What is backward disequilibrium and how do i treat it? A complex patient case study

Journal of Neurologic Physical Therapy : JNPT
Patricia L ScheetsBeth E Crowner

Abstract

Postural vertical refers to a component of an individual's perception of verticality that is derived from information about the direction of gravitational forces. Backward disequilibrium (BD) is a postural disorder observed in some older adults who have a distortion in their perception of postural vertical. Individuals with BD sustain their center of mass (COM) posterior to their base of support and resist correction of COM alignment. The purposes of this case study are to describe a patient with BD and propose a physical therapy management program for this condition. The patient was an 83-year-old woman admitted for home care services 4 months after falling and sustaining a displaced right femoral neck fracture and subsequent hemiarthroplasty. Details of the clinical examination, diagnosis, and intervention are provided and a treatment protocol for physical therapy management is suggested. During the episode of care, the patient (1) decreased her dependence on caregivers, (2) surpassed minimal detectable change or minimal clinically important improvements in gait speed and on the Short Physical Performance Battery and Performance-Oriented Mobility Assessment, and (3) achieved her primary goal of staying in her own apartment at...Continue Reading

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Citations

Jun 20, 2017·Journal of Neurologic Physical Therapy : JNPT·Ann F Van Sant
Mar 17, 2018·Journal of Neurologic Physical Therapy : JNPT·Lois D HedmanPatricia L Scheets
Mar 6, 2015·Journal of Neurologic Physical Therapy : JNPT·Edelle Field-Fote
Mar 23, 2017·Journal of Neurology·Klaus JahnJeannine Bergmann
Feb 27, 2021·Frontiers in Neurology·Andrew R WagnerDaniel M Merfeld
Mar 4, 2021·Journal of Neurologic Physical Therapy : JNPT·Patricia L Scheets
May 3, 2021·Annals of Physical and Rehabilitation Medicine·Jeannine BergmannKlaus Jahn

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