Physical Therapy and Fall Risk Assessment

This week, I just want to review some aspects of what a Physical Therapist can contribute to a Falls Risk Assessment Team (FRAT). The role of the Physical Therapist might change dramatically depending on setting, training and the skills of other FRAT members. What is listed below is a summary provided by Kim Slemp, PT, a good therapist and friend, when asked to describe what a PT can contribute over and above what an Audiology-based protocol might cover. The Physical Therapy exam she follows is described below:

Physical Therapy Assessment of Multi-factorial Balance Disorders

1. Manual Muscle Test –muscle groups are tested for strength and symmetry (i.e., right leg versus left leg). Resistance against the therapist’s hand is subjectively judged on a 0 to 5 performance scale.

2. Range of Motion – Evaluation is performed for reduced mobility of ankle, knee and hip joints. This is objectively measured using an instrument known as a Goniometer that measures change in joint position referenced to baseline.

3. Sensation –Lower extremity sensation can be assessed using subjective responses to pin prick, vibration, and sharp/dull discrimination.

4. Coordination –Subjective assessment of patient’s ability to perform smooth, rhythmic movements of upper and lower extremities provides assessment of gross motor control.

5. Posture – Subjective observation of head position in spine, spinal alignment and position of trunk is performed.


(Information provided by Kim Slemp, PT, Smyth County Community Hospital, Marion, VA.)


About Alan Desmond

Dr. Alan Desmond is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. In 2015, he received the Presidents Award from the American Academy of Audiology.

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