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The Balance Solutions Method

Kelly Beaudoin, MPST Laurie Zimcosky, DPT, cert MDT Colleen Ventura Andrew Luberger, LMT, LPTA

Physical Therapists are Faced with New Challenges

in a Growing Senior Patient Population

  • Falls are a major public health concern that is largely preventable.
  • One third of seniors over the age 65 fall each year. *1
  • Dizziness is one of the most common causes of falling, and seniors with dizziness and vertigo are the most likely to fall. *2-8
  • Dizziness is prevalent in all ages, with estimates ranging from 1.8% in young adults to more than 30% in the elderly. *9
  • Approximately  23-30% of adults have experienced at least one episode of dizziness.  Stats show that 3.5% of adults experience a chronic recurrent episode for greater than a one-year duration by the age 65. *10
  • Many of the falls among seniors can be prevented by both recognizing and treating dizziness and vertigo. *11

Balance Solutions Physical Therapy has 10 years of experience addressing this major health care concern. We have focused on treating individuals with vertigo, dizziness and balance disorders and have developed a series of educational courses based on research and experience in this area.

Our courses have empowered many Physical Therapists and the Assistants to CARE for this demanding and growing population in a variety of treatment settings.

Our courses will provide you with practical experience that you can implement immediately, safely and effectively with your patients!

Our Experience has shown that when we look at the “Whole Patient” we are able to asses and treat the whole problem, not just treat the symptoms.  Incorporating the use of manual therapy techniques in conjunction with neurological based rehab and vestibular rehab has proven to be an extremely powerful tool in our success at treating this patient population.

Vertigo

Patients with suspected vestibular disorders require neurological screening, a thorough oculomotor exam, and evaluation for benign paroxysmal positional vertigo. Balance and fall risk assessment are also essential in this patient population. Screening for factors which may contribute to “multifactorial balance and gait deficits” allows the therapist to treat the Whole Patient effectively.  Individuals with vestibular disorders may also develop cervicogenic dizziness as a result of specific reflex activation; therefore, cervical screening is an essential component during examination. 

Cervicogenic Dizziness

Patients with cervicogenic dizziness often go undiagnosed and experience chronic symptoms. There is no specific diagnostic test for cervicogenic dizziness; it is considered a diagnosis of exclusion. However, through comprehensive hands on evaluation and the application of specific manual therapy techniques, symptoms of dizziness are often decreased or alleviated within the first few visits. 

The Core

Patients presenting with complaints of ongoing dizziness after a course of vestibular rehab, or who continue to present with cervicogenic dizziness or “multifactorial balance and gait deficits”, often have underlying issues in the thoracic spine, pelvis or core. These underlying issues may not allow this patient population to compensate as most people would, therefore contribute to chronic or recurrent symptoms.  Systematic evaluation and treatment of the “Whole Patient” including screening and intervention for issues in the thoracic, lumbar and pelvic regions aid in the treatment success of these more complicated patients.

Incorporating Pilates and TRX

The use of Pilates and Tension Resistance Exercise (TRX) are excellent tools which can be used as an adjunct during rehab when treating this growing patient population.  Each method offers unique exercises which can be modified to meet an individuals needs. Each method also focuses on core strength and stabilization which is essential for maintaining good balance as well as assisting in the prevention of recurring pelvic or core issues.

Addressing this patient population can generate additional revenue streams for yourself or your facility.

  1. Hausdorff JM, Rios DA, Edelber HK. Gait variability and fall risk in community–living older adults: a 1–year prospective study. Archives of Physical Medicine and Rehabilitation 2001;82(8):1050–6.
  2. Yuri A, Carey JP, Della Santina CC, et al. Disorders of balance and vestibular function in US adults. Arch Intern Med . 2010; 169(10): 938-944.
  3. Tromp AM, Pluijm SMF, Smit JH, et al. Fall-risk screening test: A prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol. 2001; 54:837-844.
  4. Graafmans WC, Ooms ME, Hofstee MA, et al. Falls in the elderly: a prospective study of riskfactors and risk profiles.Am J Epidemiol. 1996; 143(11): 1129-1135.
  5. Herdman SJ, Blatt P, Schubert MC, et al. Falls in patients with vestibular disorders. Am J Otol.2000; 21(6): 847-851.
  6. Gananca FA, Gazzola JM, Aratani MC, et al. Circumstances and consequences of falls in elderly people with vestibular disorder. Rev Bras Otorrinolaringol. 2006; 72(3):388-392.
  7. Tinetti ME, Williams CS, Gill TM. Health, functional, and psychological outcomes among older persons with chronic dizziness. J Am Geriatr Soc. 2000; 48(4):417-421
  8. O’Loughlin JL, Robitaille Y, Boivin JF et al. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993; 137(3): 342-354
  9. Sloan PD, et al. Dizziness: State of the science. Ann Intern Med. May 1, 2001; 134(9 pt 2):823-32.
  10. Ojala, M (1989). Etiology of dizziness: a neurological and neuro-otological study. Helsinki, University of Helsinki, Academic Dissertation.
  11. Kara N. Stevens, Iain A. Lang, Jack M. Guralnik, David Melzer. Epidemiology of balance and dizziness in a national population: findings from the English Longitudinal Study of Ageing Age Ageing (2008) 37 (3): 300-305