Primary risk factors :
Muscle weakness: muscle weakness leads to decreased function
History of falls: if someone has fallen once, they will most likely fall again based on the same situation or factors. They are also vulnerable because their previous fall may have caused injury and decreased function.
Gait deficit: inability to walk properly may cause one to trip and fall
Balance deficit: decreased balance may cause inability to catch one’s self from falling.
Use of assistive device (cane, walker): reliance on a cane or walker indicates that a person has decreased ability to withstand test to balance
Visual deficit: vision is directly correlated with vestibular function, leading to balance impairment
Arthritis: pain is associated with decreased functional activity
Impaired activities of daily living: indicator for decreased physical ability to perform activities indpendently
Depression: inability to cope/improve one’s situation leads to decreased activity/function
Cognitive impairment: decreased attention span, inability to make good decisions may lead to higher occurrence of accidents, falls.
Age >80 years: generally with increased age comes decline of physical and mental capabilities
Using the list above, I came up with 3 main categories (physiological, environmental, sociological).
- Loss of vision
- Decreased proprioception/balance
- Sudden physical impairment (leading to use of an assistive device, physical impairment = musculoskeletal or neurological)
- Arthritis, leading to chronic pain, decreased physical activity
- Poor design/layout of environment
- Lighting - is the area well lit or dark?
- Ground/surface - stable or unstable? Is the ground they are walking or standing on a level surface?
- Force - was there a physical force that caused the person to lose their balance?If they were using a assistive device, was the assistive device adjusted properly for ease of use?
- Fear of falling
- Decreased independence
- Task/activity at the time of fall? What kind of activity was the person involved in at the time of the fall?
- Refusal or resistance to use an assistive device
- Refusal or resistance to limit one’s independent life style
- Refusal or resistance to exercise (take initiative of one’s health and well-being)
From my personal observations, patients with balance deficits fell into many of the following categories:
- Lower extremity weakness
- Lumbar spine symptoms
- Decline in physical activity/exercise, sedentary lifestyle
- Reliance on an assistive device
- Inability to find the time or safe/convenient environment to work on exercise
 p. 259: Kisner, Carolyn and Lynn Allen Colby. <em>Therapeutic Exercise: Foundations and Techniques</em> Philadelphia: F.A. Davis, 2002. Print.