no

no

no

no

no

yes

yes

yes

yes

yes

yes

yes

If you answered “YES” to one or more of these questions, you may have a balance problem that could put you at risk for a fall. A comprehensive balance evaluation can be performed to detect possible causes for your balance problems and a treatment program can be established.


 

no

no

yes

yes

no

yes

no

no




Take the Balance Assessment Test...

1.    Have you fallen more than once in the past year?




2.     Do you feel dizzy or unsteady if you make sudden movements such as bending down? 





3.     Do you experience numbness or loss of sensation in your legs and/or feet?




4.    Do you feel unsteady when you are walking or climbing stairs?



5.    Do you have blackouts or seizures?




6.    Do you take medicine for two or more of the following diseases: heart, hypertension, arthritis,
        anxiety, or depression?



7.    Do you use a walker or wheelchair, or do you need assistance to get around?



8.    Have you experienced a stroke or other neurological condition that has effected your
        balance?              




9.    Do you have difficulty sitting down or rising from a seated or lying down position?



10.     Do you feel unsteady when you are walking and fear that you may fall?





                      Prevention is the best medicine, and falls can be prevented!