Examination of Coordination and

Balance
Chapt3r 6
Agda
 EXAMINATION OF
COORDINATION
• Motor control
“the ability of the central nervous system to
control or direct the neuromotor system in
purposeful movement and postural adjustment
by selective allocation of muscle tension across
appropriatejoint segments.”
• Coordination
• is the ability to execute smooth,
accurate,controlled movement.
• “Coordinated movement involves multiple
joints and muscles that are activated at the
appropriate time and with the correct amount
of force so that smooth, efficient, and
accurate movement occurs.
• Coordination impairments Awkward,
extraneous, uneven, or inaccurate movements
characterize
• Dexterity refers to skillful use of the fingers
during fine motor tasks.

• Agility refers to the ability to rapidly and

smoothly initiate, stop, or modify movements
while maintaining postural control.
types of coordination
• Intralimb coordination refers to movements
occurring within a single limb

• Interlimb (bimanual) coordination refers to the

integrated performance of two or more limbs
working together
• Visual motor coordination refers to the ability
to integrate both visual and motor abilities
with the environmental context to accomplish
a goal (e.g., tracing over a zigzag line, writing a
letter, riding a bicycle, or driving an
automobile)
 A subcategory of visual motor
coordination
• with important implications for activities of daily
• living (ADL) is eye–hand coordination such as
required
• for using eating utensils, personal hygiene, or
reaching for a visual target (e.g., a book from a
shelf).
• Eye–hand coordination is perhaps more aptly
termed eye–hand–head coordination because
movement of the head is typically required for
the eyes to fixate on a target or object.
• The purposes of performing a coordination
examination of motor function are to determine the
following:
• 1. Muscle activity characteristics during voluntary
movement
• 2. Ability of muscles or groups of muscles to work
together to perform a task or functional activity
• 3. Level of skill and efficiency of movement
• 4. Ability to initiate, control, and terminate movement
• 5. Timing, sequencing, and accuracy of movement
patterns
• 6. Effects of therapeutic and pharmacological
intervention on motor function over time
 OVERVIEW OF THE MOTOR
SYSTEM
• The motor system can be grossly divided into
peripheral and central elements.
• “The highest level, represented by the
association areas of the neocortex and basal
ganglia of the forebrain, is concerned with
strategy: the goal of the movement and the
movement strategy that best achieve[s] the
goal.
• The middle level, represented by the motor
cortex and cerebellum, is concerned with
tactics: the sequences of muscle contractions,
arranged in space and time, required to
smoothly and accurately achieve the strategic
goal.
• The lowest level, represented by the brain
stem and spinal cord, is concerned with
execution: activation of the motor neuron and
interneuron pools that generate the goal
directed movement and make any necessary
adjustments of posture.”
 FEATURES OF COORDINATION
TESTS
• Gross motor tests include body posture,
balance, and extremity movements involving
large muscle groups.
• motor tests address movements concerned
with utilization of small muscle groups that
involve skillful, controlled manipulation of
objects.
• Two subdivisions of coordination tests
• Nonequilibrium tests address components of
• limb movements.
• Equilibrium or balance tests consider the
ability to maintain the body in equilibrium
with gravity both statically (i.e., when
stationary) and dynamically(i.e., while
moving).
 Movement Capabilities
• The nonequilibrium coordination examination focuses
on movement capabilities in several main areas:

• Alternate or reciprocal motion, which is the ability to

reverse movement between opposing muscle groups
• Movement composition, or synergy, which involves
movement control achieved by muscle groups acting
Together
• Movement accuracy, which is the ability to gauge or
judge distance and speed of voluntary movement
• Fixation or limb holding, which addresses the ability to
hold the position of an individual limb or limb segment
Examination
Examination
Examination