Below are some shares concerning Bilateral Scales .. scrool to the bottom for another opinion: This is a share from Dr. Williamson questions reply to: dlwilliamson@mindspring.com Using Bilateral Scales Sears has high-tech scales ... electronic with pressure transducers on all four corners .. life-time lithium batteries ... $55. Same innards as those being sold to DC's for twice the price (or more). Tip: when you buy them, try several while in the store. Put each scale in exactly the same place on the floor ... weigh yourself ... make sure you get two that give you the same weight within a 1 pound tolerance (you'll find this difference with any model of scale that is not a laboratory grade instrument selling for over $500 per scale). This is another share from Dr. Williamson I have had a number of questions about scales since sending you the information about scales available at Sears. Here are a couple of clinically oriendt responses I have made ... you may wish to post them. If subluxation is a major problem and you are able to corrrect it to a significant degree, then you will typically see a better balance. Understand what you are doing with bilateral weight measurement. Visualize the upright body as an upside-down pendulum. The pendulum constantly swings ... not just left-right but also front-back. In a body with normally controlled equilibrium, the swings of the pendulum will be small. In a body that is losing proper control of balance, the swings will be larger. At the moment that the scales lock the readings, you have taken a "snap-shot" of balance at that instant ... but you don't know if it was at the extreme of a swing of the pendulum, the center, or somewhere in between. Thus, you need to take several readings to get a better picture of the equilibrium dynamics of the body under observation. Factors that can be involved are CNS, PNS, pathology of the vestibular apparatus, functional or actual muscle pathology, pathological and/or degenerative structural change in the spine, etc. Some of these things are correctible via spinal adjustment ... some are not. If people have a problem you cannot correct, they appreciate your being honest with them. Objective measurements give you a means of telling a patient something like, "This part of your problem has responded well, this one has not. So, Mr. Jones, you may be feeling better at the moment, but it is important for you to realize that you have an underlying problem that has not fully resolved. Because you've responded well symptomatically, we can help you manage the problem in the future." There are conditions in many bodies that have become permanent or done permanent damage ... don't take responsibility for that. Many (maybe even most) patients want to blame you for not performing a miracle ... even though a neurosurgeon may tell them that they are beyond repair. Objective tests help you focus your patients on reality. A substantial portion of nervous system activity is devoted to maintaining balance and equilibrium. There are many inuts to the equilibrium system. For instance, the vestibular system, input from cervical joint capsules, visual input, cerebellar outflow, and structural distortion of the spine from various causes. Visualize the upright biped as an upside pendulum. We are never at rest. We are not normally aware of this, but try standing on one foot for 60 seconds and focus your awareness on the lower leg muscles as you maintain balance. Close your eyes and note how the effort increases. A pendulum swings. Even on 2 legs, you swing back and forth, front and back, and all combinations. When everything is "normal", the swings are small. When things are not normal, the swings are large, and they may be predominantly to one side or the other. With bilateral weight scales you must "lock in" the reading at some point since the body is in constant motion. Clearly, when you "lock in" the reading, you have taken a "snapshot" of body balance at that particular instant. However, that one snapshot is not the true representation of what the body is doing since it is always in motion. Thus, to get a better idea of what a body is doing, you must take several "snapshots" --- 3 is better than 1, 20 is better than 3, etc. In practice, 3 to 5 measurements gives you a fairly good idea of body balance. Correlate that info with other examination information from examination and x-ray. For instance, is there an uncompensated scoliosis, pelvic distortion, translation of the head or torso, etc.? Is the overall spine normally compliant, "mushy", stiff, or absolutely rigid? We could go on for quite a while like this. The point is that bilateral weight balance gives a "gross" picture of the nervous system's ability to control the body. Abnormalities in balance place greater stress on the structure of the body ... important information if it is true that structural distress causes other functional abnormalities. Remember that unresolved structural stress eventually causes pathology. If you measure bilateral balance initially and then again monthly throughout your treatment plan, you gain valuable information. If body balance has not improved significantly in 2 or 3 months, then you must ask some questions: 1. Is this body beyond repair? If not, how much can it return to normal? 2. Is what I am doing really helping this patient? If not, what do I do next? 3. A hundred more similar questions. The value of bilateral weight measurements is that they are a dynamic overview of nervous system control and/or the effect of pathological structural distortion. The measurements can become predictive (prognosis). It is an effective, simple, and inexpensive way to help monitor progress. Just remember that you can't take just 1 snapshot and get a true picture of the "reality" of that body. I have a patient who owns a "frame straightening" auto shop. He straightens frames of cars that have been in wrecks. He told me that in some cases the distortion is so extreme that you can only get it back to "bent" ... you can't get it "straight". That's also true of the human body. This is another opinion from Dr. Harman: I disagree with using the electronic scales for bilateral weight checks. First they cost more. Second, they "lock" the reading at some point. Best if you can see what's happening in real time as the amount of sway a person has may give you some information about upper cervical function. Never add or subtract more than 3 mm at a time in heel lifts, give them 2 weeks to adapt. Try adding a wedge under the heel of the heavy (presumed short leg side) and if they get even heavier (paradoxical movement) leave them alone. They have compensated and adding a heel lift may make them worse. R. Dean Harman, DC (RdeanH@aol.com) San Mateo CA 650-571-1122