balance Archives - Page 10 of 10

Imbalance vs Balance

September 20, 2019 By Cassie Zanolini, PT, DPT Leave a Comment

Balance Awareness week 2019

An imbalance is something that affects many people, especially the older adult population. Falls can pose a significant threat to the health of older adults, as well as reduce their independence. There are many physical risk factors that contribute to imbalance including muscle weakness, balance and gait, neuropathy and sensory changes, and decreased response to postural challenges. In order to reduce falls, it is our job to raise awareness about falls, work on prevention, and to assess and detect a risk of falls.

Fortunately, at our WWS Physical Therapy & Vestibular Rehabilitation clinic, we have access to a Computerized Biodex Balance System which can be used to assess static and dynamic balance. This device consists of a platform with sensors to detect your weight shift and es and a touch screen that can be adjusted to provide a variety of balance challenges and tests. Testing modules on this device can provide a comprehensive assessment of an individual’s balance that can be compared to age-predicted norms. That means we can use a patient’s assessment data to determine where they fall in relation to others. This same information can be used to develop an individualized treatment program to address a patient’s specific deficits.

During treatment sessions, our Physical Therapists can use the Biodex to provide auditory, visual, and tactile feedback to help a patient improve their balance and accelerate their rehab. The Biodex can help train patients in static and dynamic balance through a variety of different tools and games. This treatment combined with the expertise and other tools available at our clinic can help get you back on track to prevent falls and decrease balance issues.

Not only can the Biodex be used to predict and treat those at risk of falls due to age. It can also be used as a treatment for those with Parkinson’s disease, peripheral neuropathy, concussion, as well as many other issues that can affect balance.

Cassie Zannolini PT, DPT

For more information visit:

Biodex Computerized Balance System

It’s Balance Awareness Week!

September 17, 2019 By Kelsey Krebs Hanlon, PT, DPT Leave a Comment

We celebrate Balance Awareness Week September 15-21, 2019, at WWSPT.

Having good balance is something that many of us take for granted, but many people, especially in the older population, experience imbalance on a daily basis that can be debilitating.

There are three main systems that contribute to a person’s balance. The first is the visual system, which most people rely on as the primary system for balance. This reliance can present problems in low-light situations such as night time, or with visual changes that occur with age. The second system is our proprioception, which involves the ability of receptors in the joints of our feet and ankles to sense their position, as well as sensation, which can be disrupted with certain diseases such as peripheral neuropathy. The final contributor is your vestibular system, which is the tiny center located in your inner ear responsible for sending information to your brain regarding head movements and positioning. There are various disorders that can impact the vestibular system, including benign paroxysmal positional vertigo (BPPV), unilateral vestibular loss (UVL), and Meniere’s disease.

There are also other factors that can impact balance including leg strength and flexibility, hearing, brain injury, and cognitive function. Staying active and keeping up with yearly hearing and vision examinations can help to prevent imbalance. While people tend to associate declining balance with age, many do not realize that balance can be improved. This can be essential for decreasing fall risk, which is significant because The World Health Organization lists a fall as the second leading cause of accidental injury and death worldwide.

Physical Therapists, especially those who specialize in vestibular rehabilitation, are able to assess the contributing factors to your balance and design an exercise program that focuses on these deficits. The program may include leg strengthening and flexibility exercises, balance exercises, and head and eye movement exercises designed to improve the function of your vestibular system. If you are feeling less confident with your balance, don’t hesitate to contact your doctor or a physical therapist and request a consultation. It’s never too late to improve your balance and your confidence!

A simple exercise that can be done to work on balance is to stand near a stable surface with your feet together. The goal would be to maintain this position for 30 seconds. This exercise can be progressed to standing with feet together with one foot slightly in front of the other, to standing with one foot directly in front of the other, and to balancing on only one leg. As a general rule, the activity should be challenging but not so hard that you are unable to complete it for at least 8-10 seconds. To make a position more challenging, you can close your eyes (removing your vision and therefore one of your balance systems completely!), but remember that this will make the exercise much harder and be sure that you are able to grab onto the stable surface if needed to avoid a fall. Try to perform this exercise 1-2X per day if possible.

Kelsey Hanlon, PT, DPT

WWS Physical Therapy and Vestibular Rehabilitation
1456 Ferry Road
Suite 601
Doylestown, PA 18901

P:215-489-3234
F:215-489-0131
wwspt.com

When’s the right time to see a PT?

