1. Which part of the brain controls balance and gait?: Answer The Cerebellum -Balance and gait! -Motor coordination of voluntary movements -Equilibrium -Muscle tone -Subconscious: doesn't initiate but coordinates and refines movement 2. BalanceTests: Answer Gait:Have the patient walk in a regular gait:thisshould be smooth and even Heel-to-toe gait:should be able to do this with minimal loss of balance Walk on toes: should be able to perform a few steps Walk on heels:should be able to perform a few steps 3. Romberg test: Answer • Feet together, arms atsides; when in stable position, ask person to close eyes and to hold position for about 20 seconds • Negative: pt able to hold position with eyes closed • Positive: unable to hold position, need to widen stance to maintain balance • Cerebellar ataxia (MS, excess alcohol) • Loss of proprioception • Loss of vestibular function 4. Spastic Hemiparesis (abnormal gait): Answer Characteristic Appearance: Arm is immobile against the body, with flexion of the shoulder, elbow, wrist, and fingers and adduction of the shoulder; does now swing freely. The leg is stiff and extended and circumducts with each step (drags toe in a semicircle) PossibleCauses: Upper Motor Neuron Lesion of the corticospinal tract (e.g.,stroke, trauma)