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Vestibular Therapy
“Making Your Next Step a Safe Step.”

In our time we have treated many people who have been injured as a result of falling.  As a typical approach, we address cause of injury in a proactive manner. It has been decided that if we address balance before you fall then we have truly done our job.  The Next Step Balance program does provide vestibular screening, at no cost, where you will be provided with a printed report of findings.  Another reason to take the next step to a safe step.

This information is not meant to provide you with medical advice. Only a licensed physician is qualified to provide you with medical advice, however this is something you should discuss with your doctor while prepared with the rite information and the baseline screen results.

As per the AGS, BGA and AAOS Guidelines, “All patients age 55 and over should be regularly screened for risk of falling”.

Everyone knows balance problems cause falls.
Why is that important to you?

“In older adults, falls can be very serious.”

Falls are the # 1 reason for injury-related visits to an emergency room, the # 1 cause of accidental death (falls cause 70% of all accidental deaths in people 75 & over), the # 1 reason for admission to a hospital and the # 1 reason for admission to a nursing home for persons age 65 and up.

Falls now cause nearly 1,000 hip fractures every day in the United States. And as many as 50% of the older adults who suffer a hip fracture will never regain their previous level of functioning and be able to live independently again.

About 35% of community-dwelling elderly persons and 60% of nursing home residents fall each year. Many of them fall repeatedly. 50% of the people age 75 and over who fall and sustain a serious injury will die within a year as a result of the fall. [American Academy of Orthopedic Surgeons, Don't let a fall be your last trip, 1998; CDC, National Center for Injury Prevention and Control, Preventing Injuries Among Older Adults, 2001­2002; NBC Nightly News, 1998.]

Is it true most people do not know when they have a balance problem?

It's very true. Most people, particularly young to middle age people, are totally unaware that they have a balance disorder.

That's because the human balance system has built-in "back-ups", so when sensory input from one source is inadequate, the central nervous system automatically turns to another source for orientation. In other words, a fully functioning part of the balance system will help do the work of a part of the system that is not fully functional.

The problem comes when people get older and have more than one part of their balance system that's not 100% functional, and/or when they encounter an unusual situation and the working parts of their balance system are unable to compensate and overcome the unexpected "obstacle."

For example, an older person may have had a vestibular disorder (the great majority of balance problems are vestibular in nature) for many years but may have unconsciously compensated for that problem by relying on their keen eyesight to maintain their balance.
But eyesight gets worse with age, and when coupled with dim lighting, poor eyesight often causes falls. That's why many falls occur at night, when there may be little or no light available.

Can falls be prevented?

Many can. Most balance disorders are caused by some benign, easily treatable condition. In fact, one of the most common forms of balance disorder, benign paroxysmal positional vertigo (BPPV), can almost always be completely cured in 1 or 2 short therapy sessions.
If your CAPS ™ screening reveals signs of a balance disorder, your doctor may want you to have hearing and vision tests, as well as a physical evaluation. He or she may also order other diagnostic tests, such as an ENG or an MRI, to help determine what is causing your balance problem.

After the cause of your problem has been determined, because 80-85% of all balance problems respond well to specific therapeutic maneuvers and exercises, your physician may decide that you would benefit from balance or gait therapy. If so, he or she will order it, and a therapy regimen will then be custom-tailored to your specific problem.

Your therapy may involve eye-tracking exercises, for example, in which you hold a card in front of you and move the card and your head rapidly from side to side, in opposite directions, while keeping the words on the card in focus. Other exercises involve such simple movements as getting in and out of a chair several times in succession each day.

Why screen older patients for balance problems?

First, don't be alarmed if your balance score is abnormal for a person of your age. Balance problems can be caused by such common things as a cold or flu, lack of sleep, the effects of medications or even too much caffeine. In those cases the problem will usually resolve itself without any medical intervention.

But balance problems and dizziness can also be the first sign of serious health problems such as brain tumors, anemia, Parkinson's disease, multiple sclerosis, diabetes, strokes, high blood pressure, traumatic injuries and many, many others. That's why identifying patients with abnormal balance can be invaluable in the detection of other serious conditions.

There's also another reason. The simple CAPSTM balance test helps your physician identify patients who may be at an increased risk of falling. In older patients, falls can result in broken hips, other fractures, head trauma and other serious injuries, even death. That's why the Clinical Practice Guideline recommends the routine screening of all older persons.
So if your results show signs of a balance disorder, and if the reason is not immediately apparent, your physician will want to find out why. But please keep in mind that balance disorders are almost always caused by some benign, easily treatable condition.

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