Test Bank Chapter 9 Examination of Balance and Equilibrium

Chapter 9: Examination of Balance and Equilibrium

Andrea Fergus, PT, PhD

Dennis W. Fell, PT, MD

Rachel T. Wellons, PT, DPT, NCS

Multiple Choice

For Items 1–5, please refer to the following case:

Case: Mr. McMurray, a 75 year-old man, was a fairly active golfer until 6 months ago, when he was diagnosed with peripheral neuropathy related to diabetes mellitus. He now reports that he has fallen three times in the past week. He and his wife report that his balance is “off” and has gradually worsened over the past couple of months. Because of his falls, now combined with significant fear of falling, Mr. McMurray even avoids many of the simple community activities he frequently enjoyed in the past, including attending a weekly Bingo game. It will be very important to determine the impact of his balance deficit on his functional activity and on his participation. Measures should be selected that will optimally quantify his balance ability as a baseline and to help direct the development of the treatment plan.

1. What is the BEST assessment to use to measure this patient’s subjective fear of falling?

a. Activities-Specific Balance Confidence Scale

b. Berg Balance Scale (BBS)

c. 36-Item Short Form Survey (SF-36)

d. Timed Up and Go (TUG)

2. Based on the history of peripheral neuropathy related to diabetes mellitus, what impairment level test is MOST important to complete?

a. Cognitive and short-term memory assessment

b. Assessment of lower extremity muscle tone

c. Strength assessment of hip and knee musculature

d. Sensation assessment of the distal lower extremity

3. Which objective assessment is BEST used in this patient to assess his dynamic balance ability in the community?

a. Berg Balance Scale (BBS)

b. Functional Gait Assessment

c. Multidirectional Reach Test (MDRT)

d. Timed Up and Go (TUG)

4. Which objective assessment is MOST useful in planning interventions for this patient?

a. Balance Evaluation Systems Test (BESTest)

b. Berg Balance Scale

c. Dynamic Gait Index

d. Five Repetition Sit to Stand Test

5. You perform a Push and Release Test and the patient takes five steps to recover. Based on the results of this test, which of the following aspects of the patient’s balance do you infer is impaired?

a. Anticipatory postural control

b. Limits of stability

c. Reactive postural control

d. Sensory orientation

6. A decrease in balance and an increase in postural sway is noted when the patient is asked to scan the environment for objects while ambulating. Which assessment would be most appropriate to investigate this further objectively?

A. Four Square Step Test

B. Sensory Organization Test (SOT)

C. Dynamic Gait Index

D. Performance-Oriented Mobility Assessment

7. The patient complains of nausea and vertigo during movement. Specifically, he complains that he feels as though he is watching a poorly filmed home movie whenever he walks. Based on this description, which of the following neuroanatomical pathways is MOST likely involved?

a. Vestibulospinal

b. Dorsal columns medial lemniscus

c. Vestibulo-ocular

d. Spinocerebellar

8. Your patient reports falling three times in the past month. All three falls were in the bathroom and involved either tripping on the threshold or the bath mat. Which of the following objective assessment would be MOST appropriate based on this description?

a. Berg Balance Scale

b. Dynamic Gait Index

c. Sharpened Romberg

d. Four Square Step Test

9. In performing a balance screen of community dwelling elderly at the local shopping mall, which of the following would be MOST appropriate to assess fall risk?

a. Functional Reach Test

b. Berg Balance Scale

c. Performance-Oriented Mobility Assessment

d. Balance Evaluation Systems Test (BESTest)

10. You perform the TUG (Motor) and the TUG (Manual) with your patient as part of your examination. You note that the patient takes 7.9 sec longer to complete the TUG (Manual). Which of the following is the MOST appropriate assessment of these findings?

a. Times for the TUG (Motor) and TUG (Manual) must be known to establish fall risk

b. The patient is a fall risk and this is associated with difficulties with allocating attention

c. The patient is not a fall risk based on these data

d. The patient is a fall risk and this is associated with fine motor impairments

11. In assessing the balance of a 4 year-old child, which of the following assessments has been adapted for the pediatric population and norms have been established?

a. Performance-Oriented Mobility Assessment

b. Four Square Step Test

c. Functional Reach Test

d. Dynamic Gait Index

12. While observing your patient quietly standing you note increased postural sway. The patient appears to be hitching at the hips to maintain balance. Which of the following should be targeted MOST in the plan of care?

a. Stepping strategies

b. Hip strategies

c. Knee strategies

d. Ankle strategies