presented by Andrea E. Ecsedy PT
This course series is a practical interpretation of balance research with real-world applications supporting current evidence. This lecture is Part one of a three-part series describing and applying the Domains Approach to balance. This approach addresses six global areas that cover the multi-factorial complexity of balance. Part 1 will cover: Limits of Stability (LOS), Anticipatory (APC), and Reactive Postural Control (RPC). Supporting evidence, standardized tests, treatment suggestions, and documentation examples will be presented that address each domain. This course series is a practical interpretation of the plethora of balance research with real-world applications of the balance constructs presented in current research.
Andrea Ecsedy, PT, DPT, NCS currently works SavaSeniorCare Consulting, LLC as the National Director of Evidence-based Practice. Dr. Ecsedy has 33 years of clinical experience and has been a Board Certified Neurological Clinical Specialist for 25 years. Her clinical focus has been in the areas of balance and vestibular dysfunction, stroke and Parkinson’s disease and spinal cord injury. She has extensive teaching background to include guest lecturing at several University Physical Therapy curriculums as well as teaching a multitude of continuing education courses on topics of gait analysis, spasticity management and electrical stimulation.
Chapter one will review historical approaches to balance and describe why the domains approach fits posits of current practice. In the advent of demands for measurable outcomes with less treatment visits allowed this approach will give the learner practical tools to evaluate, treat, and measure multi-factorial balance dysfunction.
Based on the sentinel research by Horak and colleagues, LOS is defined. The importance of evaluating and designing treatment plans that specifically address LOS will also be discussed, along with examples and documentation suggestions.
APC will be defined, and supporting research presented on the importance of assessing this domain will also be presented. Weeding out which treatments cover this domain will be presented, along with examples of specific documentation.
RPC will be defined, and tests available to assess this domain will be reviewed. RPC is the most under-evaluated and undertreated domain. Reasons for this will be discussed and examples of how to overcome this issue will be presented. Examples of specific documentation will also be presented.