Nothing irks me more than global statements not based on fact or grounded in some sort of data. Within functional limits falls into this category. What exactly does that mean. Balance WITHIN FUNCTIONAL LIMITS? So a person falls? Never falls? Sometimes falls? It doesn't matter, when that person falls, they have fallen. How much balance do we need to have?
Balance is complex. Dynamical systems theory helps us to understand all the systems that interplay with balance eg vestibular, neuromuscular, strength, alertness, etc. I am in love with the Tinnetti lately (as I reread this I am feeling a Seekfreaks moment happening, in love, really? SO DRAMATIC). I had a very interesting case...I was evaluating a high school student with ID. As I was reviewing the report with the mother I stated, "and he is not at risk for falling". She said REALLY??? She didnt report falls at home but felt that he had poor balance. The student does not fall in school, but his gait is anything but steady. Very ataxic. Posturing of the hands. No falls, and no balance concerns from staff. I did the Tinnetti because he looked unsteady on stairs, and I had no other functional balance measure.
Seekfreaks has a lovely infographic on 9 balance tests for school based PTs. Use them. Be objective. Provide that data so that we can best support the kids we work with.
I am thinking I should do at least one of thesestandard measure for my older teens, because really, they all should be screened for balance problems, and balance problems can lead to safety issues. And doing a standardized balance measure is better than WFL...any day of the week.