PWR Client Assessment & Progress Monitoring 5 — Questions and Answers
Question 1: Which PWR! assessment strategy helps identify whether a client's balance impairment is primarily sensory, motor, or central in origin?
- Dynamic Gait Index
- Clinical Test of Sensory Interaction in Balance (CTSIB) (Correct answer)
- Timed Up and Go Test
- Functional Reach Test
Correct answer: Clinical Test of Sensory Interaction in Balance (CTSIB)
The CTSIB systematically manipulates vision and surface conditions to isolate the sensory systems contributing to balance deficits.
Question 2: A PWR! client demonstrates 'festination' during gait assessment. This term describes:
- Increased stride length with faster cadence
- Involuntary acceleration with increasingly small steps (Correct answer)
- Lateral trunk sway during ambulation
- Sudden freezing episodes when approaching doorways
Correct answer: Involuntary acceleration with increasingly small steps
Festination is the involuntary tendency to accelerate while taking progressively shorter steps, which significantly increases fall risk.
Question 3: In the context of PWR! monitoring, the Activities-Specific Balance Confidence (ABC) Scale measures:
- Objective balance performance during standardized tasks
- Self-efficacy for performing activities without losing balance (Correct answer)
- Caregiver perception of client balance ability
- Therapist-rated confidence in the client's prognosis
Correct answer: Self-efficacy for performing activities without losing balance
The ABC Scale is a 16-item self-report measure of a person's confidence in their balance while performing various daily activities.
Question 4: When should a PWR! therapist immediately pause formal assessment and consult with the supervising physician?
- When the client reports mild fatigue during the TUG test
- When the client experiences an unexpected fall or loss of consciousness during assessment (Correct answer)
- When the client's TUG time is slower than age-matched norms
- When the client requests a rest break mid-assessment
Correct answer: When the client experiences an unexpected fall or loss of consciousness during assessment
An unexpected fall or loss of consciousness during assessment requires immediate cessation of testing and urgent medical consultation for client safety.
Question 5: A PWR! client's gait assessment shows step length asymmetry, with the left step 30% shorter than the right. The most appropriate documentation of this finding is:
- Client demonstrates normal bilateral gait pattern
- Gait asymmetry noted: left step length significantly reduced compared to right (Correct answer)
- Client requires wheelchair for safe ambulation
- No intervention needed as mild asymmetry is expected
Correct answer: Gait asymmetry noted: left step length significantly reduced compared to right
Accurate documentation of step length asymmetry provides an objective baseline for tracking the effectiveness of targeted PWR! gait interventions.
Question 6: Which of the following best describes the purpose of the 10-Meter Walk Test (10MWT) in PWR! client monitoring?
- Assesses cardiovascular endurance over a fixed distance
- Measures comfortable and fast walking speed to track gait velocity changes (Correct answer)
- Evaluates dual-task walking performance under cognitive load
- Quantifies the distance a client can walk before fatigue onset
Correct answer: Measures comfortable and fast walking speed to track gait velocity changes
The 10MWT measures gait velocity at both comfortable and maximal speeds, providing a sensitive outcome measure for detecting meaningful changes in walking function.
Question 7: A PWR! therapist is tracking progress across multiple sessions and notices a client's fear of falling has increased despite improved balance scores. The best action is to:
- Disregard the fear since objective scores have improved
- Address fear of falling through education, graded exposure, and confidence-building activities (Correct answer)
- Immediately discontinue balance training to prevent psychological harm
- Refer the client to a different program unrelated to PWR!
Correct answer: Address fear of falling through education, graded exposure, and confidence-building activities
Fear of falling can persist even when objective balance improves; targeted psychological strategies within PWR! help restore confidence and prevent activity avoidance.
PWR Client Assessment & Progress Monitoring 5
Which PWR! assessment strategy helps identify whether a client's balance impairment is primarily sensory, motor, or central in origin?