HOW YOU CONTROL YOUR BALANCE
Balance is vital to normal every day life activities such as getting out of a
chair and walking, bending over to put your shoes on, washing your hair,
driving a car or going grocery shopping. Just about everything you do in your
daily life, whether for work or leisure requires balance control, and most of
the time you don't have to think about it. If balance problems develop, though,
they can cause profound disruptions in your daily life. In addition to
increased risk for falls, balance disorders can shorten your attention span,
disrupt normal sleep patterns, and/or cause excessive fatigue.
The balance control process
Ability to maintain balance is a complex process that depends on three major
components: (1) your sensory systems for accurate information about your body's
position relative to your environment; (2) your brain's ability to process this
information; and (3) your muscles and joints for coordinating the movements
required to maintain balance. The sensory systems include your sense of touch
(feet, ankles, joints), your vision and your inner ear motion sensors. For
example, we rely on our feet and joints to tell us if the surface we are
standing on is uneven or moving. We rely on our eyes to tell us if the
environment around us is moving or still. And we rely on our inner ears to tell
us if we are upright or leaning, or standing still or moving.
Normally, balance control is accomplished "automatically" without requiring our
conscious attention. When our balance "auto pilot" is disrupted, we have to
exert intense conscious effort to try to overcome the abnormal sensations and
maintain control of our balance. This intense effort, in turn, is what leads to
the common secondary symptoms such as shortened attention span and fatigue.
Loss of balance control
In a normal healthy individual our senses of touch (feet, ankles, joints),
sight (eyes) and inner ear motion sensors work together in harmony with the
brain. A person with a balance disorder, however, may have a problem in any one
of these systems, or in multiple systems. In some individuals, one or more of
the senses are missing and the person does not realize they are losing their
balance. In other people, the brain gets confused and creates an inaccurate
sense of falling when in fact the person is in balance. The risk of developing
one or more of these problems increases with age as our senses or brain centers
are exposed to degenerative or infectious diseases, or the effects of injuries
accumulated over a lifetime.
Inevitable?
Is a loss of balance control an inevitable consequence of aging? No. The
natural aging process produces changes in our bodies as we grow older, but
these changes do not necessarily result in a loss of balance control or
mobility. Healthy seniors are quite able to perform daily life activities
normally with few physical limitations. In fact, recent studies have indicated
that, elderly fallers are different from their healthy, age-matched
counterparts1,2,3. Dizziness among older adults can also be caused by a
collection of subtle degenerative or infectious processes or injuries that in
combination result in a balance problem4.
Some individuals experiencing balance problems have an obvious
medical diagnosis such as diabetes, Parkinson's disease, or even a stroke that
are primary sources of the problem. In other individuals with balance
difficulties, the cause can even be subtle undetected forms of these diseases.
However, diseases are not the only reason our senses and movements may be
compromised. A history of injuries, such as concussions, ear infections, or
serious sprains or fractures, may contribute to a loss of balance control over
time. In addition, various combinations of medications, both prescription and
over the counter, can be detrimental to our senses or brain and cause either
temporary or permanent damage.
Identifying and treating balance disorders
Because of the complexity of balance control, not all balance problems are the
same. As mentioned above, some individuals lack information from a sensory
system and do not realize they are losing their balance, while for others, the
brain gets confused and creates an inaccurate sense of being off balance.
Because of the wide variety of balance problems, determining the cause of a
balance disorder and what treatment options are the most appropriate can be
difficult. In the last twenty years, however, there have been significant
advances in evaluation and treatment approaches to balance disorders that have
proven to be highly effective and offer relief to those suffering from
imbalance or dizziness. There are also medical professionals and clinicians who
are specially trained to apply these evaluation and treatment methods.
Balance can be improved
It is not uncommon for individuals with a history of balance problems to regain
their balance control through accurate diagnosis followed by specific medical
treatment and/or rehabilitation exercises. One famous example is astronaut John
Glenn. Following his historic space flights in the 1960's, Glenn experienced
balance problems that disqualified him from service. After a rehabilitation
program, Glenn was able to return to space at the age of 77 and he performed as
well as his younger colleagues. You can recover from balance disorders and
regain your control. And you can do this even at an advanced age!
References:
- Horak, F.B., Shupert, C.L., & Mirka, A. (1989). Components of postural dys-control in the elderly: a review. Neurobiology of Aging, 10, 727-738.
- Whipple, R. & Wolfson, L.I. (1989). Abnormalities of balance, gait, and sensori-motor function in the elderly population. In Duncan, P.W. (Ed.), Balance: Proceedings of the APTA Forum, American Physical Therapy Association, Alexandria, VA, 61-68.
- Lizardi, J.E., Wolfson, L.I. & Whipple, R.H. (1989).Neurological dysfunction in the elderly prone to fall. Journal of Neurological Rehabilitation, 3 (3), 113-116.
- Tinetti, et al (2000). Dizziness among older adults: A possible geriatric syndrome. Annals of Internal Medicine 132:337-403)
- Tinetti, M.E. & Speechley, M. (1989). Prevention of falls among the elderly. The New England Journal of Medicine, 320 (16), 1055-1059.
© Copyright 2000 American
Academy of Facial and Reconstructive Plastic Surgery