Ensuring your loved ones’ safety doesn’t hang in the balance

Imagine this: You have lots of confidence in your ability to stand on a chair and reach into a cabinet without falling. Now, imagine being even a little bit too confident in that ability.

You could be pretty dangerous, according to Dr. Susan Robinson.

“That’s the person who really has a great risk for falling and injury,” she said.

The perfect thing is the person who has appropriate confidence in their balance and actual abilities.

Robinson, a professor of physical therapy, focuses her research on a variety of areas within the field.

She looks for ways to prevent falls in older adults. Robinson’s also partnering on several projects that examine balance and gait of individuals with vestibular dysfunction, Parkinson’s disease and a variety of other mobility impairments.

Robinson has published 20 articles and abstracts on balance- or rehabilitation-related topics and presented at more than 15 conferences.

Her research includes helping injured musicians who play string instruments get back to performing. She’s also helped people find technology that improves their gait. But helping people improve their balance – and ultimately their safety – is where her work really shines.

Dr. Susan Robinson working with a patient

Dr. Susan Robinson fits a patient in a harness for the Bertec Balance Advantage, which uses virtual reality to measure balance. Photo by Kevin White

Stopping expensive accidents before they happen

The vestibular system is part of the inner-ear system.  It works with your vision and proprioception, or awareness of body position, to maintain your balance.

If a person loses some of the information provided by these three systems, it can lead to falls. That can lead to expensive stays in hospitals due to hip fractures or other injuries.

According to the Centers for Disease Control and Prevention (CDC), falls cost Medicare more than $31 billion in 2015. The average hospital cost for fall-related injuries is more than $30,000 and the estimated lifetime cost of a hip fracture is more than $80,000.

It’s so valuable if you can see that someone’s at risk for falling and do something to intervene. You can prevent a fall and a hip fracture, which costs the health system an incredible amount.

Robinson and Dr. Jason Shaw, an assistant professor of physical therapy, took their show on the road to help people improve their balance.

For the past eight years, Robinson, other MSU physical therapy faculty members, and MSU physical therapy students have participated in a nationwide annual Fall Prevention Awareness Day at local senior citizen centers and independent living facilities in the Springfield area. One stop led to an interesting discovery.

“I looked over, and Dr. Shaw had the physical therapy student holding onto the gait belt while guarding the person being tested,” Robinson said, noting that caregivers place a gait belt on patients with balance or mobility issues as they transfer from one location or position to another. “I told him, ‘Don’t let them hold the gait belt. That’ll change the score.’ And he says, ‘I don’t think it’ll change the score.’” 

They performed the gait assessment with hands-on and off the gait belt.  

In this study, participants’ perceptions of their balance and actual balance scores agreed. There was not a significant difference between Shaw guarding the person while holding and not holding onto the gait belt.

“Her work could have a profound effect on patient safety when testing balance,” Shaw said.

Dr. Susan Robinson listening to patient

Using technology, like the Bioness system, Dr. Susan Robinson has seen great improvements in those with impaired gait. Photo by Kevin White

What lies ahead

The meaning of the project is significant. As a result, it warrants further study, Robinson said. She and Shaw will take the experiment further.

They want to know if there’s a difference in balance scoring between guarding by a physical therapist with Shaw’s expertise, and a physical therapy student doing the same.

“When you’re a physical therapist in a clinic and don’t know a patient’s abilities, you’re going to be safer if you have a hand on the gait belt while guarding a patient,” Robinson said. “But you don’t want to change their score, so I think that’s really an interesting project.”


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