When I teach my physical therapy colleagues and students about dizziness, vertigo, imbalance, fall risk and normal aging, I always emphasize the importance of distinguishing between normal aging and disease, or pathology.

 

That is a key point is determining prognosis and creating an effective physical therapy treatment plan for patients with imbalance and symptoms of dizziness.

We have three sensory balance systems:

Vision – the eyes, or our vision

Vestibular – the inner ear balance system, or our personal gyroscope

Somatosensory – the feet, the muscles, bony joints and especially the neck, or our proprioception

All three systems provide information to our brain to help us create our balance while we are sitting, standing and walking. Errors can occur in any of those three sensory balance systems, either due to normal aging or disease.

The visual system orients us in relation to the patterns of light photons and shadows that bounce of objects in our surroundings and our environment. The photons are detected by photoreceptors inside our eyes to create our vision.

 

The vestibular system orients our head, body, arms and legs in relation to the ground, or in relation to the pull of gravity straight down and the inertial forces we experience when we move around. These gravito-inertial forces are detected by tiny sensory organs within our inner ears.

 

The somatosensory system orients us in relation to the floor, or in response to the ground reaction force. The sensory nerves are located in our muscles, the joints between our bones and our skin.

Normal changes with aging – in all three systems of balance – are often present in older adults and are almost always appropriate to include in a comprehensive fall prevention treatment plan. 

Disease, or pathology in all three balance systems should be screened for during the history questions, based on symptom description and investigated further with screening tests during the hands-on physical exam. If signs and symptoms of disease are present, referrals to appropriate healthcare providers for detailed evaluation are indicated.

 

People who suffer from dizziness, vertigo, imbalance and unexplained repeated falls often require a team approach for optimal recovery.

 

In fact, Mary Tinetti M.D. has shown in her research that increasing the number of fall risk factors that are addressed in a comprehensive fall prevention treatment plan can have an exponential impact on reducing fall risk for a patient – it’s not a linear relationship.

In 2015, I was a National Spokesperson for the Vestibular Disorders Association campaign to raise awareness on the prevalence of undiagnosed vestibular disorders in older adults with chronic falls.

In this 90-minute webinar, I share information for professionals on normal aging, balance and how to reduce fall risk.

I look more closely at causes of vertigo, dizziness, falls, equilibrium problems and loss of balance in older adults, along with evidence-based recommendations. This webinar will give you an overview of the aging balance system, and how to help patients with and without vestibular dysfunction.

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