Balance Disorders: How Therapy Can Prevent Falls
Enjoying good balance is the result of three body systems working together:
- Visual system (eyes)
- Vestibular system (ears)
- Proprioception (awareness of one’s own posture, movement and relative position of neighboring parts of the body, or the sensation that you feel under your feet when you are standing)
If there is a disruption in any of these systems, balance problems may occur.
Why Balance Is Important
Good balance enables people to walk without staggering, climb stairs without tripping, and bend over or get up from a chair without falling. The greatest risk associated with balance problems is falling and fall-related injuries such as hip fractures. Early prevention such as balance therapy helps promote independence. Without prevention efforts, about one third of people aged 65 or older typically fall once or more each year.
Types of Balance Disorders
There are three main types of balance problems: vertigo, presyncope and disequilibrium.
Vertigo is a sense of spinning. It may feel like the room is spinning around you. One of the most common types of vertigo is benign paroxysmal positional vertigo, or BPPV, which causes brief, intense spinning feelings when the position of the head is changed. The reason it occurs is because small calcium particles in the inner ear become displaced and hit the inner ear balance sensors, causing dizziness. The cause is unknown but may be an inner ear infection, head injury, or aging (it is most common in adults aged 60 and over).
Other conditions that cause vertigo include migraine headache, motion sickness, Meniere’s disease, head injury, and a number of conditions in the ear (inflammation, a benign tumor or a herpes zoster infection). Symptoms associated with these conditions include intermittent hearing loss, buzzing or ringing in the ear, nausea and, of course, loss of balance.
Presyncope is a feeling of lightheadedness or feeling faint. This type of dizziness can be caused by a significant drop in blood pressure when standing up too quickly from sitting, called orthostatic hypotension. Other causes of presyncope inlcude cardiovascular diseases that reduce blood flow, such as abnormal heart rhythms (arrhythmias) or narrowed or blocked blood vessels.
Disequilibrium is the sensation of being off balance, and is most often characterized by frequent falls in a specific direction. This often causes unsteadiness when walking. Causes of disequilibrium include vision problems, inner ear problems (vestibular), weak muscles or unstable joints, or conditions such as Parkinson’s disease. Disequilibrium may also be a side effect of some medications.