The ability of an individual to maintain balance while performing everyday activities is necessary to prevent falls. Therapists treating patients with balance impairments may use a variety of techniques to address identified deficits in strength, range of motion, and/or coordination.

Assessment
The following objective tests and measures provide clinical insight on standing balance and should be performed along with a comprehensive evaluation. Objective tests and measures should be repeated for progress notes, recertification, and when considering discharge from therapy.
• Timed-Up-and-Go, Gait Speed, Standing or Modified Functional Reach (APTA-recommended)
• Berg Balance Scale (APTA and AOTA-recommended)
• Four Square Step test, Tandem Walk Test, One-leg Stance Test, Dynamic Gait Index

Therapy Interventions
• ACP’s patterned electrical neuromuscular stimulation (PENS) can be applied unilaterally
or bilaterally to ankles, knees, hips, or trunk prior to exercise or functional activity to facilitate increased strength and coordination of the targeted muscles and to improve ankle, hip
and stepping balance strategies.
• Progressive resistance exercise and therapeutic activity to strengthen leg musculature,
improve proprioceptive sense, and restore standing stability.
• Balance trainers can be used for those with limitations in static and dynamic balance to facilitate ankle, hip, and stepping balance responses in a fall-safe environment.
• Virtual reality can be used alone or in combination with balance trainers to offer dual task challenges during standing balance activities.

Static and Dynamic Balance Activities*