Case studies

Below you will find a series of real-life case studies highlighting the many benefits of Balance Active®, both in residential care and in the home.

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A young adult

Anna is a 19 year old young adult with the Worster Drought syndrome form of cerebral palsy causing a visual impairment, epilepsy and learning disability. Anna’s condition affects her head, trunk and all 4 limbs with her right side more affected than the left. She has generalised low muscle tone and weakness, with restriction in her hip flexors, hamstrings, gastrocnemius and soleus muscles bilaterally. She is classified as GMFCS classification level IV and therefore she is able to walk independently in a supportive walking frame and complete standing transfers with the support of 1-2 adults.

Anna was referred back into the physiotherapy service by her parents in March 2021. This was following a period of time when she was unable to attend school and therefore was not accessing physiotherapy. Anna’s inability to attend school was in part due to covid and also because her previous school provision no longer met her needs (an alternative provision was being sourced).

The programme that was in place prior to recommencing structured physiotherapy included weekly hydrotherapy (non structured), weekly horse riding and daily use of her walking frame, regular use of her bike, and daily stretches/position changes.

A new therapy plan was developed to include twice weekly direct physiotherapy sessions (30-45 minutes) to address muscle imbalance, muscle weakness – to meet the criteria for NHS guidance 1 and 2.

It was agreed that twice weekly 30-45 minute sessions would be most effective for fatigue, compliance and concentration. As part of her therapy plan the balance active was used to work on standing balance, standing endurance and to support active standing transfers from a sitting position.

Balance Active was used within the 30-45 minutes, twice weekly sessions for 5-10 minutes per session. The progression over the 6 months was significant.

Motor function	Mar 2021	Sept 2021	Change
Section C-crawling and kneeling	7.1%	47.6%	+40.5%
Section D-Standing	10.2%	33.3%	+23%

The progress observed and measured is beyond any expectation held by the therapist or family. The additional input was a more formal hydrotherapy programme and twice weekly strength and balance based physiotherapy sessions using the balance active. The balance active allowed for activities to be completed which increased postural control, confidence, standing ability and standing endurance. Anna found using it fun and was motivated throughout. It gave her independence in standing without compromising her safety. There were times when she did have seizures when using it but the minimalist design ensured that she did not injure herself and she could be safely lowered into her chair behind.

View the full report (PDF)

Reduced risk of falls

Mrs BW is an 89 year lady with dementia who is a resident in a care home. She is mobile with one stick in a stooped position and is unsteady at times. Staff were concerned about her risk of falls. Due to Covid 19 there are no Physiotherapy or Occupational Therapy visits being undertaken in the care home at the moment.

Registered Nurses, trained in the use of Balance Active assessed BW and developed a plan that included some balance and strengthening exercises along with everyday tasks which she was able to do in standing. BW really enjoyed these and her posture and standing tolerance have improved.
The staff noted…

“BW is loving doing functional activities with Balance Active and she was laughing while doing it the other day. Without it she wouldn’t be able to stand and do this. We are now incorporating this into her care plan for daily activities. Look at her posture when exercising with me – it’s amazing! She normally walks around crouched and unstable. It’s definitely helping her physically and improving her mood”.

Without Balance Active Mrs BW wouldn’t have had any therapeutic intervention. Wellington House Nursing Home in Bradford are meeting residents needs in a very person centred way using this innovative product to improve not only mobility but quality of life.

Personalisation of care

Mr KM is a 98 year old man living in a nursing home. Prior to using Balance Active he washed his hands and face in sitting using a bowl brought to him at his bedside. KM said he really wanted to stand at the sink to wash his own face so Balance Active was used next to the sink to provide anterior knee support, allowing KM to stand. The front legs were removed to allow the unit to be positioned close to the sink and KM was transported in his wheelchair to the sink.

He was assisted into standing and can now use his upper limbs to wash his own hands and face. He was delighted to be able to see himself in the mirror carrying out normal personal activities. Use of Balance Active also promoted use of his lower limbs and trunk and ensured personalisation of care and dignity.

