Consumer Information: Balance & Falls
Falls among the elderly are prevalent, dangerous, and can diminish their ability to lead an active and independent life. About one in three seniors above age 65, and nearly one in two seniors over age 80, will fall at least once this year, many times with disastrous consequences. Physical therapists can help prevent falls with evaluation and development of individualized treatment plans including exercises to improve strength, mobility, and balance.
Once a physical therapist has reviewed your medical history and completed a thorough examination, he or she will design an individualized program of exercises and functional activities for you. This program may focus on strength, flexibility, balance, coordination, and walking.
If necessary, the physical therapist will refer you to other medical professionals, such as an ophthalmologist or neurologist.
How Does the Balance System Work
Shannon L.G. Hoffman, PT, DPT
Your sense of balance comes from many different systems working together to create stability of your body and your vision. Good balance depends on correct sensory information, proper use of that information by the brain, and the right response from the muscles. The sensory information that is needed comes from your visual, somatosensory, and vestibular systems:
- Visual system: Your vision provides important information to the brain about your environment, specifically where your body is in relation to the horizon while still or moving.
- Somatosensory system: You have special sensors sensitive to stretch, pressure, vibration, and touch in your muscles, tendons, joints, and skin that help your brain to know how your body is positioned.
- Vestibular system: Balance organs in the inner ear tell the brain about the movements and position of your head. This system senses head movement and keeps your eyes focused. It can also tell the brain when your head is moving in a straight line (like when you are riding in a car or going up or down in an elevator) and sense the position of your head even when it is still (if it is upright or tilted).
Putting it all together
Information about your current state from all of these systems travels to the brain stem. The brain stem also gets information from other parts of the brain, mostly about previous experiences that affect your sense of balance. Your brain can control balance by using the information that is most important for a particular situation.
For example, in the dark, when the information from your eyes is reduced or might not be accurate, your brain will use more information from your legs and your inner ear. If you are walking on a sandy beach during the day, the information coming from your legs and feet will be less reliable and your brain will use information from your visual and vestibular systems more.
Once your brain stem sorts out all of this information, it sends messages to the eyes and other parts of your body to move in a way that will help you keep your balance and have clear vision while you are moving.
How a Physical Therapist can Help
If you feel dizzy, off balance, or have fallen, a physical therapist can help to determine how well you are using these systems (or not) to keep your balance. The physical therapist may instruct you in specific exercises that address the problem and improve how your body uses all these systems together.