Gait, Balance, Vestibular Dysfunction and Falls

There can be a number of reasons for balance problems and falls. In fact, several of the factors can be present simultaneously. Some of the most common include:

Vision Problems Vestibular (inner ear) Dysfunction Low Exercise Levels Muscular Weakness Decreased Endurance Medications Neurological Conditions (Parkinsons, Stroke, Alzheimers)

Loss of Proprioception (the neurological sense that allows one to know not only where one is in space, but also the position and location of each individual body part and joint) Impaired Sensory Function in the Legs/Feet Impaired Gait Mechanics when Standing/Walking Painful Circulatory Problems of the Legs or Feet Environmental Challenges (steps, curbs, rugs, unlevel surfaces)

In order to assess patients for fall risk, we:

• Evaluate typical balance/fall risk issues (listed above).
• Conduct a somatosensory assessment (monofilament, proprioception testing).
• Pain assessment.
• Conduct a functional evaluation (Tinetti or Berg, Range of Motion, etc) for flexibility, strength, balance, ability to walk/do activities, vestibular effect.

We then set goals based on what the patient wants to be able to do at the end of treatment.

Generally, our typical gait/balance/falls therapy protocol may include:

• Therapeutic exercise for strengthening, endurance, range of motion and flexibility.
• Neuromuscular re-education as balance exercises.
• Gait training for proper walking techniques.
• If indicated, Anodyne therapy to increase circulation, decrease pain, stiffness, muscle spasm.
• Other modalities and therapeutic techniques, sensory integrative techniques.
• Addressing any other issues having an affect on balance (vision, medication, vestibular, etc.).

Fortunately, balance is a skill that can often be improved. We blend the most appropriate therapy techniques for each individual with the most advanced methods in balance restoration. The program also focuses on motivating patients to take charge of their health and balance issues. It is essential that the patient diligently follow the home exercise/balance program in order to achieve the best results.