4/7/2016 Balance 

— Guide to Phys. Therapist Prac.

Balance

Balance is the ability to maintain the body in equilibrium with gravity both statically (ie, while stationary) and
dynamically (ie, while moving), and while upright (ie, standing, ambulating) and while sitting (ie, supported,
unsupported).

The physical therapist uses tests and measures to determine an individual's level of balance. Responses
monitored at rest, during activity, and after activity may indicate the presence or severity of an impairment,
activity limitation, participation restriction, or disability.

Examples of Clinical Indications:

Risk factors for impaired balance

Back or limb pain

Concussion history

Decreased coordination

Impaired limb or trunk sensation

Obesity

Polypharmacy

Stroke history

Vestibular disorder history

Health, wellness, and တtness needs

Fitness, including physical performance (eg, inadequate static or dynamic balance for climbing,
limited leg strength for squatting)

Health and wellness (eg, inadequate understanding of need for dynamic balance in all
functional/recreational actions)

Pathology or health condition

Cardiovascular (eg, stroke, peripheral vascular disease [PVD], hypoxia)

Endocrine or metabolic (eg, diabetes mellitus with peripheral neuropathy)

Musculoskeletal (eg, muscular dystrophy [MD])

Neuromuscular (eg, central vestibular disorders, Parkinson disease [PD], cerebral palsy [CP])

Multisystem (eg, trauma, Down syndrome [DS])

Impairments of body functions and structures

Circulation (eg, claudication)

Joint integrity and mobility impairment (eg, unstable ankle with standing and movement)

Motor function (eg, abnormal movement patterns)

Muscle performance (eg, asymmetrical muscle weakness, decreased power and endurance,
ankle inversion with spasticity)

Skeletal integrity (eg, severe kyphoscoliosis)

Activity limitations and participation restrictions

Self-care (eg, di†culty with dressing due to abnormal sitting and standing balance)

Domestic life (eg, inability to do the laundry due to di†culty with transitional balance)

Education life (eg, inability to safely negotiate classroom)

Work life (eg, inability to do shopping as household manager due to unsafe balance)

Community, social, and civic life (eg, inability to dance or to coach a Little League team due to

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4/7/2016 Balance — Guide to Phys. Therapist Prac.
unsafe balance)

Examples of What Tests and Measures May Characterize or Quantify:

Balance during functional activities with or without the use of assistive technology (eg, activities
of daily living [ADL] scales, instrumental activities of daily living [IADL] scales, observations,
videographic assessments) Speciတc Tests and Measures in PTNow

Balance (dynamic and static) with or without the use of assistive technology (eg, balance scales;
nerve conduction studies and needle, တne wire, or surface electromyography; dizziness
inventories; dynamic posturography; fall scales; motor impairment tests; observations;
photographic assessments; postural control tests) Speciတc Tests and Measures in PTNow

Examples of Data-Gathering Tools:

Cameras and photographs

Diaries

Force platforms

Motion analysis systems

Observations

Posturography

Proတles

Rating scales

Scales for weighing

Technology-assisted analysis systems

Video cameras and video recordings

Examples of Data Used in Documentation:

Balance characteristics with or without use of devices or equipment

Balance ratings on and in diတerent physical environments

Level of safety during balance

Quantiတcation of static and dynamic balance in sitting and standing or while ambulating

Safety level during balance

Last updated August 1, 2014.

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