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A physical therapist works on various balance tasks with a patient who has known balance deficits. The patient has intact visual and vestibular systems, though has deficits with somatosensory inputs. Which of the following activities would be MOST useful in improving utilization of the somatosensory system to maintain balance?

1. Standing on a firm surface with eyes open
2. Standing on a firm surface with eyes closed
3. Standing on a foam pad with eyes open
4. Standing on one leg with eyes open

Transcript

Welcome back to the Scorebuilders’ Question and Answer Podcast! This podcast provides members of the Scorebuilders’ team with the opportunity to explore challenging multiple-choice examination questions with students actively preparing for the licensing examination. My name is Scott Giles and I will be your host for today’s journey.

Ready? Let’s go!

A physical therapist works on various balance tasks with a patient who has known balance deficits. The patient has intact visual and vestibular systems, though has deficits with somatosensory inputs. Which of the following activities would be MOST useful in improving utilization of the somatosensory system to maintain balance?

1. Standing on a firm surface with eyes open
2. Standing on a firm surface with eyes closed
3. Standing on a foam pad with eyes open
4. Standing on one leg with eyes open

Balance training should focus on the integration of all three sensory systems that are involved in maintaining balance, which include the somatosensory, visual, and vestibular systems.

Let’s quickly review each of the components of balance.

Somatosensory System
This system provides information about touch, pressure, and the position and movement of the body, especially the feet and ankles.

Visual System
The visual system helps detect movement, both in the individual and the environment, and uses this information to maintain balance.

Vestibular System
The vestibular system provides information about the head and body's position and orientation in relation to gravity and motion.

The brain can adjust the relative importance of each sensory system depending on the environment and task, a process known as sensory reweighting. Patients who are highly dependent on one of these systems should be trained to incorporate the other systems when practicing balance tasks. For a patient that has somatosensory system deficits, they are likely more reliant on visual and vestibular inputs.

Let’s explore each of the options:
Option 1 - Standing on a firm surface with eyes open
Having a patient stand on a firm surface with their eyes open would allow them to rely on both visual and somatosensory inputs and would therefore not improve utilization of the somatosensory system specifically.

Option 2 - Standing on a firm surface with eyes closed
Having a patient stand on a firm surface with their eyes closed would diminish their ability to utilize visual information when attempting to maintain balance. Because of this, they would need to increase reliance on input from the somatosensory system. This is desirable since the question asked which activity would be the most useful in improving utilization of the somatosensory system. 

Option 3 - Standing on a foam pad with eyes open
Having a patient stand on a foam pad with their eyes open would diminish their ability to utilize somatosensory information when attempting to maintain balance. This occurs since the foam surface exaggerates balance deficits by decreasing the reliability of somatosensory information received from cutaneous mechanoreceptors on the plantar soles of the foot. Because of this, the patient would need to increase reliance on input from the visual system. This technique might be used for a patient that has visual system deficits.

Option 4 - Standing on one leg with eyes open
Similar to Option 3, having the patient stand on one leg with their eyes open would diminish the amount of somatosensory information that can be utilized. Therefore, they would need to increase reliance on input from the visual system.

The correct answer is Option 2

Let’s explore the all student data:
5% of students selected Option 1, Standing on a firm surface with eyes open
49% of students selected Option 2, Standing on a firm surface with eyes closed - the correct response
15% of students selected Option 3, Standing on a foam pad with eyes open
31% of students selected Option 4, Standing on a foam pad with eyes open

System Classification
This question is a Neuromuscular and Nervous Systems question which represents approximately 24% of all exam items.

Content Outline Classification
This question is an Interventions question which represents approximately 29% of all exam items.

Level Classification
This question is a Level 2 question since the question requires students to integrate numerous pieces of information or to apply knowledge in a given clinical scenario. Remediation of Level 2 questions occurs by increasing flexibility with academic content and by carefully analyzing decision making processes when answering applied examination questions.

Academic Focus Area
Looking to review related academic content? Check out page 278 in PTEXAM: The Complete Study Guide.

Thanks for joining us on the Scorebuilders Q and A podcast! See you next week!