Balance and Falls

Preventing Falls Among Older Adults

Falls are the leading cause of unintentional injuries in the U.S. Thirty-five percent of the population over the age of 40 will experience a balance or dizziness disorder during their lifetime. Advanced age greatly increases the chance of a hospital admission following a fall. However, difficulty with balance and falls is not just a result of getting older. Many falls can be prevented.

What is balance?

Balance is the ability to maintain the body’s center of gravity within its base of support during all activities.

Three components comprise the “balance system” in your body:

  • Visual system (eyes)
  • Vestibular system (ears)
  • Proprioceptive system (sense of touch)

What is vestibular rehabilitation?

Vestibular rehabilitation is an exercise approach for the treatment of disequilibrium and dizziness symptoms associated with vestibular pathology.

The vestibular system consists of the portion of the inner ear which controls balance and eye movements. In a normal system, when we move our heads, this system is stimulated and the correct balance response occurs. In a damaged system, the response can be any of the following:

  • Dizziness
  • Unsteadiness during walking
  • Nausea
  • Visual problems

Are you at risk for a fall?

Physical risk factors include:

  • Age
  • Weakness
  • Poor balance
  • Impaired proprioception or sensation
  • Vision problems
  • Medications (four or more)
  • Dizziness
  • Recent period of inactivity/bed rest
  • Loss of confidence of your ability to get around

Environmental conditions include:

  • Poor lighting
  • Uneven or slippery surfaces
  • Loose rugs
  • Steep stairs
  • Objects in walkway
  • Lack of handrails in bathrooms
  • Inappropriate, unsafe furniture
  • Long bathrobe
  • Pets underfoot

How can a physical therapist evaluate your risk of falling?

A physical therapist will:

  • Talk with you to obtain valuable information about your past medical history and present concerns
  • Test your leg strength
  • Test your leg movement (joint range of motion)
  • Test your sensation and ability to judge where you arms and legs are in space
  • Evaluate your posture
  • Measure how well, fast, far and on what types of surfaces you can safely walk
  • Test your balance responses
  • Assess how well you move while performing your daily routine
  • Discuss potential falls risk in the home environment
  • Perform simple cardiovascular testing
  • Assess your foot movement and responses
  • Assess your visual reflexes

How Can a Physical Therapist Reduce Your Risk of Falling? 

A physical therapist can help you with:

  • Exercise: Learn how to improve your range of motion, strength and cardiovascular capabilities
  • Education: Learn how to make your environment safe and how to select proper footwear for different surfaces.
  • Become aware of sensory deficits and learn how to adjust or compensate for your losses, learn energy-saving techniques to allow you to perform activities of daily living safely
  • Gait Training: Improve your ability to walk with or without a device such as a cane, walker or crutches
  • Balance Re-education: Re-educate your body to respond to loss of balance. Learn how to compensate for poor balance to make you safer in your home environment.
  • Postural Re-education: Become aware of your posture problems and learn to perform the proper stretches and exercises that will make you safer while moving.
  • Vestibular Rehabilitation: A specialized exercise program designed for the individual with dizziness and poor balance secondary to an inner ear problem.

Are You at Risk?

  1. Have you experienced a stroke, diabetes, osteoporosis, Parkinsons’ disease, or other neurological problem that has affected your balance?
  2. Do you take medicine for two or more of the following diseases: heart disease, hypertension, arthritis, anxiety, depression, pain or thyroid?
  3. Have you fallen more than once in the past year?
  4. Do you use a walker or a wheelchair, or do you need assistance to get around (including holding on to furniture when indoors)?
  5. Do you have difficulty sitting down or rising from a seated or lying position?
  6. Do you feel dizzy or unsteady if you make sudden changes in movement, such as bending over, quickly turning while walking, lying down, looking up, or quickly turning your head?
  7. Due to balance difficulties, do you restrict or are you fearful of the following activities?
  • Taking a walk?
  • Carrying a full plate across the room?
  • Getting in and/or out of the car?
  • Getting on or off of the commode?
  • Stepping off curbs?
  • Climbing stairs?
  • Walking on a crowded sidewalk?

If you answered YES to any of the above questions, you could benefit from a consultation by a physical therapist that specializes in balance.


If you have experienced a recent fall, feel unsteady on your feet or have spells of dizziness, talk to your family physician. 

 Find A Doctor Online or call (800) 339-8758

For more information about the Balance and Falls Program or to schedule an appointment, please call (828) 315-3186.

Find Us

Frye Regional Therapy Services 
420 N Center St
Hickory, NC 28601

Phone: (828) 315-3186

Fax: (828) 315-5587

Hours of Operation: Monday - Friday 7:30 am - 5 pm

Frye Regional's Balance and Falls Program is offered in the Therapy Services Department at the hospital's main campus located on North Center Street. Enter through the Therapy Services area. Valet parking is available.