Balance and Vestibular Deficits
Anyone who has ever slipped on a patch of ice knows how unnerving it can be to lose your balance - for a moment your world is turned upside down. Yet balance - the ability to control and maintain your body's position as it moves through space - is such an integral, ever present part of daily life, that most people rarely give it conscious thought. There are conditions that may impair your sense of balance, cause dizziness and contribute to falls. The effects of aging are the most common cause of balance problems. Every year, one-third to one -half of the popluation 65 and over experience falls. Balance related falls account for up to 75% of ER visits and more than one-half of the accidental deaths in people over 65. Each year nearly 8 million people in the U.S. visit their doctor due to complaints of dizziness and disequilibrium (difficulty with balance). Over 70% of the nation's population will be affected by dizziness during some point of their lives.
Symptoms often used to describe dizziness include vertigo (room spinning); lightheadedness; foggy, fuzzy, groggy or woozy sensation in the head.
Disequilibrium includes imbalance, unsteadiness, staggering, stumbling, veering or lack of "sure footedness", and falls.
How Balance Works
Balance perception and control relies on three types of sensory information:
- visual (eyes)
- vestibular (inner ear - vestibular portion)
- somatosensory (nerves providing sensory and positional input from the extremities and spine)
The eyes tell your brain about your environment and your place within it. They help you sense (see) obstacles and potential dangers and build motor memories.
The inner ear has specialized sensory organs that provides the brain with information concerning linear and rotational movement of the body even when your eyes are closed.
The somatosensory system allows you to move your feet and legs (as well as the rest of the body) and know where that body part is positioned, even if you can't see it.
When all of these systems are working properly, they work with your musculoskelectal system to keep you mobile and prevent falls. However, a problem with any of these three systems may result in difficulty with balance and or dizziness.
Identifying and Correcting the Problem
Some balance problems can be improved simply with stretching, strengthening and balance execises involving the trunk and lower extremities. Other problems causing difficulty with dizziness and balance (up to 85% of all cases) may require a more specialized treatment referred to as Vestibular Rehabilitation. Changes to the inner ear as well as how the brain processes balance information may result from natural aging processess, illness causing infection/inflammation, mild to serious head trauma, decrease blood flow (stroke), or various neurological diseases (i.e. Parkinson's and Multiple Sclerosis) affecting dizziness and balance. Exposure to certain drugs, alcohol, high doses or long-term usage of certain antibiotics (Gentamycin and Vancomycin) can cause temporary or permanent changes to the inner ear. Some causes of dizziness can also cause difficulty with vision, nausea, motion sickness, increased sensitivity to noise and bright lights, headache, and neck pain.
Vestibular Rehabiltiation involves symptom-specific positioning techniques and exercises designed to decrease dizziness and improve balance function. Treatment is customized for each patient and may last from as little as 1 - 2 visits or with more complex problems may require 1 -3 visits weekly for several weeks. Compliance with home exercise instruction is very important to achieve a successful outcome.
According to the National Institute of Health, 90% of all causes of dizziness can be found after a thorough evaluation. The Physical Therapist at New Horizons Physical Therapy are trained and experienced in performing comprehensive evaluations and treatment for a variety of balance and vestibular disorders. These disorders include but are not limited to:
- BPPV (benign paroxysmal positional vertigo)
- Vestibular Neuritis
- Neuronitis
- Labyrinthitis
- "Stable" Meniere's Disease
- Post Inner Ear Surgery
- Head Trauma
- Stroke
- Multiple Sclerosis
- Parkinson's Disease
- Peripheral Neuropathy (diabetes, nerve injury)
- Cervicogenic
- Visual Deficits
- Proprioceptive (position sense) Deficits
- Strength Deficits