July 16, 2019 By Gregory Synnestvedt PT, DPT Leave a Comment

Time to see a Physical Therapist, PT?
By Dr. Greg Synnestvedt PT DPT

Have you ever had physical therapy? Some people picture typical physical therapy as the rehabilitative process that a person goes through after joint replacement surgery. While this is one important time to participate in therapy, most people in a physical therapy clinic are coming for very common pains. The most common areas people seek PT for are 1) low back pain 2) shoulder pain and 3) knee pain. There are also people who are not in any pain at all (lucky them!) but want to improve their balance, walking, mobility, or ability to do daily tasks.

When is the right time to see a physical therapist? If you are trying other treatments for an ache or pain, it is worth seeing a physical therapist to get their opinion before going to other specialists. A recent study found that seeing a physical therapist first for low back pain reduced the overall healthcare costs and also reduced the chances of opioid prescription down the road. Whoever you see first in the healthcare system has a large impact on your path through the system—this is not the way it should be, but this is how it is. You can see a physical therapist with a direct access license for 30 days before requiring a referral from your physician, and this could give you enough time to see that you will be okay without an injection, procedure, or expensive MRI right off the bat. If your physical therapist thinks that your situation requires your physician’s attention, they will refer you to the physician for consultation.

A similar study to the one mentioned above found that early physical therapy for people with neck pain reduced the rate of imaging, opioid prescriptions, and overall costs. Early was defined as people who saw a physical therapist within 3 months. If you have an issue for more than a few weeks that isn’t getting better, it could be useful to consider trying PT.
As patients, we usually seek the “silver bullet” treatment, though this rarely exists. Ture healing and improving are nearly always processes involving time and effort. Take, for example, knee pain from arthritis, which is a very common problem. The clinical practice guidelines put out by the Academy of Orthopedic Surgeons recommends physical therapy as a primary treatment for knee arthritis, with strong evidence. Despite this recommendation, non-recommended treatments such as hyaluronic acid injections, corticosteroid injections, and opioids remain among the most commonly utilized treatments for patients in the year leading up to joint replacement (Bedard et al., 2017). This study estimated a 45% healthcare savings if only the recommended treatments were used. This is not to say that injection is never useful, but that it is worth trying physical therapy.
As a patient, you are your best advocate. If you have a joint or muscle pain or difficulty moving, ask your doctor for a referral to physical therapy and see what PT can do for you.

Bedard, Nicholas A., et al. “The AAHKS Clinical Research Award: what are the costs of knee osteoarthritis in the year prior to total knee arthroplasty?.” The Journal of arthroplasty32.9 (2017): S8-S10.
1: Frogner BK, Harwood K, Andrilla CHA, Schwartz M, Pines JM. Physical Therapy as the First Point of Care to Treat Low Back Pain: An Instrumental Variables Approach to Estimate Impact on Opioid Prescription, Health Care Utilization, and Costs. Health Serv Res. 2018 Dec;53(6):4629-4646. DOI: 10.1111/1475-6773.12984.
Epub 2018 May 23. PubMed PMID: 29790166; PubMed Central PMCID: PMC6232429.

Horn, Maggie E., and Julie M. Fritz. “Timing of physical therapy consultation on 1-year healthcare utilization and costs in patients seeking care for neck pain: a retrospective cohort.” BMC health services research 18.1 (2018): 887.
Study: Seeing a PT First for LBP Lowers Overall Costs, Reduces Chances of Later Opioid Prescription

https://www.apta.org/PTinMotion/News/2018/05/24/PTFirstForLBP/

Study: Early Physical Therapy for Neck Pain Associated With Lower Imaging Rates, Opioid Prescriptions, and Overall Cost
https://www.apta.org/PTinMotion/News/2018/12/04/EarlyPTNeckPain/

How much does exercise help a body?

June 12, 2019 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

Let’s count the ways the body benefits with exercise:

Before starting an exercise program, especially if you have been sedentary, (a couch potato), consult a doctor to make sure you do not have any underlying conditions that could be a problem. Once you have been cleared, commit to an exercise program, start slow and gradually increase intensity. Make exercise a priority, maybe get a buddy to make it more enjoyable as well as accountable, then pick the days and times you will exercise and stick to it for life. I personally prefer to work out first thing in the morning, then there are no excuses. Workout/exercise three to five times a week, by six weeks, you should notice a positive difference in how you feel. At first you may experience some soreness, but all that means is you are working your body in ways it is not used to, which is great!

