B.Sc. Robynne Smith

Physical and Vestibular Therapist
at Lifemark Health Centre, Canada

I have been a physiotherapist for 30 years and a clinic owner for six of these years. My work experience includes pediatrics, neurological rehabilitation, orthopedics, osteoporosis/arthritis and vestibular rehabilitation. My experience in pediatrics gave me the background in understanding the vestibular system, in particular in children with cerebral palsy, as they have limited movement. Treatment activities included moving the children on swings, therapy balls or scooters to help develop their sense of motion and balance.

Over the past sixteen years I have specialized in vestibular rehabilitation. I was looking for a way to provide an objective measure of balance, so that we don’t rely only on clinical results that can have a subjective bias through the use of semi-descriptive words (mild, moderate of severe sway) or by using time as a reference for balance. I began working with an old computerized posturography unit resurrected from storage in one of the hospitals.

Seven years ago I heard of a smaller and newer system, Tetrax and purchased one.

My father was one of the first people I assessed on Tetrax. At the time he was 82 and having difficulties with his balance and falling often, but did not have a diagnosis. The developer of Tetrax, Prof. Kohen-Raz, was able to interpret the finding, which identified a neurological condition. Based on this we sought further medical investigations and he was diagnosed with Parkinson’s Disease and was given medications which helped his balance.

To date, I’ve used Tetrax on close to 700 clients, mainly for diagnosis and baseline measurement. The assessment analysis shown in the reports indicates the sensory system(s) that are involved in the imbalance, if present. Tetrax is unique as it analyzes sway according to frequency of motion, and thereby can indicate if there is a visual, vestibular, somatosensory or neurological cause for the imbalance, as well as how the head/neck position can affect balance. In most cases, the Tetrax results match the clinical testing.

Tetrax is an excellent device to help discern if neck issues are contributing to the balance problem. In my experience in treating people with dizziness and balance concerns, the neck is a crucial area to be addressed. Tetrax is unique in it’s ability to test people while standing with the head bent forward, looking up or turned in either direction.

Tetrax can show how two or more sensory systems can be involved in the imbalance. The causes of imbalance and falls are usually multifactorial. For example, Tetrax can show if the vestibular system and neck and perhaps a neurological component are present.

Tetrax is a very sensitive device for measuring sway or imbalance. Very small corrections in balance by the client are detected which may not be detected when visually watching the balance. When re-evaluating balance on the same person at a later date, the sensitivity of Tetrax also allows for the comparison of improvement or regression to be seen even with small increments of change.

Tetrax is one of the best investments I’ve made for my clinic.