to detect falls. The study was fulfilled in 8 weeks of physical rehabilitation on people who suffer from Multiple Sclerosis. Multiple Sclerosis is the most common chronic progressive disorder of the CNS that commonly affects young people. Balance deficit is one of the many symptoms associated with MS, this can cause impairment that progressively increases as the disease progresses.

Physiotherapists can carry out assessments on patients using falls risk assessment tools (FRAT). FRATS use questions and observations to categorise patients as low, moderate or high falls risks (Miedany, Gaafary, Toth, Palmer & Ahmed, 2011) and identify the necessary level of intervention needed. Wong-Shee, Phillips & Hill 's (2012) research promotes the use of the TNH-STRATIFY falls score assessment tool. The TNH-STRATIFY has an extensive question list, identifying more falls risk factors. Wong-Shee et al 's. (2012) research suggests the TNH-STRAITFY has high inter-rater reliability with an excellent intra-class correlation score of 0.96. 1 is deemed a perfect score (Hallgen, 2012). The high inter-rater reliability score adds statistical power to the research regarding the use of TNH-STRATIFY due to consistency of the tool used on consecutive patients (Hallgren, 2012). Although the two raters of the tool scored high intra-class correlation scores contributing to high inter-rater reliability, the tools predictive risk factor specificity rating scored only moderately, with 0.52 (Wong-Shee et al., 2012). For FRATS to be considered as having a high level of predictive risk accuracy the predictive specificity rating needs to be greater than 0.7 (Myers, 2003). This moderate rating of accuracy significantly limits the TNH-STRATIFY 's use in clinical practice. This is due to the fact that although the tool rates highly for reliable use between clinicians, the risk factor

In the article, “In-Hospital Predictors of Falls in Community-Dwelling Individuals After Stroke in the First 6 Months After a Baseline Evaluation: A Prospective Cohort Study” we identified were that twenty-four (36%) patients fell within the 6-month period whether they were at home or in a rehab facility. Unfortunately, there is nothing physically medical staff can do to change to condition one suffers from a stroke but with strength training, physical therapy, proper lifting equipment and assistance, along with close monitoring falls can be decreased.

The control group was researched for balance, limits of stability, and gait of patients with AD, FTD’s. The balance was measured using dynamic posturography, in single and dual tasks and gait with Biodex Gait Trainer. In

The Tinetti assessment tool is an easily administered task-oriented test that measures an older adult’s balance abilities. A balance assessment was performed on a senior citizen by initial E.M on October 16, 2015. An armless chair was used to conduct the Tinetti balance and gait test. The senior successfully completed all the nine test and balance scored was sixteen. She scored sat uprightly in the chair, the attempt to arise was quick, and was able to stand without use of arms. She was able to stand without any external support and stood more than the required time when observing her standing balance. Likewise, the balance was steady when I was conducting the nudge step of the test on her. She was also steady when eyes was closed. Senior

Multiple campaigns have begun to bring awareness to falls and fall prevention. Lifestyles and changes at home can be made to help older adults live a more active, healthy and independent life. By making these changes older adults are making their quality of life better as they continue to age (“New Campaign,” 2016). Older adults should try to understand what factors put them at risk for falling. Researchers have determined the best way to prevent falls, and have identified programs that aid in fall prevention. Though not all risks can be eliminated, a plan to recognize and reduce risks can be developed with a medical provider. There are various physical activity programs that focus on increasing balance and mobility skills to reduce falls. Changes to reduce hazards in the home and community can help a person in fulfilling their daily activities (Basics of Fall Prevention, 2016). There are multiple causes that can lead to a fall, but weak muscles and poor balance contribute to most falls (Gardner et al., 1999).

My research addresses rehabilitation post-stroke, primarily improving lower extremity function. I study factors contributing to compensation, which involves greater than normal use of the non-impaired limb compared to the impaired limb. Compensation can be detrimental to rehabilitation as the impaired limb is underutilized and function cannot be restored. This may lead to weakness and impaired mobility/gait.

The risk of falling dramatically increases as one ages. According to Menant et al, a fall is defined as an “unexpected event in which the person comes to the ground, floor, or lower level”. In this study conducted by Menant et al, the authors desired to distinguish certain factors that may contribute to falls associated with the elderly.

(2010) randomly allocated 33 elderly women to an intervention group (IG; n = 17) and a control group (CG; n = 16). Baseline and 8-week assessments were made with a dynamometer for strength and a force plate for postural control; the limits of stability (LOS) test and the modified clinical test of sensory interaction for balance (CTSIBm) were used during postural control assessments (Boughen, Dunn, Nitz, Johnson, & Khan, 2003; Clark & Rose, 2001). The IG participated in a balance and lower extremity exercise program under direct therapy supervision, twice a week. The lower extremity exercises targeted the hip flexors, knee extensors, and ankle dorsi- and plantar-flexors. Burt et al. reported an 82.3% adherence

Multiple sclerosis is the disease of the central nervous system. Most of the people suffering from it have the problem with walking, with characteristics like slower rate, decrease length and dynamic balance. Surveys demonstrate that more than 50% of people diagnose with MS have had falls at any point and is a recurrent dangerous problem. For that purpose, walking, balance and risk for fall test are performed as a part of their rehabilitation, and it is an inevitable tool for planning individualized treatments. However, there are some risks connected with it and they should be measured.

Fall experience in older adults is related to different consequences. The most common psychological effects caused by falling experience are fear of falling, loss of self-efficacy, activity avoidance and loss of self-confidence (Alice et al., 2008). Fear of falling is an increasing problem and serious concern among older adults (Kong et al., 2002). Related to the falling experience, older adults frequently report fear of falling (World Health Organization, 2007) also termed as ‘post-fall syndrome’ (Murphy & Isaacs, 1982). Post-fall syndrome occurs when ambulatory persons develop an intense fear and walking disorders (i.e. gait and balance abnormalities) after a fall experience. Since, Murphy et al. defined post-fall syndrome, fear of fall was identified as one of the key symptoms of this syndrome and has gained recognition as a specific health problem among older adults. Fear of falling is widespread and has been reported as the most common fear of older adults (Howland et al., 1993). It is an important aspect to consider, particularly for those who develop fear after having fallen (Gagnon & Flint, 2003). However, fear of falling was also frequently found among older adults who had not yet experienced a fall due to age related

A stroke is an interruption to the blood supply of the brain; causing permanent brain damage and often resulting in physical impairment (WHO, 2015). This essay will outline the implications that stroke can have on balance. Additionally, three balance re-education journal articles will be identified and their clinical reasoning impact stated.

Falls are the leading cause of injury-related visits to emergency departments especially among seniors [1-4] and a rapid grasp for external support or a quick step, which serves as postural adjustment to restore center of mass (COM) equilibrium, after loss of balance are broadly accepted as a critical motor skill to prevent a fall from occurring [1-3, 5, 6]. Basically speaking, a fall could happen in two conditions: under