This week is the Vestibular Disorders Association’s (VEDA) Steps-2-Balance week. There are many different causes of vestibular disorders and balance issues. Many believe that instability is a normal part of aging. As we grow older, we stumble more often or lose our balance more easily. However, falls and instability is not considered to be a normal part of the aging process.
To maintain balance and navigate obstacles in the world, our various systems; vision, hearing, sensory systems, and vestibular systems, need to work together and integrate information. Over time these systems, explained more fully below, can become impaired, and impact one’s balance.
Vision – Visual input from our eyes is important in detecting obstacles, changes in terrain, and depth. Age commonly results in visual changes, which then impact balance. Difficulty with contrast and depth perception may make performing steps or curbs difficult. Cataracts and other eye changes may result in clouding of the lens and impaired sight.
Hearing – External sources of sound can help give our brain reference points. Auditory cues that come from our environment can help our brain build a better representation of spatial awareness. Natural aging and exposure to loud sounds throughout a lifetime contribute to hearing loss. Impaired hearing may contribute to difficulty with sound differentiation, spatial awareness, and even postural alignment.
Sensory systems – Proprioceptive information comes from our muscles and joints and lets the brain know where our body is in space. Sensory input from our skin, in particular the bottoms of our feet, provide our brain with information about the type of surface that we are on. Neuropathy and other age-related changes can impair these systems, giving our brain less input. This would make it more difficult to balance on one foot or on more compliant surfaces.
Vestibular system – Information from this inner ear system provides the brain with input regarding equilibrium and motion. This helps us to maintain our balance with head movement, as well as coordinate eye and head movement. Various vestibular disorders can impact this system, resulting in impairment, instability, and dizziness.
In static stance, these systems all work together in order to maintain balance. However, if one of these systems is impaired, then our stance becomes less quiet and we exhibit more sway. For example, if you stand with your feet together on the ground you may notice that your stance is fairly steady. If you close your eyes, impairing the visual input to the brain, your stance likely becomes more unsteady. This also occurs if you repeat the activity on a soft or foam surface, which would impair sensory input to the brain causing you to rely more heavily on information from your vestibular system.
Age-related changes impacting these systems directly impact your balance.
If you or someone that you know is having a balance issue, it may be beneficial to get each of these systems evaluated. Our staff at WWS Physical Therapy and Vestibular Rehabilitation, Doylestown, PA., can provide you with information, exercise, and balance training to improve your confidence and help you meet your goals.
Dr. Cassie Zanolini, PT, DPT,
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