Patients with balance disorders/postural instability may be suffering from ealry parkinsonism: Reporting them to neurologist is moral responsibility of physiotherapist.

Those patients who complaining with balance and postural disability and frequent fall can be a case early Parkinson. Although this patient shows good strength in antigravity group of muscles, normal sensations still they feel unstable, postural instability & poor balance and frequent falls.
So in these patients this postural instability and poor balance can’t be explained in this patients & many a time regular strengthening & balance training doesn’t help.
So the probable cause is early Parkinsonism (GRADE I, unilateral involvement). As a therapist we spend more time with these patients. We are the people who notice these problems during balance training of these Patients. So it is physiotherapist’s moral responsibility to evaluate these patients on the guidelines of extra pyramidal disorders/parkinsonism and refer these patients to neurologist and report your finding. In these patients therapy alone doesn’t give optimum results we require the medical management to control extra pyramidal symptoms.
Common complains of these patients are-
1. Postural instability
2. Slowness of movement
3. Weakness of one side of body
4. Leaning toward one side.
5. Stiffness & rigidity