The Pondera Balance Force Balance test will tell us your balance age and compare the relative contributions of the visual, vestibular and proprioceptive systems in maintaining balance.
The feeling of balance is the results from the combination of senses from a number of body systems, including the eyes (visual or ocular system), ears (vestibular system) and the body's sense of where it is in space (proprioception).
When all these senses are intact, humans and other animals have a feeling of equilibrium or balance, allowing us to move throughout our daily lives confident that the world is still.
People with problems to one or more of these senses loose this sensation of stillness and often express this with feelings of anxiety, bumping into things, falling over, dizziness, vertigo, motion sickness, vestibular migraine, as well as other presentations.
The pondera balance system is a quick, easy, non invasive, computerized and standardized balance assessment. It involves the patient standing upright, for brief intervals of 30 seconds, with eyes open and closed on a firm and unsteady surface. As seen in the photo, there is no risk of a patient falling as the assessor is nearby, if a patient was unsteady. If the assessor feels that , with a dizzy patient, that this is too uncomfortable with a patient, this will be discussed and may not be performed.
The data received regarding balance is then compared to a normative database specific to sex, age and height. This information is then used to create a Patient Report that demonstrates relative balance age, falls risk and the most likely cause of poor balance (visual, vestibular or proprioceptive error) . Measuring sway using the pondera force plate provides an accurate look at a patients stability and cause for injury and can direct your therapy onto a specific vestibular input for therapy.
The Pondera force platform is an excellent tool for patient education regarding their relative risk for injury vs stability, and to monitor their improvement with repeat tests often being performed.
The vestibular system is made up of two groups of three semi-circular canals, and the utriculus and sacculus. The vestibular system is our major determinant for balance providing information on the horizontal, and how we are accelerating in relation to the horizontal.
The vestibular system integrates with information from the eyes (visual information) and body (proprioceptive information) to determine postures, reflex actions and control movements. It does this by having vestibulo-ocular and vestibulo-spinal reflexes.
It was long thought that a problem with the vestibular system is unchangeable or that it might just get better with time, however evidence suggests that certain head movements will stimulate individual canals providing therapeutic input for weakness in certain aspects of the vestibular system.
Pondera can aid the detection of vestibular problems as it will show the consistently poor balance in all aspects of testing, especially while standing with eyes closed on a perturbed surface. Weakness in certain canals may also be demonstrated by the predominant direction of sway and a weakness in those same directions when measuring the limits of stability.
A patient report is printed off and helps determine if your vestibular system is a key cause of your presentation.
Every moment even while sitting “still” your brain is getting bombarded with pieces of sensory information letting you know where your joints are in space, the relationship they have to each other, how they are capable of moving and the speed at which they are capable of moving.
This constant feedback is unconscious and exists to allow us to move our selves in the environment. Most of this information is relayed to subcortical areas and helps to unconsciously co-ordinate movements and to setup basic postures.
If there is a problem with proprioceptive feedback, be it from mechano receptors, muscle stretch receptors, skin receptors or golgi tendon organs the result is seen both locally at the sight of altered information like the loss of coordination in an injured joint, AND centrally causing an adaption in body positioning and function,like the development of a limp.
Most proprioceptive changes stem from an injury (mechanical, chemical or emotional) and cause varied adaptive changes which can lead to exuberation of existing problems, development of new problems and will cause a change in autonomic behaviour including balance and posture.
Poor proprioceptive feedback will be picked up by Pondera by showing a large change in balance score when tested with eyes closed with an increase in fatigue ratios with eyes closed.
A patient report is printed off and helps determine if your proprioceptive system is a key cause of your presentation.
The ocular system is arguably one of the most important neurological systems in the body. The eyes are the only sense that transmits information to every lobe in the brain as it is the means by which visually, the brain knows its position in space. As we are gravity dependent, we maintain a focus of looking straight ahead with binocular vision due to our visual system.Our body can be seen to posturally adapt to fulfil this function. This is most commonly seen with a head tilt to keep a horizontal gaze.
The Pondera system challenges our visual system by performing two of the four tested positions with eyes closed. The assessor is always adjacent to the patient so if there is any fall risk, this is avoided. If the assessor feels that , with a dizzy patient, that this is too uncomfortable with a patient , this will be discussed and may not be performed.
A patient report is printed off and helps determine if your ocular system is a key cause of your presentation.
The patient receives a one page report that explains which area of the balance network is under most stress – Visual (eyes) , Vestibular system (ears) or Proprioceptive system (body). This often aligns with our Chiropractic Neuro Rehabilitation and General Chiropractic services. These results can guide future management strategies to improve outcomes.