Comprehensive Neurological Balance Assessment Protocol

Overview

This standardized protocol ensures thorough evaluation of balance function through systematic assessment of multiple systems contributing to postural stability.

Required Equipment

• Examination table
• Stopwatch
• Foam pad (optional)
• Visual target
• Romberg test space
• Assessment forms

Assessment Components

1. Static Balance Testing

Modified Romberg Test

1. Standard Position

   • Feet together
   • Arms crossed
   • Eyes open (30 seconds)
   • Eyes closed (30 seconds)

2. Tandem Position

   • Heel-to-toe stance
   • Arms crossed
   • Eyes open (30 seconds)
   • Eyes closed (30 seconds)

2. Dynamic Balance Testing

Gait Assessment

• Observe normal walking pattern
• Tandem walk assessment
• Turning evaluation
• Dual-task walking

Functional Reach Test

1. Position patient alongside wall
2. Measure maximum forward reach
3. Record displacement in centimeters

3. Vestibular Assessment

Head Impulse Test (HIT)

1. Rapid head rotation while fixating
2. Observe for corrective saccades

Dynamic Visual Acuity

• Assess visual acuity during head movement
• Compare to static acuity

Scoring and Documentation

Rating Scale

0 = Unable to perform 1 = Severe impairment 2 = Moderate impairment 3 = Mild impairment 4 = Normal performance

Documentation Requirements

• Test results for each component
• Observed abnormalities
• Fall risk assessment
• Recommendations for intervention

Safety Considerations

• Ensure proper spotting position
• Clear environment of hazards
• Have assistive device ready if needed
• Stop testing if patient reports dizziness