Clinical assessment of balance disorders

This review focuses on how new insights into sensorimotor control of posture are being applied to the clinical assessment of patients with balance disorders. Clinical balance assessments can be divided into three main approaches: a functional assessment, a systems assessment and quantitative posturography. A functional approach to assessment is used to identify whether or not a balance problem exists in order to assess risk of a fall, whereas a systems approach is used to determine the underlying cause of the balance problem in order to custom design a treatment program. Different types of posturography can be used either to assess balance function or to identify the underlying cause. A systems approach to clinical assessment of balance seeks to identify the constraints or disordered subcomponents underlying control of balance related to biomechanics, motor coordination and sensory organization. Clinicians also need to try to differentiate primary constraints on balance control from the compensatory strategies patients use to accomplish the goals of posture.