Published in UAB Insight, Spring 2008
New Program Detects and Treats Disorders
More than 90 million American adults have experienced dizziness or a balance problem. Each year approximately 1.8 million people 65 years and older receive emergency department treatment for nonfatal injuries from falls, and more than 433,000 of those are hospitalized.
Therapists in UAB’s Balance Rehabilitation Program, available through the Outpatient Physical Therapy Department at Spain Rehabilitation Center, combat the consequences of balance and vestibular problems with therapy tailored to address each patient’s condition.
“We began the program to address the specific needs of patients with balance and vestibular problems and provide standardized rehabilitative care for this population,” says UAB Clinical Coordinator for Outpatient Physical Therapy Gayle Benson, PT, ATP.
“The program helps physicians identify and treat patients at risk for falling or who have decreased mobility because of balance impairment,” she says. “For many patients, our program can mean the difference between living independently or in an assisted living or nursing care facility.”
New guidelines issued by the American Academy of Neurology advise physicians to routinely ask patients about recent falls and further assess them for specific neurological deficits that predict falls, such as gait and balance disorders; deficits of lower extremity strength, sensation, and coordination; and cognitive impairment (Neurology. 2008;70:473-479).
Benson says patients answering yes to any of the following questions are at risk for falls: Have you had two or more falls in the past year? Have you had one fall with an injury in the past year? Have you felt unsteady or nearly fallen? Are you afraid that you are going to fall?
The Program
UAB’s program includes evaluation to determine the source of the balance and vestibular dysfunction. According to Benson, the condition of the balance control system’s sensory and motor components is key to identifying the source of problems. Sensory impairment can cause vestibular, visual, or peripheral sensory loss while motor impairment leads to decreased strength, range of motion, and coordination.
“Patients needing analysis are tested using computerized dynamic posturography [CDP], sensory organization testing, vestibular screening, or dynamic vision testing,” Benson says. CDP examines the interaction of sensory input in the brain by exposing patients to a variety of controlled visual and support-surface conditions. Such testing generates a quantitative assessment of the components of postural control.
“Our testing allows us to determine if a patient’s problem is a sensory, motor, or vestibular issue or a combination of them all,” she says. Armed with this information, therapists develop interventions that address patients’ specific impairment.
Patients with neurological impairments stemming from traumatic brain injury, cerebral vascular accident, Parkinson disease, or peripheral neuropathy are candidates for the program. Those with orthopaedic conditions and injuries, including joint replacements, chronic ankle sprains, and lower limb amputations also can benefit from the program, she says. Prospective patients need a physician referral. Call 205.975.4922 or fax referrals to 205.934.4351.
For more information:
Gayle Benson
1.800.UAB.MIST
mist@uabmc.edu