Fall Prevention has become a national concern. Recently, the National Safety Council Injury Facts, 2008 edition, found the following statistics:

“Falls are the #1 cause of death as a result of unintentional injury among persons age 75 and over.”

“Falls are the #2 cause of death as a result of unintentional injury among persons between the ages of 65-74, with motor vehicle accidents being #1.”

“Falls are the #3 cause of death as a result of an unintentional injury among all ages.”

“Overall, falls are the #1 cause of nonfatal unintentional injuries treated in hospital emergency rooms among all ages."

“Falls result in the second most expensive worker’s compensation claims costs. The average cost of a claim due to a fall or slip is $23,929. Claims due to motor vehicle accidents are first, at an average cost of $46,033.”

The Fall Prevention Program is designed to initially identify those that are at risk of having a fall. Once the patient is identified, the patient will undergo a thorough history and extensive physical examination. There are a number of underlying conditions that may cause the patient to be unstable, and Dr. Slone will evaluate them all.

The physical examination consists of performing a complete head to toe assessment looking for muscle tone imbalances, cortical/brain desynchronization, anatomical differences and vestibular related disorders. When muscle tone imbalances are present, one side of the body will require a greater amount of stretch than the other, causing increased instability.

Dr. Slone utilizes the latest technology as it pertains to Fall Prevention and vestibular related disorders. A posturography plate, which is called a Computerized Assessment Posturography System (CAPS), is used to identify where the patient is experiencing their instability. Testing consists of evaluating the patient’s Static Balance, Limits of Stability, Targeting as well as Sit to Stand Tests.

The Static Test allows Dr. Slone to assess the ability of a patient to maintain balance while the patient is in specific positions. It allows Dr. Slone to specify a wide array of head, body, arm and leg positions, as well as eye positions, visual tasks, and respiratory tasks. These tests may be performed with or without perturbation.

The limits of stability testing assess the distance a patient is able to sway without losing their balance. Tests are either performed in four directions (anterior, posterior, right and left) or in eight directions (above 4 along with forward left, forward right, backward right, backward left). By identifying and treating the patient’s decreased ability to sway, the patient will be able to maintain an upright position more easily as well as be able to recover from unstable positions at a greater rate. This treatment improves quality of life from kids to seniors.

The targeting test is performed with the patient on a force plate while looking at a monitor. While looking at the monitor, an icon will represent the location of the patient, a separate visual target/icon will appear and the patient attempts to move their body/icon over the target. Information regarding accuracy, time it takes to initiate and reach the target and directional strengths/weaknesses are all analyzed and hard data is provided.

The sit to stand test has the patient going from a seated position to a standing position, measuring the time it takes the patient to initiate movement, the amount of time the patient becomes stable, the amount of stability during the test as well as fatigability or adaptation while performing multiple repetitions. This test will also evaluate if the patient is using one lower extremity more than the other when going from a seated to standing position, providing information on muscle imbalance. Not only is this important as it relates to identifying muscle imbalance and stability, but if the patient is putting increased stress on one lower extremity, they may be more prone to injury or hip fractures.

The patient’s balance will also be assessed with a Videonystagmography (VNG) as it relates to various head positions. When a patient has an underlying vestibular condition, certain head positions may cause instability or lack of balance as well as vertigo. This information is important to understand in treating the patients underlying conditions. If a vestibular issue is present, the specific area needs to be corrected as well as rehabilitated.

Neurodevelopmental disorders may also cause instability in a patient’s ability to maintain in an upright position. Depending on the history and examination of the patient, a neurodevelopmental evaluation may be performed to determine if the instability is due to a decrease in the patient’s neurologic development.

Please contact our office for an appointment or click here to download our Fall Prevention Flyer.

The Balance Testing Video:

This footage included here is a portion of the initial evaluation. The "Post Check" section is how the patient responded after receiving treatment on the initial appointment. The "Second Appointment" section shows how the initial treatment has improved his condition. Please note that the patient was able to stand with his feet together in the post check and before the second appointment.

The First Morning Appointment Video:

The patient was responding well in our office, however he stated that he would have a difficult time in the morning. This is how he presented on the first morning appointment. The "Post Morning Appointment" is how the patient did following the morning treatment. Often, patients who's nervous system is compromised, will have a difficult time in the morning, do to decreased oxygen, activation or fuel as a result of sleeping through the night. Dr. Slone addressed these issues in this appointment and the patient benefited from it.