NASM: Chapter 10

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Balance
When the body is in equilibrium & stationary, meaning no linear or angular movement.
Dynamic Balance
The ability to move and change directions under various conditions without falling.
Example of dynamic balance
Running on an uneven surface.
Why is it important for PT's to understand that gaining and maintaining proper balance is vital for their clients?
Due to the high risk of injury. Statistically 80% of US adults will experience low back pain, roughly 80-100k ACL (anterior cruciate ligament) injury & 11 million Dr visits for foot/ankle problems annually.
Is balance a static or dynamic process.
Both. Maintaining proper balance is a process that requires muscular balance, joint dynamics and neuromuscular efficiency.
Altered balance is caused by what?
Muscle imbalance, joint dysfunction, pain, and swelling.
Describe how alterations in the kinetic chain affect movement quality and bring about flawed movement patterns?
Flawed movement patterns alter the firing order of the muscles activated, which disturbs specific functional movement patterns and decreases neuromuscular efficiency. Prime movers may be slow to activate, whereas synergists and stabilizers substitute and become overactive (synergistic dominance). The combined effects of flawed movement patterns lead to abnormal joint stress, which affects the structural integrity of the kinetic chain and may lead to pain and joint dysfunction, and further decrease neuromuscular efficiency.
Ones "limit of stability" is defined as?
The distance outside the base of support that they can move into without losing control of their center of gravity.
How is the clients limit of stability tested?
By using multiplanar, proprioceptively enriched environments (unstable yet controlled), using functional movements to improve dynamic balance & neuromuscular efficiency.
What type of progression would be appropriate for stability training?
1. Floor
2. Balance Beam
3. Half foam roll
4. Foam pad
5. Balance disc
6. Wobble board
7. BOSU ball
Balance programs performed at least ___ minutes a day, __ times per week for ___ weeks improved static and dynamic balance ability.
10, 3, 4
Balance training progression:
Easy to hard
Simple to complex
Stable to unstable
Static to dynamic
Slow to fast
Two arms/legs to single arm/leg
Eyes open to eyes closed
Known to unknown
Balance training body positions:
2 legs/stable or unstable
1 leg/stable or unstable
Phase 1 of balance training is?
Stabilization
Examples of stability balance training?
Single leg balance
Single leg balance reach
Single leg hip internal & external rotation
Single leg lift & chop
Single leg throw & catch
Proper balance training should focus on which plane of motion?
Frontal, Sagital & Transverse
How would you describe balance stability training to the client?
During these exercises your body will be placed in unstable environments so it learns to react by contracting the right muscles at the right time to maintain balance.
Phase 2 of stability training is?
Strength
How would you describe balance strength training to the client?
During these exercises a single leg will go through a full ROM. Movements will require dynamic control in the mid-range of motion by using stabilization at the end of each motion. These movements will improve your neuromuscular efficiency.
Example balance strength exercises:
Single leg squat
Single leg squat touchdown
Single leg Romanian deadlift
Multiplanar step up to balance
Multiplanar lunge to balance
Phase 3 of stability training is?
Power
How would you describe balance power exercises to the client?
During these exercises we will have the body move from a dynamic state to a controlled stationary position. We accomplish this by using eccentric strength, dynamic neuromuscular efficiency and reactive joint stabilization.
Example balance power exercises:
Multiplanar hop with stabilization
Multiplanar single leg box hop up with stabilization
Multiplanar single leg box hop down with stabilization
In which phase of balance training should the leg in which the client is standing on remain still and not move?
Stabilization. However the arms, torso and other leg can move.
What is the tempo of balance stabilization training?
Slow tempo
In balance strength training can the leg the client is standing on move?
Yes. These movements allow the standing leg to move when needed.
What is the tempo of balance strength training?
Medium tempo
In balance power training can the leg being stood on by the client move?
Yes, in fact the movements will be dynamic as reactive joint stabilization is taking place.
What is the tempo of balance power training?
Fast tempo. The movements will be the speeds seen in everyday life.
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