Balance problems can lead to falls – there is a solution


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By Jessica Deak, PT, DPT

Did you know that 1 in 4 adults aged 65 and over fall each year? In fact, falls are the second leading cause of accidental or unintentional deaths worldwide. Do not let yourself or your loved ones become part of this statistic. Have you noticed that you or your loved one has been losing mobility and independence because of a history of falls or fear of falling?

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There are many things that can be done in order to prevent a fall from occurring. This starts with a comprehensive assessment of the problem, and if needed, establishing an individualized and targeted approach to correct the reasons for falling or fear of falling.

Physical therapists are the experts in balance assessments and predicting fall risk. Our practice has developed a fall screening program that consists of four evidence-based physical tests and two questionnaires. Supported by research, these measures have been shown to predict elevated fall risk. The tests include the Timed Up and Go (TUG), Functional Reach Test, 4 Square Step Test, and the modified Clinical Test for Sensory Interaction of Balance (mCTSIB) using a computerized balance device. These tests will be administered by a physical therapist who will then discuss your individualized results with you to determine whether a course of physical therapy may be recommended.

The TUG which requires the participant to stand up from a chair, walk a short distance and then sit back down has been verified as a good predictor of mobility and fall likelihood. A person who takes longer than 13.5 seconds to complete the TUG is at a higher risk for falling.  The Functional Reach Test requires the participant to perform a reaching task in a static standing position. This test has also been verified as a screen for mobility and balance. A score of 6 inches or less indicates a significant risk for falls.  In addition, the 4 Square Step Test is another great measure of functional mobility and balance. It measures how well the participant can change directions while stepping. A score of greater than 15 seconds indicates fall risk.

The mCTSIB is a test that is administered on a computerized force plate device that measures postural sway of your body in various conditions. There are research-based values programmed into the software that will be used to compare your results to normative values of other individuals in your age and height categories. This test will also be used to determine if you are at risk for falling.

In addition to the four static and dynamic balance and mobility tests, two questionnaires or self-reported measures are completed. This comprehensive and research backed screening process gives the physical therapist a clearer picture of an individual’s fall risk. This screening should only take 10-15 minutes. Specific results are reviewed with the client, and recommendations are made based on those findings. These results should also be sent to your primary care physician to ensure they are aware of the results and support the recommended plan to correct the identified problems. Physical therapy treatment for balance impairments is typically covered by your health insurance.

Dr. Jessica Deak is a Doctor of Physical Therapy at db Ortho PT of Manalapan, located at 120 Craig Road, Suite 2. Dr. Deak can be reached at 732-462-2162 or via email at You can also find out more about the practice at and register for a Free Fall Assessment online.

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