RISK ASSESSMENT AND PREVENTION

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Balance Questionnaire

Do you have a balance problem?  If so:

1.Does looking up increase your balance problem?  2. Does your balance problem restrict your travel?    3. Do you have difficulty getting in or out of bed?   4. Does dancing or quick movements of your head increase your balance problem?   5. Because of your problem is it difficult for you to walk alone or walk around your home in the dark?   6. Because of your problem, do you feel handicapped or depressed?   7. Does bending over increase your problem?   8. Do you have an unsteady gait?   9. Have you experienced dizziness and been unable to stand?   10.Do you have weakness in your legs or ankles?   11.Do you have arthritis pain in your hip, knees or ankles?   12.Have ever suffered a stroke or have a seizure disorder?   13.Are you unable to stand safely for 2 minutes with no assistance, pick up an object and stand safely or unable to get out of a chair that does not have arms?    IF you answered YES 2 or more times, you may have a balance problem and could benefit from our FREE computerized posturography screening. Back to Home