May

5

When I discuss falls and fall risk with people, their thought process is typically, “well, there is nothing wrong with me, I feel fine”.  That is exactly the inherent dangerous mindset that leads to fall related injuries.  Most people think that to have a high risk of fall means that they would be wobbly and unstable just standing and that they would realize that their risk of fall was elevated.  This is simply not true.  If you are this unstable just standing, your risk of fall has already gotten so high, that you are no longer ambulatory, as just standing and resisting the earths gravitational pull is too much for you.  Human beings have amazing redundancy in our brain circuitry, as a fail safe, so that if something goes wrong with one system, there is usually a backup system in place.  With balance, there are three main systems: vision, sensation from the feet and spine, (proprioception), and the inner ear, (vestibular labyrinth).  Each of these systems on their own should yield enough information for you to effectively stabilize yourself in the earth’s gravitational field. But what happens when we test that, which is exactly what we do when we test someone’s balance and thus risk of fall?  Well, first and foremost, what we see is that most individuals, especially the elderly, have become extremely visually reliant.  So once vision is eliminated by closing the eyes, we can measure the decrease in stability.  This is comparable to coming home at night in the dark, when most falls occur, as vision, which has become overcompensated upon, is poor.  Now lets look at proprioception.  Again, most elderly have some degree of arthritis, which reduces the amount of proprioceptive information reaching the brain.  Consider the same scenario of coming home in the dark, and stepping from a hard cement sidewalk, onto soft wet sod.  Again, enough to cause anyone with poor balance and stability to lose their balance and fall.  In this latter scenario, the vestibular labyrinth is entirely responsible for maintaining your balance.  If it is not working as it should be, your balance is compromised and a fall results.  Well, this is exactly how we test your balance in our office.  Using a CAPS computerized dynamic posturography platform, we can selectively eliminate one or more forms of balance, allowing us to test the remaining form.  Testing is thus extremely accurate and falls become readily predictable.  It is at this point where we would intervene with fall prevention treatment specific to your loss.  With this treatment, we typically see improvement of two full categories within one or two treatments.  This is outstanding as it is taking someone who was previously at an elevated risk of fall, who probably had little to no idea that they even had poor balance, and then improving their balance and reducing their risk of fall significantly.  So if you have not been screened, come in and get screened; it’s free.  And if you have been screened and do have an elevated risk of fall, for goodness sake, don’t disregard it, lets fix it!