Leveling the ground for patients with balance difficulties


By: Dr. John Conde DC, DACNB Special to the Boca and Delray newspapers
Balance is a very loose term describing an even distribution of weight enabling someone or something to remain upright and steady. It can also be described as the ability to move or remain in a position without losing control or falling. Either way, disequilibrium or difficulty with balance and stability affects at least 6.2 million Americans at any one time.
Balance is the result of several body systems working in unison; the proprioceptive system provides feedback to the brain of where the body is in spaces and it does this from muscle and joint sensors, the visual system (eyes), and the vestibular system (inner ear) which is made up of a maze-like structure in the inner ear with microscopic cells that resemble little hairs. Hence, dysfunction in any of these systems can lead to disequilibrium. For example, in the aging population eye-sight may fade, we lose lean muscle mass, arthritis can start infiltrating our joints, and the microscopic hair cells in the inner ear die off and do not regenerate. Susceptibility to falling increases dramatically. Another example is in a patient that may have suffered a stroke. If the damage was in areas key to maintaining balance such as the brainstem and cerebellum (small brain), then losing balance is inevitable.
The “gold-standard” for assessment and treatment of dynamic posture and balance is a protocol termed computerized dynamic posturography. Posturography in general is a non-invasive specialized clinical assessment technique used to quantify how well a person is able to exhibit stability and control posture and balance. There are two major categories of posturography testing; static in which the patient is examined on a flat surface, and dynamic in which the patient is examined with an experimentally induced external perturbation surface like a foam cushion. Dynamic testing is much more representative of real-world environments and therefore is the testing protocol of choice. The patient will stand on a highly advanced foam pad with specialized sensors at the base which will quantifiable the smallest amount of movement. The CAPS system (Comprehensive Assessment of Postural Systems) is the most accurate and well researched device on the market as it meets and exceeds all ISGPR standards for precision and reliability.
The main reason why Computerized Dynamic Posturography using the CAPS system is so effective is that it gives us the specificity of imbalance so a precise treatment plan can be made targeting the deficient regions of the brain involved. It also gives us objective data so we can re-measure quickly to assess the efficacy of the treatment. For example, a patient may present with a certain sway pattern in a certain plane and at a certain degree which improves post-treatment. This is all quantifiable and contributes to the push for evidence-based medicine. In essence, we know the patient is improving from the data generated. Lastly, the CAPS system is equipped with rehabilitation modules that are the most in-depth and robust in the field. The modules are diverse and highly interactive and can help with a variety of balance difficulties.
Dr. John Conde is a Board Certified Chiropractic Neurologist, one of only one thousand in the country. He holds diplomate status through the American Chiropractic Neurology Board. He provides specialized care for difficult cases of back neck pain, numbness-tingling, vertigo-dizziness balance disorders, fibromyalgia, migraines, AD/HD, autism, and dyslexia. His office is located at the Atlantic Grove in Delray Beach, FL and can be reached at 561-330-6096, drconde@thecondecenter.com, and at www.thecondecenter.com