Precautions

Tests for balance and coordination should be conducted in a safe and controlled area where patients will not experience injury if they become dizzy or fall.

Description

Assessment of balance and coordination can include discussion of the patient's medical history and a complete physical examination including evaluation of the heart, head, eyes, and ears. A slow pulse or heart rate, or very low blood pressure may indicate a circulatory system problem, which can cause dizziness or fainting. During the examination, the patient may be asked to rotate the head from side to side while sitting up or while lying down with the head and neck extended over the edge of the examination table. If these tests produce dizziness or a rapid twitching of the eyeballs (nystagmus), the patient may have a disorder of the inner ear, which is responsible for maintaining balance.

An examination of the eyes and ears may also give clues to episodes of dizziness or incoordination. The patient may be asked to focus on a light or on a distant point or object, and to look up, down, left, and right moving only the eyes while the eyes are examined. Problems with vision may, in themselves, contribute to balance and coordination disturbances, or may indicate more serious problems of the nervous system or brain function. Hearing loss, fluid in the inner ear, or ear infection might indicate the cause of balance and coordination problems.

Various physical tests may also be used. A patient may be asked to walk a straight line, stand on one foot, or touch a finger to the nose to help assess balance. The patient may be asked to squeeze or push against the doctor's hands, to squat down, to bend over, stand on tiptoes or stand on their heels. Important aspects of these tests include holding positions for a certain number of seconds, successfully repeating movements a certain number of times, and repeating the test accurately with eyes closed. The patient's reflexes may also be tested. For example, the doctor may tap on the knees, ankles, and elbows with a small rubber mallet to test nervous system functioning. These tests may reveal muscle weakness or nervous system problems that could contribute to incoordination.

Preparation

No special preparation is required prior to administration of balance and coordination tests. The patient may be asked to disrobe and put on an examination gown to make it easier for the doctor to observe muscles and reflex responses.

Aftercare

No special aftercare is generally required, however, some of the tests may cause episodes of dizziness or incoordination. Patients may need to use caution in returning to normal activities if they are experiencing any symptoms of dizziness, lightheadedness, or weakness.

Risks

These simple tests of balance and coordination are generally harmless.

Normal results

Under normal conditions, these test will not cause dizziness, loss of balance, or incoordination.

Abnormal results

The presence of dizziness, lightheadedness, loss of coordination, unusual eye movements, muscle weakness, or impaired reflexes are abnormal results and may indicate the problem causing the loss of balance or incoordination. In some cases, additional testing may be needed to diagnose the cause of balance or coordination problems.

	A patient sits on a ball, working on his balance. He wears a belt so that the physical therapist can catch him if he loses balance.
(Custom Medical Stock Photo. Reproduced by permission.)

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