Balance dysfunction is a common cause of falls in an aging population, which makes physical therapy intervention vital to prevent injury. Understanding the true cause of disequilibrium, or imbalance, is important for treatment.
There are three different systems that control balance: vision, proprioception, and the vestibular system. Visual feedback provides an image of one’s environment; decreased visual feedback can disrupt balance due to a lack of awareness of the environment. Proprioception is the perception of spacial orientation, or where one’s body is in space. A decrease in proprioceptive feedback can distort an individual’s ability to negotiate changing surfaces. The vestibular system provides a perception of motion and orientation in relation to gravity, as well as controls eye movement to permit a clear visual image of surroundings (Walter). Vestibular dysfunction from various causes can elicit a variety of symptoms including vertigo (dizziness), nausea, headache, imbalance, tinnitus (ringing in the ears), and visual disturbances.
The good news: physical therapy can help! Depending on the cause of symptoms, a general balance / strengthening program may be permitted for essential fall prevention. If symptoms are more vestibular / vertiginous in nature, vestibular rehabilitation may be warranted. Vestibular rehabilitation typically incorporates balance training and adaptation or habituation of activities that are symptom producing or magnifying. Balance and vestibular rehabilitation can be valuable and provide a substantial impact on one’s life with regard to fall prevention.
Lori Hooker, DPT
References: Jeff Walter, PT, DPT, NCS (Vestibular Rehabilitation Therapy: Practical Management of the Patient with Dizziness and Balance Dysfunction)