Are You Headed for a Fall?

1. Have you fallen more than once in the past year? Yes Or No
   
   
2. Do you take 4 or more medications? Yes or No
   
   
3. Do you feel dizzy or unsteady if you make sudden changes in movement such as bending down or quickly turning? Yes or No
   
   
4. Do you have a fear of falling? Yes or No
   
   
5. Have you experienced a stroke or other neurological problem that has affected your balance? Yes or No
   
   
6. Do you experience numbness or loss of sensation in your legs and/or feet? Yes or No
   
   
7. Do you use a walker or wheel chair, or do you need assistance to get around? Yes or No
   
   
8. Are you inactive? (Answer yes if you do not participate in a regular form of exercise, such as walking or exercising 20-30 minutes at least three times a week.) Yes or No
   
   
9. Do you feel unsteady when you are walking, climbing stairs? Yes or No
   
   
10. Do you have difficulty sitting down or rising from a seated or lying position? Yes or No
    
    

      If you answered "yes" to one or more of the questions, you could be at risk.
      The best way to determine if you have a problem is to talk with your
      physician who might recommend that you get a balance screening test from
      a qualified clinician.
    

      For more information, you may also contact 360° Balance at 512-345-4664
      or by e-mail at questions@360balance.com