Are you at risk for falling?

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Balance Self Test - To help determine if you may be headed for a fall, take the Balance Self Test below. The best way to determine if you have a problem, however, is to talk with your physician who might recommend that you get a balance screening test from Balance and Mobility Therapy.

Balance Self Test

• Have you fallen more than once in the past year? Yes No
• Do you take medication for two or more of the following diseases: heart disease, hypertension, arthritis, anxiety or depression? Yes No
• Do you feel dizzy or unsteady if you make sudden changes in movement? Yes No
• Have you had a joint replaced? Yes No
• Have you experienced a stroke or another neurological problem that has affected your balance? Yes No
• Do you experience numbness or loss of sensation in your legs and/or feet? Yes No
• Do you use a walker or wheelchair, or do you need assistance to get around? Yes No
• Do you feel unsteady when you are walking or climbing stairs? Yes No
• Do you have difficulty sitting down or rising from a seated or lying position? Yes No