Human balance is very important in performance and safety during functional activities. Maintaining your balance is a complex process that uses sensory information to create muscle responses to keep you from falling.
There are 3 basic components that affect your balance:
1. The Vestibular System: Complex mechanism in the inner ear that controls balance by monitoring the position of your head.
2. The Visual System: Uses input from your eyes to detect the changes in the floor surface.
3. The Somatosensory/Proprioception System: Uses sensory input from your lower extremities to give your brain feedback about the floor.
How do these systems affect your balance?
If you have an inner ear disturbance, such as an infection, it causes your body to react incorrectly when your head position changes. This will present as dizziness during movement.
If you have visual impairment, you might have difficulty detecting changes in the ground surfaces during low light situations, such as going to the bathroom in the middle of the night.
If you have sensation problems in your feet, such as neuropathy, you will not get accurate feedback to your brain about the ground surface.
Why is this important and can physical therapy help?
Knowing which of these 3 systems might be impaired can help physical therapists set up the plan of care. For example, a patient who has diabetic neuropathy in his feet relies heavily on the vestibular and vision systems to maintain balance. It would be important for this patient to know that he should turn a light on if he needs to use the bathroom in the middle of the night. This will reduce his risk for falling.
Understanding the 3 systems also helps physical therapists improve balance. One way to improve balance is to improve the function of the impaired system. There are specific techniques to improve vestibular function and proprioception/balance training can improve lower extremity feedback.
Another way to improve balance is by compensating to enhance the function of the systems already working well. For example, proprioception activities, such as standing on one leg or standing with eyes closed, can teach the body to rely more on sensory feedback from the legs. This can be very helpful in a patient who has difficulty with vision in low light.
Understanding and training these 3 components of balance, can greatly improve balance and reduce fall risk.