By: Troy Giordano PT, DPT >> Book a Visit It’s been reported that non-fatal falls have cost the American healthcare system 80.0 billion dollars (1). Falls are one of the leading reasons someone will present to the ER. In fact, about 3 million people will visit the ER per year due to a fall. More seriously, […]
By: Troy Giordano PT, DPT
>> Book a Visit
It’s been reported that non-fatal falls have cost the American healthcare system 80.0 billion dollars (1). Falls are one of the leading reasons someone will present to the ER. In fact, about 3 million people will visit the ER per year due to a fall. More seriously, falls account for 38,000 deaths a year in adults 65 years and older (2).
These statistics are staggering and worrisome. People’s fear and avoidance of day-to-day tasks/activities because of concerns of falls are not unfounded. Avoiding tasks may put someone in fewer situations where they may fall, but it does little to help improve balance. This avoidance may actually decrease one’s ability to balance as these systems are used less and less.
So how can we improve our balance while staying safe? Furthermore, what within our body manages our balance?
3 Major Balance Systems
Balance is sensed and classically broken down into 3 major systems:
1. Visual System
Traditionally, the visual system is our strongest sense, and it uses horizon and visual cues around us to help us right ourselves with gravity.
2. Somatosensory Systems
Responsible for our sensation of pressure, touch, and general body awareness.
3. Vestibular System (colored in grey)
While lesser known, the vestibular system is located within our inner ear and helps sense acceleration, turns, and senses overall motion.
In physical therapy, it is critical to evaluate each of these systems to see where one’s balance is being hindered. Of course, these systems are involved in sensing our balance. Ultimately, specific parts of our brain (cerebellum, basal ganglia, and prefrontal cortex as seen below) synthesize this balance information and send appropriate signals to our muscles to create balance reactions: stepping, weight shifting, ankle motion, etc.
For your general layperson, teasing out and self-investigating where balance is deficient is challenging and unsafe in most instances. To test someone’s balance, rigorous testing is a necessity, and oftentimes these tests will cause someone to fall; If it weren’t for the practitioner during these tests, that is.
Furthermore, training after a balance assessment should also be rigorous and certainly deserving of a practitioner to ensure safety.
3 Phases of Rehabilitation for Balance
Thankfully, balance systems & balance reactions can be improved relatively quickly. Rehabilitation of one’s balance can be broken down into 3 phases:
1. Early Phase
Characterized by standing balance and improving standard mobility, such as sit-to-stands, marching, and narrow bases of support.
2. Mid Phase
Moves into more dynamic tasks such as head turns, reaching, side stepping, backwards stepping, curbs, and stairs.
3. Late Phase
Taking these tasks and adding other challenges to distract the patient so balance reactions become automatic. This phase really wants to improve people’s confidence so they can focus on the world around them and be less concerned with constant focus on balance.
Schedule an Appointment with a Physical Therapist at Evolution PT
Balance is certainly an important part of one’s fitness. When it is deficient, it can limit our social life, limit how much we can accomplish day to day, and increase the likelihood of serious injury. However, when our balance is well maintained, it can be the key to a fruitful, healthy life. If you are experiencing dizziness, imbalance, or withdrawal from day-to-day activities secondary to fear of falls. Strongly consider booking a visit with a physical therapist at Evolution to get an assessment of your balance. Balance is something you don’t want to fall behind on.
