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KEY TERMS
Ankle strategy—An automatic posture response in which the body moves as a unit over the feet to control postural sway.
Base of support—The location on a body or object where most of the weight is supported.
Center of gravity—The center of weight in a body or object.
Hip strategy—An automatic posture response in which control comes from the pelvis and trunk.
Posturography—The study of posture and its effects on health.
Somatosensory system—The components of the central and peripheral nervous systems that process information about the muscles, pain, temperature, pressure and joint position.
Vestibular system—Interaction among the inner ear structures associated with balance and position sense, and the central nervous system.
Visual system—Components that transmit information from the retina to the brain.
training on a force plate designed to provide visual feedback about a patient's COG has not been shown to be convincingly more effective than conventional physical therapy in adults with hemiplegia. This may be due to the fact that weight shifting on a force plate may not carry over to such higher-level tasks as walking.
Prognosis
Prognosis depends on the cause of pathology, level of impairment, and such other factors as comorbidity. The basal ganglia disorders are progressive; therefore, while medical and physical therapy management may be effective in slowing the decline of function and training compensatory strategies, the overall prognosis is fair at best. Cerebellar lesions or cerebral stroke may allow for slight to significant return to function, depending upon the extent of the damage to the brain tissues. In a study on gait recovery following stroke, prognostic indicators included the ability to weight shift immediately poststroke; and later in recovery, affected knee extension strength. In true orthopedic cases with no neurological involvement, recovery may be less complicated if it depends purely on restoration of range of motion or strength to a musculoskeletal structure.
Health care team roles
Upon diagnosis of pathology by a physician and referral of an individual to physical therapy, the physical therapist is responsible for examination, evaluation, diagnosis, prognosis, and intervention.
Author Info: Peggy Campbell Torpey, MPT, The Gale Group Inc., Gale, Detroit, 2002