My Doctor wants me to have my balance tested. What does that mean?

You may be scheduled for a Physical Therapy Evaluation. This includes a thorough assessment of strength, flexibility, functional balance skills, and evaluation and discussion of any factor such as pain, fatigue, dizziness, or changes in lifestyle which may be affecting your balance. This session includes determining your needs and setting appropriate goals to address these needs.

You may be scheduled for VNG test or video nystagmography. This test is performed to determine if your dizziness and/or vertigo is being caused from an inner ear problem. Your eye movements will be measured while you perform different head movements. The testing is performed as you sit or lie down on your back and sides. This test helps your Doctor and Physical Therapist know how to treat your dizziness.

· For your first appointment, please sign in at the front desk and let them know it is your first physical therapy visit. You will be brought back to the physical therapy room for your evaluation.

New Patient Information:

• Please bring any special equipment with you to your first appointment, such as walking devices or braces. Dress comfortably in clothing that allows movement and well fitting, sturdy shoes.
• For future visits, please sign in at the front as you enter, and then wait in the waiting area just outside the PT room until your appointment time.
• Appointments are 45 minutes long. Please be on time for your appointment. This time has been reserved for you. Please call the clinic if you need to reschedule an appointment and give at least 24 hours notice. We understand that there may be exceptions such as illness or emergencies. To call, press the extension 222 as you hear the recording begin and if no one answers, please leave a message.
• A typical course of physical therapy will be 2-3 times a week for 4 weeks. This will vary according to your needs. The frequency and duration will be determined after your initial evaluation and recommendations will be discussed with you during your first visit.
• We file claims for Medicare and most private insurance carriers. The co-pay will be billed to you after we file. We will work with you on special circumstances. Please ask about co-pay amount.
• A part of your therapy will be a home exercise program. These exercises will be very specific to your particular needs. Please take seriously the instructions that your therapist gives you as this will enhance your improvement. This is a team effort!

Fall Prevention and Balance Program

Are you dizzy, unsteady, or afraid of falling? Dizziness and feelings of imbalance can take away your confidence with activities you would normally enjoy. You might even stop being as active due to fear or weakness and make the problem worse. A loss of independence can be very frustrating. A fall prevention program can help you regain your independence and return to activities which you enjoy.

WHAT CAN BE DONE?

Our goal is to help you become as safe and as independent as possible. Our program takes into account your individual medical condition, your lifestyle, and your individual needs. At the Clinic for Neurology, P.A. we can help determine the reason for your dizziness or imbalance by performing a comprehensive evaluation and designing an appropriate treatment program. Under the direction of a physician, we will perform tests on the four areas which affect your balance:

• Vision
• Nervous System
• Muscles and Joints
• Inner Ear (Vestibular)

A physical therapist will evaluate your balance reactions and muscle strength and flexibility. We utilize the newest technology in vestibular disorder evaluation and therapy for dizziness and balance disorders.

HOW CAN EXERCISE HELP PREVENT FALLS?

Balance Therapy” provided by a physical therapist specializing in fall prevention emphasizes body awareness and improvement of reactive strategies to regain stability when balance is lost. Studies suggest that having adequate muscle strength and flexibility alone are not enough to maintain balance. The body’s balance system is very complex, relying on kinesthetic, visual, vestibular and other sensory coordination. Balance training “specificity” is a key component to preventing falls. Athlete’s use this principle when training for a specific event. Maintaining adequate balance to live and function into later life must also be “training specific”.

While strength and flexibility are important, balance as a skill must also be emphasized in a “fall prevention program”.

To train balance, postural control strategies are used. An “ankle strategy” is used when the body moves as a single entity about the ankle joint, in other words, swaying the upper and lower body in the same direction. This strategy is subtle and used to maintain postural stability. Impairments in the central or peripheral nervous system will alter one’s ability to maintain normal postural stability. Adequate flexibility and strength in the ankles and adequate foot sensation and proprioception are necessary in using an ankle strategy.

To prevent an impending fall, a “hip strategy” may be used, where the upper and lower body move in opposite directions to control balance. An effective hip strategy requires adequate hip range of motion and power, and particularly lateral stability. When hip or ankle strategies are inadequate to maintain balance and cannot be improved, an assistive device is necessary to improve safety.

When a force results in displacement beyond the maximal stability limits, a “step strategy” can be used. Taking a step widens the base of support and alters the center of gravity. To utilize a step strategy, one must have adequate central processing, a rapid response time, and adequate lower body muscle strength, power, and flexibility.

These strategies come natural to the young and “able bodied” person. Physical inactivity in the elderly contributes to loss of muscle strength, especially the antigravity or postural muscles, loss of flexibility, and decreased speed in which they execute their movements. Older adults with dysfunctional vestibular problems feel dizzy or unsteady and are experiencing associated alterations in their sensory systems.

Multiple systems contribute to maintaining one’s balance and mobility.

Sensory, motor, and cognitive systems are integral in the development and maintenance of good balance and mobility. Age associated changes can be addressed by a multidimentional program including physical therapy for “training specificity” and improving fitness

Return to Physical Therapy Main Page
Physical Therapy Information for Physicians