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Postural Perturbations: New Insights for Treatment of Balance Disorders

Fay B Horak, Sharon M Henry, Anne Shumway-Cook
Published 1 May 1997
Fay B Horak
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Sharon M Henry
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Anne Shumway-Cook
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Abstract

This article reviews the neural control of posture as understood through studies of automatic responses to mechanical perturbations. Recent studies of responses to postural perturbations have provided a new view of how postural stability is controlled, and this view has profound implications for physical therapy practice. We discuss the implications for rehabilitation of balance disorders and demonstrate how an understanding of the specific systems underlying postural control can help to focus and enrich our therapeutic approaches. By understanding the basic systems underlying control of balance, such as strategy selection, rapid latencies, coordinated temporal spatial patterns, force control, and context-specific adaptations, therapists can focus their treatment on each patient's specific impairments. Research on postural responses to surface translations has shown that balance is not based on a fixed set of equilibrium reflexes but on a flexible, functional motor skill that can adapt with training and experience. More research is needed to determine the extent to which quantification of automatic postural responses has practical implications for predicting falls in patients with constraints in their postural control system.

Key Words:
  • Balance
  • Electromyography
  • Neurology
  • Posture
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    Vol 96 Issue 12 Table of Contents
    Physical Therapy: 96 (12)

    Issue highlights

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    • Effect of Virtual Reality Training on Balance and Gait Ability in Patients With Stroke: Systematic Review and Meta-Analysis
    • Effects of Locomotor Exercise Intensity on Gait Performance in Individuals With Incomplete Spinal Cord Injury
    • Case Series of a Knowledge Translation Intervention to Increase Upper Limb Exercise in Stroke Rehabilitation
    • Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis
    • Reliability and Validity of Force Platform Measures of Balance Impairment in Individuals With Parkinson Disease
    • Measurement Properties of Instruments for Measuring of Lymphedema: Systematic Review
    • myMoves Program: Feasibility and Acceptability Study of a Remotely Delivered Self-Management Program for Increasing Physical Activity Among Adults With Acquired Brain Injury Living in the Community
    • Application of Intervention Mapping to the Development of a Complex Physical Therapist Intervention
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    Postural Perturbations: New Insights for Treatment of Balance Disorders
    Fay B Horak, Sharon M Henry, Anne Shumway-Cook
    Physical Therapy May 1997, 77 (5) 517-533;

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    Postural Perturbations: New Insights for Treatment of Balance Disorders
    Fay B Horak, Sharon M Henry, Anne Shumway-Cook
    Physical Therapy May 1997, 77 (5) 517-533;
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    More in this TOC Section

    • Advances in the Treatment of Vestibular Disorders
    • The Role of Vision and Spatial Orientation in the Maintenance of Posture
    • Evaluation of Postural Stability in Children: Current Theories and Assessment Tools
    Show more Special Series on Balance

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