Balance in Daily Life


Balance is vital to normal everyday life activities that include getting out of a chair and walking, bending over to put on your shoes, washing your hair, driving a car, or going grocery shopping. Everything you do in your daily life, whether for work or leisure, requires balance control. Most of the time, you do not even think about maintaining your balance. When balance problems start to occur, they can cause profound disruptions in your daily routine. In addition to increased risk for falls, balance disorders can shorten your attention span, disrupt normal sleep patterns, and cause excessive fatigue. Individuals with balance and dizziness problems can have trouble with the simplest of tasks.




Balance Control Process


The ability to maintain balance is a complex process that depends on 3 major body components.


1. Your sensory systems for accurate information about your body’s position.


2. Our brain’s ability to process this information


3. Your muscles and joints for coordinating the movements required to maintain balance.


When operating correctly, the vestibular system allows us to maintain an upright posture, and corrects our balance when challenged. It also gives us the ability to visually fix our sight on an image and keep ourselves in motion without falling or losing our balance.


Crest Treatments and Solutions


The form of treatment prescribed for vestibular disorders depends upon:

1. Symptoms

2. Medical history and general health

3. A physical examination by a qualified doctor

4. Diagnostic test results.


In addition to being treated for any underlying disease that may contribute to the balance disorder, treatment can include:



Vestibular Rehabilitation Therapy (VRT):

VRT uses specific head, body, and eye exercises designed to retrain the brain to recognize and process signals from the vestibular system and coordinate them with information from vision and proprioception. The choice and form of VRT exercises differs from person to person.



Home-Based Exercise:

Home exercises are often a vital part of treatment. Appropriate VRT exercises will be assigned by the physical therapist to be performed at a prescribed pace, along with a progressive fitness program to increase energy and reduce stress.


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Words from the PT


    • Loss of balance is a fact of life as we grow older

    • People with dizziness, vertigo, or vestibular (inner ear)

      dysfunction just have to “live with it”

    • Falls are inevitable as we age


In reality, balance disorders and vertigo

can be treated and controlled!



    • Proper evaluation and diagnosis of balance and fall-

       related issues are critical to correcting the problem

    • Treatment can greatly reduce the symptoms of

       dizziness, vertigo, and equilibrium

    • Therapy can improve the loss of flexibility and strength

       associated with age due to lack of activity

    • The effects of aging are not solely responsible for loss of

       balance or the symptoms of dizziness and vertigo

How does the vestibular system work?


The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or occur for unknown reasons. The most common diagnosed vestibular disorders are:


       • Benign Parozysmal Positional Vertigo (BPPV)

       • Labyrinthitis or Vestibular Neuritis

       • Meniere’s Disease

       • Secondary Endolymphatic Hydrops

       • Perilymph Fistula

       • Superior Canal Dehiscence

       • Acoustic Ceuroma

       • Ototoxicity

       • Enlarged Vestibular Aqueduct

       • Mal de Debarquement

       • Migraine-Associated Vertigo

       • Autoimmune Disorders

       • Allergies



Canalith Repositioning Maneuvers (e.g., the Epley Maneuver):

A specialized form of VRT is available to treat benign paroxysmal positional vertigo (BPPV). This treatment is often referred to as the Epley maneuver and involves a series of specifically patterned head and trunk movements to move tiny displaced otoliths to a place in the inner ear where they can’t cause symptoms.



Dietary Adjustments:

Many people with Ménière’s disease, secondary endolymphatic hydrops, and migraine-associated dizziness find that certain modifications in diet are helpful in managing their disorder. Avoidance of non-dietary substances such as nicotine and some types of medications may also reduce symptoms.




The use of medication in treating vestibular disorders depends on whether the vestibular system dysfunction is in an initial or acute phase (lasting up to 5 days), or a chronic phase (ongoing).




When medical treatment isn't effective in controlling vertigo and other symptoms caused by vestibular system dysfunction, surgery may be considered. The type of surgery performed depends upon each individual's diagnosis and physical condition. Surgical procedures for peripheral vestibular disorders are either corrective or destructive. The goal of corrective surgery is to repair or stabilize inner ear function. The goal of destructive surgery is to stop the production of sensory information or prevent its transmission from the inner ear to the brain.


Symptoms from vestibular disorders are invisible and unpredictable. This does not mean that they are imaginary, but that they often contribute to a wide range of psychological impacts. People who have a vestibular disorder often need support and may benefit from counseling to cope with lifestyle changes, depression, guilt, and grief that come from no longer being able to meet their own or others’ expectations.



The Balance Institution Solution:

Our Balance therapists specialize in vestibular rehabilitation therapy (VRT). We provide a multidisciplinary balance testing approach that includes Neurological, Audiological, and Physical Therapy evaluation and treatment protocols. Crest Therapists utilize the NeuroCom Smart Balance Master developed by NASA to monitor balance and motor skills for the space program.


Our computerized equilibrium tests will evaluate the sensory and motor parts of your balance system. The sensory systems include your sense of touch/position (feet, ankles, & joints), your vision, and you inner ear motion sensors. Motor tests measure your ability to execute coordinated movements, both voluntary and involuntary, to maintain your balance. These tests will help define the cause of your balance problem and will help the balance specialist develop a customized treatment protocol for maximum benefit.


Crest Physical Therapists also provide services designed to prevent or slow down the progression of balance disorder conditions that may develop from injury, disease, and other causes. Our professionals help patients affected by balance disorders to regain function using exercises designed for the individual’s specific weakness.


Crest Physical Therapy works closely with those medical specialists who diagnose and treat disorders of the brain and nervous system. This includes Otolaryngologists, Neurosurgeons, Audiologists, and your family physician.



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