The benefits of exercise include but are not limited to the following: Improved sleep, improved gastrointestinal motility, improved brain function, more energy, stronger heart and lungs, stronger bones and muscles, improved posture, better balance, improved mental state, etc. The list goes on and on. Pick an activity you like and stick to it, or mix it up, just do something!

Boot camp fitness trainer yelling during squat exercises

Some examples of great exercise include walking, swimming, dancing, biking, yoga, weight lifting, circuit training, Tai Chi, martial arts, boxing, gardening, hiking, etc. Again, the list is endless. The best exercise/activity for your body is the one you will do. – commit to doing. The body was meant to move, so move it. Right now there are more opportunities to exercise for people of all ages, so take advantage of them. Groups are great because they add a social component, which adds to the fun and accountability. The better shape you are in prior to an injury or illness, the better you are able to deal with and/or recover from it. George Bernard Shaw once said: ”We don’t stop playing when we grow old, we grow old, when we stop playing.”

A physical therapist can help you get moving again, especially if you have any problems with your balance, joints, muscles, or endurance, that keep you from participating in various activities with confidence. So, the best exercise/activity is the one you will do. The body was meant to move, so move it.

As always, check with your doctor first, then get moving, and get more out of life!

Are Your AT Risk for A Fall?

October 26, 2017 By Wendy Webb Schoenewald, PT, OCS Leave a Comment

One-third of older adults lose their balance and experience a fall each year. Many suffer fractures or head injuries, which can lead to an increased burden on caregivers and healthcare costs. The fear of falling again is powerful and can often drive people to restrict their activities thinking that they are reducing their risk, but the resulting de-conditioning may actually increase fall risk.

There are many tests available that determine Fall Risk, however, because falls depend on many different factors, no single test is the ‘gold standard’.” Research published in the Journal of Geriatric Physical Therapy in early 2017¹ combined the findings of multiple studies of fall-risk in community-living adults over the age of 65 to determine what best predicts future falls. They found that the answer s to five questions and performance on two simple screening tests helped to identify those who should have a more comprehensive fall-risk assessment by a medical professional.”

Have you had a fall in the past?
Are you concerned that you might fall?
Do you routinely use a cane or walker?
Do you need assistance performing any of your activities of daily living?
Are you taking any psychotropic medication?
- Any medication capable of affecting the mind, emotions or behavior, i.e. sleeping pills, antidepressants, some dementia/Alzheimer’s medications, etc.

A ‘yes’ answer to any of the above suggests that a more in-depth evaluation of fall risk would be beneficial. Additionally, the following two tests appear to be reliable screens of who should have a fall risk evaluation and treatment to reduce their risk:

Can you stand on one foot with eyes open for >6.5 seconds?
Is your normal walking speed <1m/s?
- This can be determined by measuring out a 20-foot span, with a 5-foot distance before and after (for getting up to normal walking speed and slowing down at the end) and seeing if it takes longer than 6 seconds to walk through the 20-foot span. Start timing when the first foot enters the 20-foot span and stop timing with the last foot leaves the span.

Individuals with vestibular disorders (dizziness and balance disorders related to the inner ear or its connections within the brain) are also at increased risk of falling. Ask our WWSPT vestibular therapists to measure your fall risk and work to improve balance and reduce the risk of falling.

Resources:

LifeMark Canada blog; don’t Fall this Fall!

Lusardi, Michelle M et al. Determining Risk of Falls in Community-Dwelling Older Adults: A Systematic Review and Meta-analysis Using Posttest Probability. Journal of Geriatric PT Jan/Mar 2017

Imbalance vs Balance

It’s Balance Awareness Week!

When’s the right time to see a PT?

How much does exercise help a body?

Are Your AT Risk for A Fall?

Our Mission at WWSPT

WWSPT Mission 2.0

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations

Our Mission at WWSPT

WWSPT Mission 2.0

Connect With WWSPT:

Contact WWS Physical Therapy

Ask About WWSPT Professional Associations