Comprehensive Treatment is the Key to Success
Treatment for balance disturbances begins with a comprehensive Balance/Vestibular Evaluation. An extensive, individualized assessment is used to determine the cause(s) of decreased balance and increased risk of falling. Posture, balance, strength, coordination and function are addressed. Because there are many causes for impaired balance, the treatment can differ from patient to patient depending on the Physical Therapy test results.
Balanced is in a way our sixth sense and can be improved with practice and repetition. We all remember what it was like as a child to ride our bicycles for the first time without training wheels. The whole process was scary at first ; but with practice, we learned to distribute our weight and maintain our center of gravity over the bicycle. Soon maintaining our balance on our bicycle was second nature: an automatic reflex.
The same process happens in a patient recovering from a stroke learning to walk again. An individualized program for each patient is designed to include ambulation training and a variety of exercised for strength, flexibility, mobility, balance and gaze stabilization. Dealing with balance challenges with close supervision by the Physical Therapist will help the patient negotiate various environments, such as areas with curbs, uneven surfaces, dim lighting conditions, and changes in direction. Our approach at New Stride Physical Therapy gives the patients the tools to regain control of their lives, rebuild self esteem and prevent falls.
What is Balance?
- Balance is defined as maintaining the center of gravity over the center of mass.
- Balance depends on the central nervous system and our ability to integrate input from the inner ear (vestibular system), eyes, muscles and sensation of the lower extremities.
- Our body receives this neurological information from our environment;t and using righting and equilibrium reactions to maintain control.
- Righting reactions and equilibrium reactions help us to make the appropriate postural adjustments and maintain good postural alignment.
What is the Vestibular System?
The vestibular system begins forming within twenty-four hours of embryonic formation. It is the system of balance and consists of five distinct end organs: 3 semicircular canals that are sensitive to angular accelerations (head rotations) and two otolith organs (the utricle and the cupula) that are sensitive to linear (or straight-line) accelerations. Vertigo is a feeling of movement, including spinning. Benign paroxysmal positional vertigo (BPPV) happens when the position of the head is changed. This might include standing after bending down, turning the head in bed, or extending the neck to look up. People with BPPV can often identify which movements cause the most problems.
BPPV is diagnosed by the Physical Therapist using the Hallpike Test. The Hallpike Test will tell the Physical Therapist if the inner ear is being over stimulated by calcium bicarbonate particles in the semicircular canals. The Epley Maneuver is a maneuver used to treat benign paroxysmal positional vertigo (BPPV) of the posterior or anterior canals. It works by repositioning particles from the affected semicircular canal to be relocated, using gravity, back into the utricle, where they can no longer stimulate the cupula, therefore relieving the patient of bothersome vertigo.
What Causes Balance Disturbances?
- Vestibular and inner ear disorders
- Neurological problems such as stroke or head injury
- Orthopedic injuries or procedures such as spine injuries or total joint replacement
- Medication may cause dizziness or disequilibrium
- Decreased strength and flexibility secondary to inactivity
Patients who are afraid of falling tend to become inactive; the inactivity causes de-conditioning and further loss of balance. Therefore better balance equals better health. Human beings were not built to be sedentary, static organism. Our bodies are healthiest when in motion. Inactivity does not only cause muscle weakness but also causes a decline in cardiovascular health and loss of bone mass.
Common Complaints of Patients with Balance Disorders
- Feelings of dizziness, unsteadiness, vertigo
- Loss of balance
- Confusion in crowds
- Feeling of light-headedness or nausea
- Trouble reading
- Fear of falling
- Tendency to stumble or fall easily
Each year 1/3 of adults over age 65 experience dizziness, balance problems or falls. These adults become inactive and weak. Resistive exercise and weight-bearing activities such as walking, keeps our bones healthy and muscles responsive. If you are a women, this is especially important because 50% of post menopausal women will suffer from osteoporosis. Patients with osteoporosis are susceptible to fractures and much more likely to fracture a hip with a fall. Falls and hip fractures are the leading cause of injury and death in older adults.
The Good News: Physical Therapy Can Help!
Falls are not inevitable. Loss of balance is not a fact of life as we get older. Loss of flexibility and strength are largely due to inactivity. Imbalance is usually caused by several problems, not solely due to age. Proper evaluation can detect specific balance problems and risk for falls. Focused exercise can improve balance activities. Vestibular disorders are responsible for over 50% of patients’ complaints of dizziness and are treatable in Physical Therapy.
If you suffer from a balance problem or know someone who has vertigo; we can help. Our Certified Vestibular Physical Therapist brings immediate results in one to two treatments. Unless you have an unusual complex condition, a good Physical Therapist will bring fast improvement. Be wary of a facility that uses passive treatment such as heat or ice. This should never be the main part of you program for balance, mobility, and fall prevention.