Quality of life

Mr TM is a 88 year old man living in a residential home. The care staff noticed that Mr TM was becoming more unsteady when walking and were concerned that he was at risk of falling. They asked if Balance Active could help him. A remote functional assessment was carried out and Mr TM was assessed undertaking prescribed exercises using Balance Active (under supervision of care staff).

He really enjoys these sessions and asks staff to get him the Balance Active – he now views this as part of his daily activity. Staff have been trained to safely supervise him so this form of activity is becoming the norm. Staff report his walking has improved, along with his mood – he is now aiming to visit the seaside (which the care home are trying to arrange). Use of Balance Active has given Mr TM wider goals and enhanced his quality of life.

Physiotherapy

JP is a 76 year woman who suffered a haemorrhagic stroke leading to right sided weakness several years ago. She made good progress with rehabilitation – she walks with a stick and drives an adapted car. Over time she noticed that her right leg felt stiff, particularly at the hip. This was affecting her ability to walk – she struggled to stand fully upright and found it difficult to take weight on her right leg, making her move more slowly and feel unsteady.

When assessed by her physiotherapist (Sheffield Neuro Physiotherapy) she was found to have right leg weakness and muscle shortening, particularly in her hip flexors, causing her difficulty taking weight through her right leg. As a result her balance was adversely affected (she was unsteady) and her walking ability starting to reduce – she was unsteady indoors and felt unsafe outdoors. Together they decided to try Balance Active as a means of improving her standing balance and walking. Balance Active enabled her to perform new exercises in her own home that help her stand upright, so her tight hip flexors are stretched and her weak hip extensors are recruited functionally and strengthened. Her physiotherapist said: “There is a real case for it reducing staffing requirements when delivering effective therapy as without Balance Active an extra pair of hands holding her knees would be needed”.

JP is able to practice on Balance Active for 15 minutes, twice a day including symmetrical and asymmetrical standing, upper limb stretches, rotations, loosening up her thoracic and lumber spine and unilateral reaching. Her physiotherapist noted: “She’s improved in her balance, her range of motion, her awareness of her legs, her walking is measurably faster, stepping, foot placement, hip and knee placement have improved. She feels an especially big difference in her hip – it is less stiff. She can’t wait to keep doing more of the same – she is really enjoying he therapy!”

JP was asked I where she’d be if she didn’t have Balance Active over the past three months: “My walking would be worse, I’ve done similar exercises on a stander and it doesn’t open up the front of my hips in the same way. I’m able to walk both indoors and in the surrounding countryside”.

Falls Conference presentation

We were asked (at very short notice) to present to a recent Falls Conference. The video provides an introduction to Balance Active, along with details on the product design, functionality, application and assembly.

Functional Improvement

Ms M is an 80 year old female who presented with reduced mobility and balance problems. She has fallen in the past and mobilised with furniture indoors and a wheeled walker outdoors. She has a medical history of mild spinal stenosis, bronchiectasis, and kyphoscoliosis. Ms M lives in a ground floor flat with her husband. She had to steady herself with upper limbs in order to prepare food, drink, wash and dress. She struggled to transport items from the kitchen. She unconsciously accommodated to her balance deficits and felt she was getting old, which troubled her. Ms M agreed to try Balance Active. She received prescribed balance exercises, 3x per week for 10-15 minutes per session on Balance Active .

Before Balance Active ®:

Unable to walk unaided
Unable to walk and carry
Fear of Falling = Moderate concern (Short FES-I)
180 turn = 6 steps
Flexed posture

After Balance Active ®:

Able to walk independently indoors
Able to walk and carry from kitchen to living room
Fear of Falling = Low concern (Short FES-I)
180 turn = 4 steps with no light touch
Upright posture

Ms M said “This is life changing! My walking outside has improved so I can go to all over the place now and I’ve had fewer chest infections”.