Kyle Cosgrove

Isabelle Ruiz
Kenny Liu
Elysia Ortiz
7/6/17
Postural Control Case Study (Group 2)

A. Postural Impairments:
Sits independently with posterior tilt causing lumbar flat back and thoracic kyphosis
Right shoulder depression
Forward head, rotated to right
Stands with Center of mass over left leg (muscle weakness
Responds to large protuberances on left non paretic arm
Unable to use paretic arm
Reaches with left arm in response to small forward protuberance
Right shoulder and pelvis retracted, leg externally rotated
Not able to step to recover from large protuberance
Unable to recover from backwards
Several tries from sit to stand
Requires bars on toilet
Firm surface eyes opened, assistance with eyes closed
Unable to maintain balance standing on foam

Jean does not have complications with steady-state balance on flat surfaces, however
she has a hard time reacting on uneven surface with eyes open. Anticipatory balance is poor
with large protuberances. Limited reactive control on affected side. Does not have any on
paretic side in standing. In sitting, Jean is able to react to protuberance using her non-paretic
side. Jean relies on somatosensory strategies, visual inputs, and tactile cues to provide
information about the environment. When these are removed, she has large swaying with eyes
closed in standing on both flat and uneven surfaces.

B. Although stated she can independently go from sit-to-stand and maintain position with a
walker, we dont agree that Jean is functionally independent. Given the above postural
impairments, she presents with inadequate recovery strategies that make it unsafe for
her to return home. Mobility around her home or other environments is limited.
C. Berg Balance Scale- To identify the specific deficits present
Romberg Test- To measure vestibulocochlear function
Observation of postural control in sitting and standing
ROM, MMT, proprioceptive testing, and dermatomal testing, DTR
D. Attempt to improve balance skills although Jeans condition is chronic and muscle
activity is limited at 82 years old. Balance activities on unstable surfaces would be a
 Kyle Cosgrove
Isabelle Ruiz
Kenny Liu
Elysia Ortiz
7/6/17
staple example of such intervention. Given Jeans tendency of falling once or twice a
month, patient education of fall recovery strategies along with sit-to-stand transfers
would be emphasized. Referral for social services consult in hiring a home aide is
recommended, as functional decline is anticipated.