How does the Balance System Work?

What are the symptoms of a balance disorder?

Who should have a balance screening?

What is Dizziness?

What is Vertigo?

What is Vestibular Rehabilitation?

What are causes of a Balance Disorder?

How common is dizziness and imbalance?

Why am I having balance problems /and or dizziness?

What other symptoms are commonly seen with vestibular disorders?

What is Vestibular Rehabilitation?

I’m not dizzy and just have balance problems, will I still benefit from therapy?

What are some of the risk factors for falls?

What other neurological conditions may benefit from balance rehabilitation and fall prevention?

How does the Balance System Work?

Movement of fluid in the semicircular canals signals the brain about the direction and speed of rotation of the head--for example, whether we are nodding our head up and down or looking from right to left. Each semicircular canal has a bulbed end, or enlarged portion, that contains hair cells. Rotation of the head causes a flow of fluid, which in turn causes displacement of the top portion of the hair cells that are embedded in the jelly-like cupula. Two other organs that are part of the vestibular system are the utricle and saccule. These are called the otolithic organs and are responsible for detecting linear acceleration, or movement in a straight line. The hair cells of the otolithic organs are blanketed with a jelly-like layer studded with tiny calcium stones called otoconia. When the head is tilted or the body position is changed with respect to gravity, the displacement of the stones causes the hair cells to bend.

The balance system works with the visual and skeletal systems (the muscles and joints and their sensors) to maintain orientation or balance. For example, visual signals are sent to the brain about the body's position in relation to its surroundings. These signals are processed by the brain, and compared to information from the vestibular and the skeletal systems. An example of interaction between the visual and vestibular systems is called the vestibular-ocular reflex. The nystagmus (an involuntary rhythmic eye movement) that occurs when a person is spun around and then suddenly stops is an example of a vestibular-ocular reflex.

What are the symptoms of a balance disorder?

When balance is impaired, an individual has difficulty maintaining orientation. For example, an individual may experience the "room spinning" and may not be able to walk without staggering, or may not even be able to arise. Some of the symptoms a person with a balance disorder may experience are:

• A sensation of dizziness or vertigo (spinning).
• Falling or a feeling of falling.
• Lightheadedness or feeling woozy.
• Visual blurring.
• Disorientation.
• Some individuals may also experience nausea and vomiting, diarrhea, faintness, changes in heart rate and blood pressure, fear, anxiety, or panic. Some reactions to the symptoms are fatigue, depression, and decreased concentration. The symptoms may appear and disappear over short time periods or may last for a longer period of time.
  

What causes a balance disorder?

Who should have a balance screening?

Anyone who has a history of falling, Anyone 55 years of age or older, Anyone who complains of dizziness, Anyone expressing a fear of falling, Anyone 50 years of age or older who; Is having difficulty adjusting to wearing new glasses, especially bifocals. Has deteriorating hearing or previously undiagnosed hearing loss which requires treatment or hearing device.

What is Dizziness?

Dizziness is defined as a feeling of being woozy, drunk, unsteady, or giddy. It is a general term used to describe the sensation of imbalance.

What is Vertigo?

Vertigo refers to an hallucination of motion, and is often described as a spinning sensation. It usually implies a disorder of the inner ear.

What is Vestibular Rehabilitation?

Vestibular rehabilitation involves special exercises to help a patient with a balance disorder adjust (accommodate) to the balance problem so as to diminish recurrent symptoms.

What are causes of a Balance Disorder?

Some common causesof a balance disorder are: Infections (viral or bacterial), head injury, disorders of blood circulation affecting the inner ear or brain, certain medications, and aging may change our balance system and result in a balance problem. Individuals who have illnesses, brain disorders, or injuries of the visual or skeletal systems, such as eye muscle imbalance and arthritis, may also experience balance difficulties. A conflict of signals to the brain about the sensation of movement can cause motion sickness (for instance, when an individual tries to read while riding in a car). Some symptoms of motion sickness are dizziness, sweating, nausea, vomiting, and generalized discomfort. Balance disorders can be due to problems in any of four areas:

How common is dizziness and imbalance?

Dizziness occurs in approximately 30 percent of the elderly. Every year, one-half of the population age 65 and over experience falls.

Why am I having balance problems /and or dizziness?

In order to maintain balance we use three sensory systems that send information to our brain: Inner Ear: vestibular system Somatosensory: sensation through our joints and feet. Vision The Brain integrates the information sent by these three sensory systems and sends the correct motor command to our muscles so that we are able to maintain balance. People who complain of dizziness and/or disequilibrium may have problems with one or more of these sensory systems. In a large percentage of cases, balance problems and/or dizziness are caused by the vestibular system of the inner ear.

What other symptoms are commonly seen with vestibular disorders?

Vertigo is commonly present with vestibular disorders; it is properly defined as an illusion of movement of oneself or one’s surroundings. In addition disequilibrium, oscillopsia (jumpy vision), nausea, headaches, muscle tension, fatigue, and impaired memory and/or concentration may also be present. Central Nervous System (brain and spinal cord) problems resulting from stroke, head injury, and concussion often present with similar complaints.

What is Vestibular Rehabilitation?

Vestibular rehabilitation is an exercise program designed by specially trained therapists to help reduce or eliminate symptoms of dizziness and help compensate for loss of balance within the vestibular system.

I’m not dizzy and just have balance problems, will I still benefit from therapy?

Many patients are referred to vestibular/balance rehabilitation for: Fall prevention/education Unsteady gait, weakness Home safety assessment Use of appropriate assistive device AFO stabilization

What are some of the risk factors for falls?

Falls may result from multiple causes including: medications, cluttered home, poor lighting, lower extremity weakness, arthritis/joint pain, slippery shoes, inconsistent usage of assistive devices for walking, poor vision, decreased sensation in the feet, and/or inner ear weakness.

What other neurological conditions may benefit from balance rehabilitation and fall prevention?

Patients with Parkinson’s and multiple sclerosis will benefit from therapy to maximize their level of function, educate with fall prevention in the home and community, use of appropriate walking aide.