Ten Point Scale, Seven Point Scale, Nine Yards discussed on Academy of Neurologic Physical Therapy Podcast
Or track You know as people develop the as what do their what those are self perception do. Because i i would bet that people don't realize that they're hitting those apa's yes which can be measured right there. There's ways to measure that of course in the lab it's harder in the clinic But really interesting and And i just love this conversation of i never. I never thought there were api as you develop in reactive bounce. I love that So so this might be a nice time to Pause for a second because you've given us lots to chew on and just go through some of the basics right for people listening in I think a lot of the balance terms get used generally and a lot of times that that means they get used incorrectly right. So the specificity of gets lost and you are a balance expert and i just loved to use some of this time to talk about differentiating some of those commonly used balanced terms. Herb so i am. I have my advisor extent. Wants the traditional keeping your center of mass over your base support. He or somebody during my dissertation defense said you know what a tree stump in can keep it center mass over. Its based in support. But it's not very useful so when most people say they they mean keeping your center of mass within your base of support but even just normal walking. We don't do that. We're constantly moving our center of mass and then rearranging our base of support to fit our new center of mass location. And so i tend to talk more about stability and he is a pretty standard maybe more engineering based definition so it's the ability of the system to return to its previous state. So if i'm walking along and somebody pushes me or slips me or or pulls the floor out from under me my ability to go back to walking in that controlled normal way is stability or the converse. If i can't you know if i fall or Eight stumbles steps or can't get back to that normal walking vets instability. So it's it's the ability of that system to come back to its its baseline Which i think is a lot more useful when we're looking at human movement and the things that people need to do every day It's another piece that we think a lot about in our lab is in. You would know you very familiar with this in working with with stroke and stroke research but people who are really active putting themselves in harm's way more so there may be more likely to fall but there are some more active and they're sedentary and therefore they're challenging themselves and arguably maintain their balance and all the subsystems involved in in balanced control healthier people rarely fall off sofas so if somebody spends all day sitting on a sofa there not as likely to fall until they have to move while some of my stroke population can fall out of a chair at rest. Well yes other. But in general yes. I completely agree so There is definitely a sweet spot in the active enough to not be sedentary maintaining all the systems that you need and not so active that you're that you're putting yourself in too much risk which you know is a different point for every person right. Yes yes so so balance. If i heard you correctly is not such helpful term. It's funny because it's one that we make sure to teach and pt school and we all know it. But i think it's fine to say the realm of balance as long as people understand that includes an awful lot of different things and that there are more specific concepts that you need to think about when you're gonna start doing assessments and intervention design. Very nice and then are there any other Terms that you think it misused or would i think people. Maybe don't think i actually i take that back. People thinking more about proactive versus reactive. I think that once you do balanced training in on a clinic clinical setting often enough for long enough. They become a little bit more intuitive. I know that with my students. We really have to to sit in. Have them work through things physically or mentally. You know what's reactive. Throw a ball cheer responding. But you still have all those pasta adjustments ahead of time. You have time to to call up a motor peremet whole nine yards. It's it's a proactive activity. It's not reactive. yeah. I love that. Because i've had i've had students and even you know license collisions where they just start to say save. There's activity in it. It's reactive like okay. You had to respond to where through bond. You didn't know how to time but you saw it before you had to respond to it and therefore it's still and you have interest of respond. yes yes. Beautifully stated yeah still so with that. I wanna go back to to take another flight if you will out of the stability measure. Because i think as you define those terms it really added to just what a important and helpful tool. This is clinicians With that how did you go about validating this and then what are your next steps using it or your next steps and research so in that we have on since the paper that that you asked me about. We've modified after having just a lot of different people look at the ten point scale and we've changed it to a seven point scale and we and we have found that that is easier for people to use we unfortunately were in the middle of a really big Balanced training study with individuals with stroke. And we've been exactly you're now that data collection has been on hold so we've been using the new seven point scale for that. Study at part of the point of that study was to really look at the use of the scale in different types of balance training in this population who sometimes have phases sometimes have difficulty with.