Practice Exam #2, question #48

[Anna Polonowski]

Can you please explain why the answer is C not D? Thank you!

48. A patient requires assistance to prevent falling on conditions 4, 5, and 6 of the Sensory Organization Test. What does this finding suggest?
a. Impaired use of visual and somatosensory cues for balance
b. Impaired use of vestibular cues for balance
c. Impaired use of visual and vestibular cues for balance
d. Impaired use of vestibular and somatosensory cues for balance

[Anna Polonowski]

I specifically do not understand why if the eyes are open for conditions 4,6. The vestibular and somatosensory systems are required for all 3 conditions which would make think those 2 are impaired, since he loses balance with or without vision. Thanks!

[Kyle Reedy]

Hello, I will explain my rationale for this one.

In conditions 1-3 somatosensory is pereserved and in result we have no falls. In conditions 4-6, we impair the somatosensory and start to cause falls. despite the other inputs. For proper balance we need 2/3 of the balance inputs. This patient only preserves his balance with accurate input form the somatosensory system (not on compliant surface)

Condition 1: all 3 are used (somat, visual, vestib) balance is preserveed
Condition 2: somat and vestib are used and balance is preserved
condition 3: somat and visual are used and balance is preserved
condition 4: visual and vestib are used and balance is LOST
condition 5: vestib only and balance is LOST
condition 6: visual only and balance is LOST.

so what we are seeing here is presentation of patient that is somatosensory dependent (must have accurate somatosensory cues) for balance and has some degree of impairment with the visual and vestibular systems for balance.

hope this helps

[Anna Polonowski]

Thanks,Kyle. That is helpful.

[Chrissy Durrough Lugge]

Great explanation, Kyle! Thanks!

One note – in condition 6 of the Sensory Organization Test, only vestibular cues are available (somatosensory and visual are inaccurate). The answer to this question remains the same – if somatosensory cues are not available, the patient loses his/her balance.

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